Tuesday, October 3, 2023

What Vaccine Is Most Effective

Safety For Those Who Are Pregnant Lactating Or Planning A Pregnancy

Which Covid-19 vaccine is most effective?

Early on in the Covid vaccine rollout, there were no data on which to determine if the vaccines were safe for people who are pregnant or lactating. But after several studies, experts have concluded the vaccines are safe during pregnancy and lactationand furthermore, they are important for these two groups to receive. This study in the New England Journal of Medicine, for instance, looked at the safety of Pfizer and Moderna vaccines in pregnant and lactating people.

The CDC and the American College of Obstetricians and Gynecologists advise that people who are pregnant or lactating should get vaccinated, because of the risk Covid infection poses to them.

There are a lot of rumors making the rounds that getting vaccinated against Covid will negatively impact a persons ability to conceive a child. ESPN football reporter Allison Williams recently announced she was quitting the network which has a vaccine mandate because she wants to have another child.

Number Of Doses/amounts Of Vaccine Per Dose

The primary series of both the Moderna and the Pfizer vaccines is two shots: a priming dose, followed by a booster shot. The interval between Moderna doses is 28 days for the Pfizer vaccine, its 21 days.

Each dose of Pfizers contains 30 micrograms of vaccine. Moderna went with a much larger dose of vaccine, 100 micrograms. It means the company is using a little more than three times as much vaccine per person as Pfizer is. While Modernas initial results didnt seem to justify the much larger dose, data suggest the protection the companys vaccine generates is declining at a slower rate than Pfizers is some experts believe the higher dose may be at least partially responsible.

The J& J vaccine is, as mentioned, a single-dose vaccine. The company has also tested a two-dose regimen, with the two shots given 57 days apart. The results from that 30,000-person trial were presented during an Oct. 15 meeting of FDAs Vaccines and Related Biological Products Advisory Committee, as part of its application for an EUA for its booster dose.

Read The Latest On Covid

Get reliable information on developments in the authorization, distribution and administration of COVID-19 vaccines.

J& Js one-shot vaccine for adults was another major step toward vaccinating millions of people across the country. While its single-dose, easy-to-store logistical advantages make it an attractive option, its important to understand what to expect with the Johnson & Johnson COVID-19 vaccine and the need for a booster shot.

The AMAs What Doctors Wish Patients Knew series provides physicians with a platform to share what they want patients to understand about todays health care headlines, especially throughout the COVID-19 pandemic.

In this installment, two physician experts took time to share what patients should know about the J& J vaccine. They are:

  • Mira Irons, MD, president and CEO of the College of Physicians of Philadelphia. In a prior role, Dr. Irons served as chief health and science officer at the AMA.
  • Sandra Fryhofer, MD, an Atlanta general internist who serves as the AMAs liaison to the Centers for Disease Control and Preventions Advisory Committee on Immunization Practices . Dr. Fryhofer also is a member of ACIPs COVID-19 Vaccine Work Group.

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All three vaccines continue to offer solid protection against severe illness, though there is concern within the Biden administration that this too will weaken if boosters are not given.

A key question at this point is whether the booster shots will solidify protection in a way that is more sustained, or if these additional doses mark the start of a regular booster shot effort.

When Can I Get A Covid

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On Monday, the FDA cut the waiting period between the second dose of an mRNA vaccine, like Moderna’s shot, and a booster from six months to five.

The CDC and other health authorities are now urging people to get boosters as soon as they’re eligible, to keep the immune response against omicron, delta and other coronavirus variants of concern as strong as possible. Moderna’s mRNA vaccine booster has been approved for healthy Americans ages 18 and up. The FDA on Monday approved giving a booster of Pfizer-BioNTech’s vaccine, Comirnaty, to kids as young as 12 and to those 5 and up with compromised immune systems or certain other health conditions.

Last month, President Joe Biden outlined a plan to contact the 64 million people on Medicare and AARP’s 38 million members about getting a booster. Nationwide pharmacy chains like Walgreens, CVS and Rite Aid are also contacting customers who got a vaccine at their stores when it’s time to schedule a booster.

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Kaiser Permanente Finds That Pfizer Vaccine Is Almost 90% Effective Against Covid

A recent Kaiser Permanente study found that the Pfizer COVID-19 vaccine is almost 90% effective at preventing infections 1 month after being fully vaccinated. The study took place between December 2020 and August 2021. It included almost 3.5 million people.

It also reported results for vaccine effectiveness against specific COVID-19 variants . After 1 month, the Pfizer vaccine was about 93% effective at preventing infections caused by the Delta variant within the health system. But after 4 months, it was estimated to be 53% effective.

Even though Pfizer vaccine protection may get lower over time, experts still consider it an effective vaccine. During the study, the vaccine was 93% effective against hospitalization from the Delta variant for up to 6 months.

However, declining vaccine protection has started the discussion around booster doses, including who needs them and when. Currently, booster shots are only recommended for special groups, like older adults or people with certain medical conditions.

  • What this means: You may be more likely to get sick after 4 months of being fully vaccinated with the Pfizer vaccine. But its still very effective at lowering your risk of ending up in the hospital.

  • What this doesnt mean: Everyone should get a booster shot right now. If youre not eligible quite yet for a booster shot, its important to wait for updated guidance on when to get it.

To read more about this study, click or tap here.

How Well Do These Vaccines Work In Different Populations

The vaccines appear to work equally well across subgroups defined by age, sex, race, ethnicity and among those at risk for developing severe COVID-19. All four seem to protect against more severe cases and hospitalization, but evidence is still limited.

Importantly, all four vaccines exceed Health Canadas 50 per cent efficacy standard. While each of the vaccines that Health Canada has authorized has different efficacy numbers, the reality is that you will have a greatly reduced chance of getting COVID-19 with any of the vaccines that have been authorized, Supriya Sharma, Health Canadas chief medical adviser, said in a press conference on March 5. I would not hesitate to roll up my sleeve to get any of .

TheNational Advisory Committee on Immunization advised in early March against using the AstraZeneca shot in adults aged 65 years and older, citing a lack of efficacy data for that age group. As more data comes in, Well be able to make better decisions about who ought to get which vaccines, Thompson predicts.

Width of 95% confidence interval depends on number of participants in subgroup. 1,2,3

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Both Vaccines Highly Effective Recommended

The researchers noted that the matched population during the period of Delta dominance was, on average, younger. This group also had a higher percentage of Black participants, current smokers, and those who had received no flu vaccinations in the previous 5 years at a VA facility and it included a lower percentage of those with underlying chronic conditions.

“The 24-week risk of COVID-19 outcomes was low after vaccination with mRNA-1273 or BNT162b2 , although risks were lower with mRNA-1273 than with BNT162b2,” the study authors wrote. “This pattern was consistent across periods marked by alpha- and delta-variant predominance.”

The researchers noted that although early clinical trials and then real-world observational studies found that the Pfizer and Moderna vaccines were both highly effective against symptomatic COVID-19 , no direct comparisons had been attempted.

In the VA news release, first author Barbra Dickerman, PhD, MSc, of Harvard said that both vaccines are recommended because they both are highly effective. However, while the estimated differences in effectiveness were small on an absolute scale, they may be meaningful when considering the large population scale at which these vaccines are deployed,” she said. “This information may be helpful for larger decision-making bodies.”

Cdc Expands Booster Recommendations In Response To Omicron Variant

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But what is the best strategy for boosters going forward? And if boosters are needed for years to come, as Pfizer CEO Albert Bourla has suggested, will they need to be modified?

Studies show an extra dose of the current Covid vaccines “increase levels of neutralizing antibodies against all the variants,” Fauci, director of the National Institute for Allergy and Infectious Disease, said Friday at the White House Covid-19 Response Team briefing. “There’s every reason to believe that if you get vaccinated and boosted that you would have at least some degree of cross-protection, very likely against severe disease, even against the omicron variant.”

This week, the health minister of Israel, which started giving out third doses of Pfizer booster shots in summer, said that a fourth booster dose might be necessary if the country’s Covid cases continued to climb.

Pfizer-BioNTech, Moderna and Johnson & Johnson are working on omicron-specific vaccines to use against the new variant if lab tests show significant declines in protection against severe disease, though it could take months before they’re ready to be distributed.

Still, there is discussion among some health experts about whether it is appropriate to use the existing vaccines as boosters against new, emerging strains, as the shots are still formulated to target the original form of the virus identified in late 2019.

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Which Vaccine Is The Best One

The experts agreed: The best vaccine is the one that is first available to you.

What I tell my patients and family members is to take whatever vaccine you can get, says Mark Mulligan, MD, a professor at NYU Grossman School of Medicine and director of the NYU Langone Vaccine Center, who led the clinical trials for the AstraZeneca and Pfizer vaccines at New York University . Theyre all highly effective. You cant really make any discernment from one to another.

Some have speculated that the Pfizer and Moderna vaccines with their roughly 95% efficacy rates in clinical trials are better than the Johnson & Johnson vaccine and the AstraZeneca vaccine . But comparing the different vaccines efficacy rates is sometimes like comparing apples and oranges, according to Anna Durbin, MD, a professor at Johns Hopkins University School of Medicine and Johns Hopkins Bloomberg School of Public Health in Baltimore who specializes in infectious disease and vaccines.

What I tell my patients and family members is to take whatever vaccine you can get. Theyre all highly effective. You cant really make any discernment from one to another.

Another complication is what the researchers conducting the clinical trials were measuring. The efficacy number reported in clinical trials was against any COVID-19 symptoms even mild ones.

What were trying to do is prevent severe illness, Durbin explains. All of them are close to 100% at preventing hospitalized COVID-19.

Will We Need An Annual Covid Booster Shot

With vaccines appearing to offer waning protection and the continuing evolution of variants, Hoge said we will most likely need seasonal COVID boosters, much like we do with the flu, at least to protect those at high risk of infection.

The CDC updated its guidance to indicate that, starting in 2022, some immunocompromised people will be able to get a fourth COVID-19 booster shot. Israel, Germany and other nations are researching the efficacy of a fourth shot and Dr. Anthony Fauci, chief medical adviser to the president, said a fourth jab was “conceivable” in the US, too.

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How Effective Are Covid

The pandemic has brought many tricky terms and ideas from epidemiology into everyones lives. Two particularly complicated concepts are vaccine efficacy and effectiveness. These are not the same thing. And as time goes on and new variants like omicron emerge, they are changing, too.

Melissa Hawkins is an epidemiologist and public health researcher at American University. She explains the way researchers calculate how well a vaccine prevents disease, what influences these numbers and how omicron is changing things.

Moderna Vaccine Vs Omicron

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There are not any studies that offer definitive estimates for the Moderna vaccines effectiveness against Omicron, though scientists believe it may be similar to Pfizer-BioNTechs vaccine.

A preliminary study of blood samples from 30 people who had received two doses of the Moderna vaccine showed that their antibodies were at least about 50 times less effective at neutralizing Omicron.

With a 50-microgram booster, however, antibodies increased 37-fold. On the other hand, a 100-microgram booster, the amount given to immunocompromised people as a third primary shot, increased antibody levels more than 80 times.

There is not yet enough data to give estimates for effectiveness. However, a booster has been shown to increase antibody levels significantly.

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Moderna Covid Booster Faq: You Can Mix And Match With Pfizer After 5 Months

Booster shots for Moderna’s Spikevax vaccine have proven highly effective against omicron. You can now get boosted 5 months after a second shot of Pfizer.

New research shows the Moderna booster significantly increases protection against COVID and omicron.

The US Food and Drug Administration on Monday reduced the waiting period between the second shot of Pfizer’s mRNA vaccine and a follow-up booster from six months to five, but retained the six-month waiting period for those who received initial vaccinations of Moderna’s COVID-19 vaccine. That means you can get a Moderna booster five months after an initial Pfizer vaccination, but still need to wait six months after your second shot of Moderna.

Acting FDA Commissioner in a media call on Monday, stating, “If you got J& J, you get a booster after two months. If you got Pfizer as your primary series, you can get a booster at five months or beyond. If you got Moderna, you can get a booster at six months or beyond.”

As the omicron variant continues to be the dominant COVID-19 strain in the US, responsible for nearly 60% of new infections, research indicates that, without a third shot, vaccines are minimally effective against the highly contagious mutation. The good news is that research also indicates the Moderna booster is highly effective in increasing that protection.

The Johnson & Johnson Vaccine And Blood Clots: What You Need To Know

In the minds of many, the halt of the Johnson & Johnson vaccine in April delivered doubt just as the mass COVID-19 vaccinations were making progress. There are three vaccines authorized for use in the United States, but Johnson & Johnsons was a particularly important one, partly because its one-shot dose made it seem as though we might achieve herd immunity faster. Then, the government recommended pausing the companys vaccine after six women who received it developed rare blood clotsand one woman died.

We spoke to Yale Medicine infectious diseases expert Jaimie Meyer, MD, MS, and Yale Medicine hematologist Robert Bona, MDthey shared insights about the pause and answered commonly asked questions.

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Which Booster Will Create The Largest Antibody Response

Since mixing and matching is permitted, people are searching for the booster that will create the maximum impact. On social media, posts are spreading, claiming to rank the boosters.

Do you agree with this chart? First 2 was Moderna and Im really curious if I should get Pfizer booster instead of another Moderna.

Amanda TM

To verify, our team reached out to a pair of medical experts, Dr. William Schaffner from Vanderbilt University and Dr. Amesh Adalja from Johns Hopkins University.

We also tracked down the data, behind this social media graphic. The data comes from an NIH study that evaluated 458 individuals, split into nine groups. Each group represented a combination of one of the three vaccines, and one of the three boosters.

The numbers reflected in the social media graphic, show the “Geometric Mean Fold Rise” calculated through the study.

“Geometric fold rise refers to the level of antibodies that are measured after you get a vaccine,” Dr. Adalja said. “So anytime you boost, you’re going to get a rise in antibody. They’re going to rise two-fold, three-fold, or whatever it might be.”

The data indicated that there was a much bigger antibody response for mRNA boosters. This was especially the case for those who received the Johnson and Johnson vaccine as their initial dose, who saw the following antibody jumps in the study:

The data does have limitations, as noted by the study itself.

Adalja also noted that antibodies are not the only way to measure immunity.

Duration Of Immunity Provided By Vaccines

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The duration of immunity varies with different diseases and different vaccines. Lifelong immunity is not always provided by either natural infection or vaccination. The recommended timing of vaccine doses aims to achieve the best immune protection to cover the period in life when vulnerability to the disease is highest.

  • Many vaccines used today are relatively new and data concerning the length of time that they give protection is continually being updated
  • For many diseases immunity wanes following natural infection
  • The duration of immunity provided by vaccines varies depending on a range of factors, particularly the vaccine itself
  • Live vaccines generally induce longer lived immunity than sub unit vaccines
  • Sub unit vaccines frequently require primary courses and boosters
  • Polysaccharide vaccines do not generate long-lived memory cells
  • If the interval between doses is too short the duration of immunity can be affected. Hence minimum intervals are required
  • In the very young and very old the duration of immunity can be limited

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