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Traditional Johnson & Johnson vs. Pfizer and Moderna with mRNA: Which Vaccine to Choose

Two COVID-19 vaccines are already available in the United States, and a third, developed by Johnson & Johnson, recently applied for an emergency use authorization. should be seen on February 26... This means that it may be available in early March. Live Science.

Photo: Shutterstock

With so many options, many people wonder if it matters what kind of vaccine they get.

The short answer is that you are better off getting the vaccine you are offered than not being vaccinated at all. But there are several reasons why certain vaccines may work better for different populations. It is also more traditional.

What is this tradition

The J&J vaccine uses the common cold virus to inject coronavirus proteins into cells and trigger an immune response. The body recognizes "dead" viruses and reacts to them by making antibodies, but not causing disease. A vaccine created according to this principle is a vector vaccine; such a scheme has been used in medicine for a very long time. With this technology, for example, vaccines have been created against polio, hepatitis B, diphtheria, whooping cough, tetanus or influenza.

And the Pfizer / BioNTech and Moderna vaccines use a new technology called mRNA. The principle of operation of mRNA-based vaccines is that they contain a viral molecule - messenger RNA (mRNA), enclosed in a lipid nanoparticle. Once in the body, mRNA enters the cell and begins to synthesize pathogenic-specific antigens that provoke an immune response.

The good thing about the technology is that mRNA is a fairly simple molecule, so it can be produced relatively quickly and in very large quantities. However, this method also raises the greatest concerns. The problem is that old, time-tested vaccines of this type simply do not exist, so it is not known how it will behave in the human body in the long term. MRNA vaccines are now being approved for the first time in an effort to find a solution to the coronavirus crisis.

Read more about mRNA and other types of vaccines in our material.

What about efficiency

The Johnson & Johnson vaccine has been shown to be 66% effective in reducing severe to moderate cases of COVID-19, which involve either two mild symptoms or another serious symptom such as low blood oxygen or rapid breathing.

In other words, people vaccinated with J&J are three times less likely to develop mild to moderate COVID-19 than participants who received a placebo.

Meanwhile, the Pfizer / BioNTech vaccine is 95% effective and the Moderna vaccine 94% effective in preventing any symptoms of COVID-19. That is, they are able to prevent even mild cases of the disease. All three vaccines are believed to be 100% effective in preventing hospitalizations and deaths associated with COVID-19.

Dr. William Lange, a former White House physician and medical director at JobSiteCare, said lower efficacy should not discourage people from being vaccinated with the drug. Unlike Pfizer and Moderna, Johnson & Johnson has tested its vaccine against a South African strain that can evade neutralizing antibodies that the immune system uses to prevent cells from infecting the coronavirus.

“The lower efficacy may be real, but it could also be the result of testing in a slightly different environment due to the newly emerging strains,” Lang said. "If I or my 88-year-old father were offered J&J, I would not hesitate to agree."

Given the emergence of strains that evade vaccination, it is necessary to reduce the spread of the virus as quickly as possible to reduce the likelihood of further mutations, Gulik said.

On the other hand, the Moderna and Pfizer / BioNTech vaccines, which send mRNA to muscle cells to tell the body to trigger an immune response to the coronavirus protein, do have a higher efficacy, Lang said.

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Gulik said high-risk groups, such as the elderly, who have less robust immune responses, and those with weakened immune systems, should be prioritized for higher-potency vaccines.

“I would probably choose the Moderna and Pfizer two-dose vaccine, at least for my HIV patients. But if the insurance only covers a specific vaccine, I would ask to administer it to patients, because I just want the vaccine to be used, ”Gulik said. "But I would choose a two-dose injection if I had the right to express my preferences."

Storage conditions and number of injections

While Moderna and Pfizer dual injection regimens appear to be more effective on paper, Johnson & Johnson's vaccine has the advantage of not requiring re-injection and can be stored at normal refrigerator temperatures for several months, explained Dr.Peter Gulick, professor of medicine and infectious disease expert at Michigan State University. This could help in vaccinating more people, especially those who cannot return for revaccinations, and in regions where access to hospitals is difficult, he said.

On the subject: J&J vaccine 66% effective: why those who feared Pfizer and Moderna will get this vaccine

Johnson & Johnson's less stringent vaccine storage requirements could be an advantage in rural areas, Gulik said.

“The drugs can be put in the refrigerator and stored there, while Moderna and Pfizer need much lower temperatures for the vaccine to remain viable,” Gulik said. "The fact that you can easily store Johnson & Johnson's vaccine in your doctor's office, pharmacy, etc. could make it more affordable."

This one-shot vaccine may also be better for people who find it difficult to get to hospitals or mass vaccination sites (especially those who are bedridden or otherwise at home).

“People get one shot, but there is no guarantee that they will return for a second shot,” Gulik told Live Science.

With the advent of new strains of coronavirus, any protection is better than no protection. Because a one-shot vaccine like Johnson & Johnson only requires one shot, the same number of doses can give twice as many people as other vaccines, which may be better for controlling the spread of the virus. However, the initial supply of J&J vaccine will be limited. The company promised the first 12 million doses in March, but may be lagging behind those production rates, according to The New York Times.

According to the World Health Organization, there are already more than 110 million cases of COVID-19 in the world, and most of us will not have the opportunity to choose between drugs: it is important to just get vaccinated.

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