All About the Moderna, Pfizer, and Johnson & Johnson Vaccines – Healthline

COVID-19 is the illness thats caused by the novel coronavirus SARS-CoV-2. To date, the Food and Drug Administration (FDA) has provided emergency use authorization to three different vaccines to help protect against COVID-19:

Read on to learn how each vaccine works, how safe and effective each one is, and how to decide which one may be the right choice for you.

The vaccines that have been authorized for emergency use in the United States so far use two different types of technology:

Lets break down how each vaccine uses one of these two technologies to help promote immunity against the coronavirus. Check out the infographic below to see a visual representation of how the mRNA and adenovirus vector vaccines work.

The Pfizer-BioNTech vaccine is also called BNT162b2 in the scientific literature and Comirnaty in some countries. Its given in two doses spaced 21 days (3 weeks) apart.

The Pfizer-BioNTech vaccine uses mRNA technology, which develops immunity using the following process:

The Pfizer-BioNTech vaccine must be stored at ultra-cold temperatures between -112F (-80C) and -76F (-60C) to keep the mRNA molecule in the vaccine stable.

Once diluted and prepared for an injection, it can remain at room temperature for up to 6 hours before it becomes unusable.

You may see the Moderna vaccine called mRNA-1273 in scientific papers. Like the Pfizer-BioNTech vaccine, the Moderna vaccine is given in two doses spaced 28 days (4 weeks) apart.

The Moderna vaccine also uses mRNA technology that uses the same mechanism as the Pfizer-BioNTech vaccine to build immunity to the coronavirus spike protein.

Similar to the Pfizer-BioNTech vaccine, the Moderna vaccine must also be stored at very cold temperatures, between -58F (-50C) and 5F (-15C). Once a vial is opened and prepared for an injection, its stable at room temperature for up to 12 hours.

You may see the Johnson & Johnson (J&J) vaccine referred to as JNJ-78436735 or Ad26.COV2.S in scientific papers. Unlike the Pfizer-BioNTech and Moderna vaccines, the J&J vaccine can be given as a single dose.

The J&J vaccine uses an adenovirus vector, which is a modified inactivated adenovirus (a type of virus) thats designed not to cause disease in people.

Once the vaccine delivers the adenovirus vector into a host cell, the vector is broken down and the adenovirus cannot cause any harm in the body.

Heres how the J&J vaccine works:

Unlike the two mRNA vaccines, the J&J vaccine can be refrigerated rather than frozen because its more stable at higher temperatures. Once a vial is opened and prepared for injection, it can be kept at room temperature for up to 2 hours.

Vaccine efficacy measures the percent reduction of COVID-19 in those who are vaccinated compared with those who have not been vaccinated.

Efficacy is one of the key metrics reported in clinical trials that the FDA reviews when deciding to grant emergency use authorization. Efficacy metrics are also more reliable when a higher number of participants are involved in a clinical trial or study.

Efficacy is measured in a trial or study about 2 weeks after an injection. This is because it takes about 2 weeks to build immunity after receiving one to two doses of any of these three COVID-19 vaccines.

This means youre considered fully vaccinated when its been:

Lets take a look at efficacy data from the large-scale clinical trials for these vaccines.

In the phase 3 clinical trial of the Pfizer-BioNTech vaccine, 43,448 people participated. Each participant received two doses of the vaccine or two doses of a placebo spaced 21 days (3 weeks) apart.

Researchers assessed vaccine efficacy 7 days after the second dose of the vaccine. At this time, it was found that vaccine efficacy was 95 percent.

Heres some other important data from the trial:

In the phase 3 clinical trial of the Moderna vaccine, 30,420 people participated. In this trial, each participant got either two doses of the vaccine or two doses of a placebo spaced 28 days (4 weeks) apart.

Researchers evaluated vaccine efficacy 14 days after the second dose of the vaccine. At this point, vaccine efficacy was found to be 94.1 percent.

Heres some other important data from the trial:

In the phase 3 clinical trial of the J&J vaccine, 39,058 people participated. The trial tested a single dose of the vaccine.

Researchers evaluated vaccine efficacy 14 days after the single dose of the vaccine was given. The results also broke down efficacy by COVID-19 severity and location.

Overall, J&J vaccine efficacy was found to be 66.3 percent. Overall efficacy varied among countries:

J&J vaccine efficacy for severe to critical COVID-19 was:

Heres some other important data from the trial:

COVID-19 vaccines must be proven effective and safe before the FDA can grant emergency use authorization.

The Pfizer-BioNTech, Moderna, and J&J COVID-19 vaccines have met safety and efficacy requirements. Well discuss some possible side effects in more detail later in this article.

People who have had severe allergic reactions to a COVID-19 vaccine or any of its ingredients should not be vaccinated.

Each vaccine manufacturer provides fact sheets with complete lists of vaccine ingredients:

The CDC states that people with an underlying health condition can get vaccinated as long as they havent had a serious allergic reaction to:

This includes people who have a weakened immune system. Specific safety data for people with compromised immune systems is limited. But since these authorized COVID-19 vaccines dont contain live virus, they can be safely given to immunocompromised people.

Vaccination is important for people with underlying health conditions. This is because many types of underlying health conditions can increase the risk of severe COVID-19.

Before getting vaccinated, talk with a healthcare professional and let them know about any underlying health conditions you have or medications youre taking.

The CDC states that people who are pregnant or breastfeeding can receive any of these three authorized COVID-19 vaccines. Theres limited safety data for pregnant and breastfeeding people, but evidence is growing that the vaccines pose minimal risk.

Pregnant people are also at an increased risk of serious illness as well as preterm birth and other pregnancy outcomes due to COVID-19.

If youre pregnant or breastfeeding and are concerned about COVID-19 vaccination, talk with a healthcare professional about:

Each COVID-19 vaccine is associated with side effects.

We dont yet know whether there are long-term side effects to these vaccines. But the CDC notes that long-term health effects are unlikely. These vaccines will be monitored for safety many years after emergency use authorization.

You may experience one or more of the following side effects after receiving the Pfizer-BioNTech vaccine:

These side effects are typically mild to moderate and go away in a few days. Side effects felt throughout the body, like fever and aches and pains, are more commonly reported after the second dose.

More serious side effects include a serious allergic reaction called anaphylaxis, which can include symptoms like:

The Pfizer-BioNTech clinical trial reported only four other serious side effects from the vaccine:

Researchers also reported no deaths due to receiving either the vaccine or the placebo during the trial.

Possible side effects of the Moderna vaccine include:

These side effects are often mild to moderate and go away in a few days. Systemic side effects like fever and aches and pains are more commonly reported after the second dose.

The Moderna vaccine is also associated with delayed pain, swelling, or redness at the injection site, sometimes called COVID arm. The Moderna clinical trial data found that this typically happens 8 or more days after either dose and lasts for 4 to 5 days.

Anaphylaxis has also been reported as a serious side effect of the Moderna vaccine. Clinical trial data also notes that treatment-related severe side effects were higher in the vaccine group than the placebo group.

Seventy-one (0.5 percent) of the 15,185 participants who got the vaccine reported severe side effects, including:

In this clinical trial, two deaths occurred in the vaccine group. One died by suicide, while the other died from cardiac arrest. Investigators could not confirm whether these deaths were related to the vaccine.

Side effects of the J&J vaccine are typically mild to moderate and disappear a few days later. They can include:

Anaphylaxis has also been reported with the J&J vaccine.

The J&J vaccine is also associated with the risk of a very rare blood clot condition called thrombosis with thrombocytopenia syndrome (TTS). TTS was most often observed in females between the ages of 18 and 48.

After a brief pause to review TTS risk, J&J vaccinations resumed in the United States after it was determined that the benefits of the vaccine outweighed this and other risks. The CDC estimates that the risk of TTS is 7 per 1 million for females under age 50.

Other severe side effects observed during the clinical trial of the J&J vaccine only reported by 7 out of the 21,895 participants who received the vaccine, or about 0.03 percent included:

While researchers did observe blood clot events, most were in people with underlying conditions that increase blood clot risk. In total, 11 clotting events were reported in the vaccine group compared with three in the placebo group.

Lastly, the clinical trial of the J&J vaccine reported three deaths in the vaccine group. However, researchers concluded that none of these deaths were related to the vaccine.

Its completely normal for viruses to mutate. These mutations can sometimes harm the virus, making it weaker or less infectious. But new mutations can also provide a virus with an advantage.

So far, many virus variants have been detected for the coronavirus. Some are considered variants of concern because they may be associated with increased transmission or can break through the immune system, even in vaccinated people.

Some reported variants include:

Research into how effective each vaccine is against coronavirus variants is ongoing. Lets discuss what we know so far.

An April 2021 study assessed the Pfizer-BioNTech vaccines activity against variants by using serum from people who had been vaccinated with the Pfizer-BioNTech vaccine. Serum is the part of the blood that contains antibodies.

When this serum was tested against test viruses with spike proteins from different variants, researchers found that Alpha and Gamma test viruses were neutralized at a similar level to the original variant. Neutralization of Beta test viruses was still robust, but lower.

A July 2021 study from Qatar, where most cases of COVID-19 are due to Alpha or Beta, looked at vaccine efficacy in real-world circumstances. Researchers looked at confirmed COVID-19 cases in vaccinated and unvaccinated people.

The vaccine efficacy in people who had been fully vaccinated with the Pfizer-BioNTech vaccine was estimated to be:

Additionally, research from public health officials in the United Kingdom indicates that the Pfizer-BioNTech vaccine is also effective against Alpha and Delta. The vaccines efficacy in fully vaccinated people was:

A July 2021 study found that two doses of the Pfizer-BioNTech vaccine were about 88 percent effective against the Delta variant.

Similar serum studies have also been carried out for the Moderna vaccine.

One study observed that test viruses with spike protein from Alpha were neutralized similarly to the original coronavirus variant. But neutralization was about 6.4 times lower against test viruses with the Beta spike protein.

Another serum study from June 2021 looked at the Moderna vaccines effectiveness against Beta and B.1.429, a variant first detected in California.

Researchers found that the B.1.429 variant was two to three times less sensitive to neutralization, while Beta was 9 to 14 times less sensitive.

The clinical trial of the J&J vaccine was carried out at a different point during the pandemic than the trials for the Pfizer-BioNTech and Moderna vaccines. During the J&J trial, several variants were circulating or common in many parts of the world.

For example, researchers in the trial found that 95 percent of sequenced COVID-19 cases in South Africa were due to the Beta variant. The vaccine efficacy of the J&J vaccine in South Africa was 52 percent overall and 73.1 percent for severe to critical COVID-19.

In Brazil, 69 percent of the sequenced COVID-19 cases were caused by the P.2 lineage at the time of the trial. Here, the efficacy of the J&J vaccine was 66.2 percent overall and 81.9 percent for severe to critical COVID-19.

Overall, the J&J vaccine still appears to be quite effective at reducing the likelihood of developing COVID-19, particularly for severe to critical COVID-19, in locations with variants.

The U.S. federal government is providing all COVID-19 vaccines free of charge during the pandemic, regardless of a persons health insurance or citizenship status.

If you seek a COVID-19 vaccination during this time, you cannot be charged for:

Its unclear whether any of these three authorized vaccines will still be free after the pandemic ends, since all three are produced by for-profit pharmaceutical companies.

But its likely (though not yet confirmed) that youll have to pay for the COVID-19 vaccine after the pandemic is declared over by the World Health Organization (WHO) or other national public health agencies. Potential payment may include both receiving the initial vaccination or a booster shot.

The Pfizer-BioNTech, Moderna, and J&J COVID-19 vaccines are currently authorized in the United States by the FDA under an emergency use authorization (EUA). This is a little bit different than a typical FDA approval.

Simply put, an EUA is a method through which the FDA can allow unapproved medical products to be used during a public health emergency, like a pandemic.

When reviewing a product for an EUA, the FDA must decide that the overall benefits of the product outweigh its potential risks.

Heres what happens during this process:

In addition to the United States, these three COVID-19 vaccines have been authorized or approved in a variety of other countries around the world.

Its important to note that additional authorizations or approvals may occur rapidly.

The Pfizer-BioNTech vaccine was authorized by the FDA on December 11, 2020, for emergency use in people 16 and older. It has since been authorized for use in adolescents between the ages of 12 and 15 as well.

On December 31, 2020, the WHO listed the Pfizer-BioNTech vaccine for emergency use. Since then, many other countries have either authorized or approved the vaccine.

The Moderna vaccine was authorized by the FDA for emergency use in adults 18 and over on December 18, 2020.

Additionally, on April 30, 2021, the WHO listed the Moderna vaccine for emergency use. It has been approved for use in numerous countries worldwide.

The J&J vaccine was authorized by the FDA for emergency use in adults 18 and over on February 27, 2021.

It was listed by the WHO for emergency use on March 12, 2021. Many other countries have also authorized or approved the J&J vaccine.

Now, lets briefly discuss each company that produced the vaccine.

Pfizer is an American pharmaceutical company headquartered in New York City. Its mission is to develop drugs and vaccines that can help improve health and wellness.

Some of Pfizers more well-known products include:

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All About the Moderna, Pfizer, and Johnson & Johnson Vaccines - Healthline