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I wish it was easier to tell which vaccine was the better one to take. I know the "correct" answer is "whichever one is available to you", but let's pretend we'

I wish it was easier to tell which vaccine was the better one to take. I know the "correct" answer is "whichever one is available to you", but let's pretend we're free-agent adults here and put the infantile answers aside for a moment. There seems to be a very strong urge not to compare any of them as better, which puts users in a position of information asymmetry where they might not make the best health choices for themselves. Is there any realistic way to compare which of the vaccine selections available in the USA is better given certain conditions? For example, if someone has a history of reacting to vaccines (GBS), is the attenuated adenovirus from J&J a better choice compared to the mRNA alternatives?

smnrchrds 6y ago
I think that's what the challenge study was supposed to do, but it didn't go ahead.
_delirium 6y ago
I'm not sure there's enough data at the moment to give an answer. Each of the approved vaccines had a double-blind placebo-controlled study run, but on different timelines and in different locations, so it's hard to conclude much from small differences between the reported numbers.
- ehsankia 6y ago
  Right, unless you do a full trial with all vaccines side by side with similar sample/timeline, it's not really possible to tell. Also, the error bar on these effectiveness numbers are realistically probably +/- 5% or more, so it's not like a 76% is definitely worse than the 80%. The dosage also matters. J&J for example decided to study one dose first, but are now doing a phase trial to see how good the immunity is for a 2-dose program. So potentially if you get a second dose (maybe down the line), you will also get a stronger immunity closer to the other 2 dose vaccines.
  - hannob 6y ago
    > Also, the error bar on these effectiveness numbers are realistically probably +/- 5% or more, so it's not like a 76% is definitely worse than the 80%. But we're talking 91% vs. 76%.
    - itake 6y ago
      You can't compare the 91% vs 76% numbers because the 91% test was performed in the late summer last year between virus waves and in a location with an less-contagious form of the virus. Whereas the JJ virus was tested during the fall 2nd-wave in South Africa when there was a lot of cases and more cases of a higher infection strain. The only fair comparison would be if all of the testing was done at the same time in the same geographic location. source: https://www.youtube.com/watch?v=K3odScka55A&feature=youtu.be https://www.youtube.com/watch?v=K3odScka55A&feature=youtu.be
      - boc 6y ago
        There was a new, recent study that showed that the mRNA vaccines were still 90% effective among healthcare workers during the big surge in December/January period when the variants were certainly present.[1] This doesn't mean the J&J vaccine is bad by any means, but it does show how incredible the new mRNA vaccines have performed. [1] https://www.statnews.com/2021/03/29/real-world-study-by-cdc-shows-pfizer-and-moderna-vaccines-were-90-effective/ https://www.statnews.com/2021/03/29/real-world-study-by-cdc-...
        ehsankia 6y ago
        From that same study: > The study suggested that even the first dose of vaccine was 80% effective at preventing infection Which is within the error bar of J&J's one dose result in the US (75%). We will have to see the results of the 2-dose J&J trial coming out soon, but I expect that to be around 90% too. It's also worth noting that some places in the world (UK, Canada), have been using 1-dose pfizer regimen to get the most out of their short supply, with possible 2nd shot 3-4 months down the line. Similarly, we could see a delayed J&J booster being given to increase immunity to matching 90%.
balls187 6y ago
"whichever one is available to you" is not an infantile answer. It's a rational answer. Humans are notoriously irrational in their decision making, and focusing on which is better in order to make the best health decision may lead to making a decision that is far worse.
- smnrchrds 6y ago
  Not the OP, but let's rephrase: if you go to the clinic to get the shot and they tell you they have so many doses of all vaccines available that it's up to you to choose which one to take, and either way, you are going to get the shot today, which one should you choose? And how much does this choice matter in your expected health outcomes?
  - josefresco 6y ago
    I would ask the doctor and not trust my ignorance (as a non-medical professional) to provide me the answer. Everything being equal? I'm taking the shot that doesn't require me to come back for a second.
    - smnrchrds 6y ago
      And what would the doctor say? And please don't reply "whatever the correct answer is", because then I will have to ask "what is the correct answer" and we end up in an infinite loop.
      - 35fbe7d3d5b9 6y ago
        The guidance provided so far is that all three shots are equally effective. That's likely what the doctor would say. From my own, semi-informed research: * The effectiveness of J&J is likely under-reported because it was tested during a significant outbreak. * Moderna seems to have slightly higher reports of side effects compared to Pfizer, though unlikely to be statistically significant. * I am a young, healthy person. With that calculus: 1) I'd pick whichever was available to me the fastest. In my area immunizations are by appointment and segmented by vaccine. I'd rather have Moderna tomorrow than wait a week for an appointment for another to open up. 1.a) In the unlikely case that I had a choice between the shots, I'd select J&J, as it has been shown to be safe and effective with one shot. This simplifies my life. In reality, scheduling a vaccine seems to be the hardest. No one of the ~10 or so I've talked to who have had their first shot between January and early March have had the ability to chose. When I received my first dose of Pfizer last month I didn't have a choice of options; I was on four or five call lists and took the one that offered me an appointment. My wife received Moderna because her work coordinated mass vaccinations and that's what they offered. A coworker received J&J because there were leftover doses that needed to be administered. Perhaps that's changed, but as many states open up to 16+ I suspect it'll remain the biggest challenge.
hannob 6y ago
It seems a lot of people don't really want to discuss this, but I think the facts are relatively clear: The mRNA vaccines have an effectiveness above 90% and none of the others comes close to that. Biontech and Moderna are so close to each other that there's probably no argument for either of those. I'd take any approved vaccine without hesitation if it'd be offered to me right now. But if I am free to choose: It'd be Biontech or Moderna.
- paconbork 6y ago
  I opted for pfizer just because they let you get the second shot a week earlier
- da_big_ghey 6y ago
  I have been seeing legitimate concern with the response of "i want the better one" or "i want the quicker one" because these are being each obstacle to quick spread of vaccine. But attempting for to say only "just as good" or "no difference" is only creating more mistrust between public with agencies that already having great mistrust from public.
- babelfish 6y ago
  I received Pfizer, but I would also probably choose Moderna if I had the choice. IIRC a Pfizer shot has 30ml of mRNA and Moderna has 100ml of mRNA. I know that the amount of mRNA injected shouldn't make a difference so long as your body learns the proper immune response, but my monkey brain thinks "more = better".
  - mgerullis 6y ago
    Wouldn’t less of the same thing with an almost identical outcome be better? I mean, it’s a liquid being shot into your arm, not chocolate.
  - 0xcafecafe 6y ago
    I chose to get Pfizer for the exact same reason. If it was able to get the same effectiveness as Moderna with lesser mRNA it seemed to be an efficient choice (as a programmer :))
maxerickson 6y ago
I had a preference for the mRNA vaccines because the immunity appears to build faster. It's not enough of a difference to wait for one of the others, but it would drive my choice if I had an option. When I made my appointment, the clerk warned me that they only had 2 dose vaccines, apparently enough people wanted the 1 dose that it was worth mentioning it. So it can be pretty situational which one is 'better'.
Taek 6y ago
I've been trying to follow along and I'm not super confident in my answer, but Pfizer and Moderna both seem to be doing incredibly well, either one is a safe choice as "this is the best I can do for myself" AstraZeneca seems to be lagging behind, and what little data I've seen on J&J seems to suggest that it's better than AstraZeneca but still not as effective as Pfizer or Moderna.
pwarner 6y ago
"whichever one is available to you" is still the right answer since as some other comments suggest there isn't enough data, yet. For sure one is likely better than the others. If we had the data we'd make the choice, but it seems it's not possible to know yet. The better one may be the one that protects against the variant that is forming via mutation right now in some person in Iowa. But yeah, we don't know yet. So you can wait until we know more, for sure eventually in retrospect we may see there is a clear vaccine winner. But really today just get one, or wait and see which one is the winner, with the risks associated with waiting. I think that's the free-agent adult pants decision. Also, let's say you get vaccine A today. And in 6 months, it turns out you really wanted vaccine B since it's way more effective it turns out. Why can't you just get vaccine B in 6 months? I imagine if vaccine B is the clear winner, they are going to crank up production on that one as much as they can?
N_A_T_E 6y ago
Its my understanding that the mRNA (pfizer and moderna) had better efficacy numbers from the phase 3 trials than J&J. 94% vs 72% when comparing similar phase 3 trials with >30k participants. I am interested to see if there is any difference in how long the protection lasts for. Hopefully we will get that knowledge as the long term studies continue. https://www.nytimes.com/interactive/2020/health/pfizer-biontech-covid-19-vaccine.html https://www.nytimes.com/interactive/2020/health/pfizer-biont... https://www.nytimes.com/2021/02/27/health/covid-vaccine-johnson-and-johnson.html https://www.nytimes.com/2021/02/27/health/covid-vaccine-john... https://www.nytimes.com/2021/02/27/health/covid-vaccine-johnson-and-johnson.html https://www.nytimes.com/2021/02/27/health/covid-vaccine-john... Disclaimer: I worked on the tech side of the moderna trial so I'm biased.
eCa 6y ago
> I know the "correct" answer is "whichever one is available to you", but let's pretend we're free-agent adults here and put the infantile answers aside for a moment. The way this sentence is worded negatively affects the way the rest of your comment is read. You would have created a better foundation for discussion (I believe/hope) if you had removed all the snark: "I know the answer is 'whichever one is available to you', but lets put that aside for a moment."
- y-c-o-m-b 6y ago
  I disagree. I think it's a good way to illustrate the bullshit that needs to be curated from some of the armchair expert answers here on a constant basis. People can grow thicker skin and not let a slighly snarky argument undermine a valid discussion. This isn't reddit, there's no reason for the hivemind mentality here. I come here to see discussions around the substance of the content and not ridiculous semantic disputes or someone flexing their "iamverysmart" muscle
UncleMeat 6y ago
> Is there any realistic way to compare which of the vaccine selections available in the USA is better given certain conditions? No. Because the trails were structured differently and measured different things and there is little interest in doing studies comparing the options rather than just administering them to as many people as possible.
dougmwne 6y ago
The Pfizer and Moderna mRNA vaccines seem to have strong evidence of being more protective than other options. The AstraZeneca vaccine has some early evidence of not being protective against the South African variant and has some minor safety concerns around extremely rare blood clotting. As far as I have heard anecdotally, the mRNA vaccines seem to have stronger flu-like symptoms, especially for the second dose. If you are in the USA you should be able to easily choose between the three approved vaccines, so it is relevant to gather good information, just as you would with any medical decision.
- DebtDeflation 6y ago
  Pfizer, Moderna, and J&J used a prefusion-stabilized version of the spike protein; AZ used the wild spike protein. The former should prove more effective against variants as a result. https://cen.acs.org/pharmaceuticals/vaccines/tiny-tweak-behind-COVID-19/98/i38 https://cen.acs.org/pharmaceuticals/vaccines/tiny-tweak-behi...
wycy 6y ago
Moderna and Pfizer seem to be nearly bit-for-bit identical at the mRNA level, though Moderna seems to have stabilized the mRNA better to be viable at higher temperatures. J&J appears to be slightly less effective with its one dose, but would probably be just as effective as Moderna and Pfizer (if not more) if a second dose were given. J&J simply doesn't need the second dose because 75+% is still considered extremely good. Even though J&J isn't considered one of the "mRNA vaccines", it still functions similarly to the mRNA vaccines. Their adenovirus carries the mRNA, allowing it to be remain stable in your body for longer, building strong immunity from 1 dose.
- solosoyokaze 6y ago
  A single dose of Moderna or Pfizer is 80% effective: https://www.cnbc.com/2021/03/29/cdc-study-shows-single-dose-of-pfizer-or-moderna-covid-vaccines-was-80percent-effective.html https://www.cnbc.com/2021/03/29/cdc-study-shows-single-dose-...
  - wycy 6y ago
    This appears to be a very new finding. I seem to remember earlier studies suggesting single doses of Moderna/Pfizer were between ~53-70% effective. The number 53 sticks out in my memory for some reason. Could be misremembering though. Edit: Looks like the earlier results I was thinking of say 52% effectiveness from 1 dose, but that included people who were infected very shortly after the first dose. > Using the data from the published study of the Pfizer vaccine, Public Health England determined that vaccine efficacy was 89% for 15-21 days after dose 1 – and before dose 2 on day 21. The range was between 52% and 97%. Source: https://globalbiodefense.com/2021/03/20/how-effective-is-the-first-shot-of-the-pfizer-or-moderna-vaccine/ https://globalbiodefense.com/2021/03/20/how-effective-is-the...
bgentry 6y ago
It's unfortunate that you've been downvoted as this is a worthwhile discussion to have. I think the short answer is that we simply don't know yet which one is "better", especially since there are so many dimensions for what can make one vaccine better than the others: - dosing schedule - logistical constraints like refrigeration, shelf life - rate of severe side effects (like allergic reactions) - rate of mild side effects (like the severe cold symptoms I got from the J&J shot) - duration of immunity - effectiveness against emerging variants - effectiveness at preventing hospitalization vs severe disease vs transmission vs infection altogether We just don't have data to fairly compare the vaccines on all these dimensions. The answer from a public health perspective is to get as many shots in as many arms as fast as possible, as long as they have low rates of severe side effects and are reasonably effective. However I agree that it sows distrust to not be honest & upfront about the fact that it's highly unlikely that all vaccines are actually equal, and that we simply don't have the data to know exactly how they differ. That could easily be followed up with a "once we figure out which ones are actually better we'll give additional vaccines and/or booster shots to those that drew the short straw". Pretending they are all equal is only going to further erode trust when we inevitably figure out how they're not actually equal.
- sharkweek 6y ago
  I'm not going to go deep on this right now because I don't have the emotional will to type out the entire story but my in-laws have kinda fallen off the "trust healthcare professionals" boat over the last couple of years. This pandemic has really shined a light on their lack of trust in institutions, and while they both got the J&J vax, they are proactively sending me and my partner literature about why mRNA is dangerous / should be avoided / how it's all a big plot to... X/Y/Z. They're not crazy, I swear. In fact if you sat and had a conversation with either of them, you'd think they were some intelligent / kind people. But for some reason, I have to spend way more time than I care to combating misinformation they send us to the point where we had a harsh talk recently that we need them to stop bringing it up or we'll cut off communication for a bit. If I had to take a guess... they got to retirement with too much free time on their hands, so they spend all day on their phones reading crap they see on the internet. They might have had their initial biases, but when they see a headline that strengthens the bias they can't get enough.
vmception 6y ago
Bloomberg has really good analysis in their vaccine tracker. Especially all the data about vaccines not offered in the west (for all vaccines they have a timeline of testing, use, and also temperature, and a description of their type and the organizations involved instead of just “China” “Russia” while saying “Oxford” “Pzifer” for others). Worth paying for a subscription during this pandemic. For me, the list in order of preference is: Pzifer Moderna Sputnik V Sinopharm JnJ (steep bell curve to get to this point) I think its helped me, who was already sold on the mRNA ones. But most important to me is how it undermines most of the “plandemic” theories, not that they were ever convincing, only how they never factored in geopolitical realities.
y-c-o-m-b 6y ago
This article has a chart you can refer to: https://www.businessinsider.com/covid-19-vaccines-efficacy-variants-south-africa-uk-brazil-2021-3 https://www.businessinsider.com/covid-19-vaccines-efficacy-v... It includes data on the variants and how the differing vaccines are impacted by those variants. Disclaimer: this is just preliminary data and obviously needs way more research. I've also been following the Israeli studies for Pfizer and that's what lead me to choosing the Pfizer vaccine over the Moderna one. One follow-up question I had is this: is it dangerous to have more than one type of vaccine? Provided it's spaced out long enough (2-6 weeks apart) and there's an abundance in supply of course.
- smiley1437 6y ago
  For covid vaccines, there is currently a trial in the UK studying the outcomes on alternating doses of different vaccines. A positive outcome would be significantly increase flexibility in scheduling second shots. From what I understand, mixing vaccines is not a new strategy for vaccinations in general (it's called heterologous prime-boost) and can provide enhanced immunity. https://www.advisory.com/daily-briefing/2021/04/01/vaccine-mix https://www.advisory.com/daily-briefing/2021/04/01/vaccine-m...
bluGill 6y ago
There is one real consideration that most of forgotten about: what is your personal allergy situation. For a few people the wrong vaccine is potentially much worse, but what vaccine is wrong is different for each person.
newacct583 6y ago
> There seems to be a very strong urge not to compare any of them as better, which puts users in a position of information asymmetry where they might not make the best health choices for themselves. This is a bad analysis. Disease management is simply not a case where "best health choices for themselves" has any meaning whatsoever. The best choice, the UNAMBIGUOUSLY best choice, for everyone, everywhere, is to get the vaccine that is available first as soon as you possibly can. Period. That's the "best" choice. Imagining that you can do better individually relies on an intuition that everyone else will be following the rules while you cheat. And that's why no one wants to give you answers as to which the "best" vaccine is.
jmull 6y ago
(Note: this is from a US perspective, so I'm leaving AZ, and other vaccines that don't have EUA here out of it.) Your questions would need to be answered by scientific medical research... which hasn't been done. The "strong urge not to compare any of them" is good because there isn't a good basis for doing sound comparisons. Also, even if you somehow knew, for example, that Pfizer was X% more effective or X% safer for you than J&J, but J&J was available now while Pfizer would be available in 4 weeks, you would still need to add the risk of four additional weeks of unprotected exposure to the equation for Pfizer to understand the relative risks. Putting it together: (A) there isn't a sound way to compare the relative efficacy of J&J, Pfizer, and Moderna (especially on an individual basis) (B) waiting will increase your risk of serious problems from covid means "whichever one is available to you" is the right answer (not an "infantile" one -- careful there; you're throwing around a pejoritive, but I'm pretty sure you're the one who has a superficial grasp of the situation.) As more data is collected it may be possible to break things down, e.g., by age group or region (if a particular variant is dominant in a region a particular vaccine is especially effective against that variant), but we'll have to see.
13415 6y ago
If I could choose I'd currently take Pfizer-Biontech. My second choices would be a tie between Moderna and Sputnik V, third choice J&J, last choice currently AstraZeneca because of the lower efficacy and elevated risk of trombosis (which according to the latest German data seems to be fairly high for a vaccine). I cannot choose, though, and will probably get AstraZeneca once it's my turn.

smnrchrds 6y ago

I think that's what the challenge study was supposed to do, but it didn't go ahead.

_delirium 6y ago

I'm not sure there's enough data at the moment to give an answer. Each of the approved vaccines had a double-blind placebo-controlled study run, but on different timelines and in different locations, so it's hard to conclude much from small differences between the reported numbers.

ehsankia 6y ago
Right, unless you do a full trial with all vaccines side by side with similar sample/timeline, it's not really possible to tell. Also, the error bar on these effectiveness numbers are realistically probably +/- 5% or more, so it's not like a 76% is definitely worse than the 80%. The dosage also matters. J&J for example decided to study one dose first, but are now doing a phase trial to see how good the immunity is for a 2-dose program. So potentially if you get a second dose (maybe down the line), you will also get a stronger immunity closer to the other 2 dose vaccines.
- hannob 6y ago
  > Also, the error bar on these effectiveness numbers are realistically probably +/- 5% or more, so it's not like a 76% is definitely worse than the 80%. But we're talking 91% vs. 76%.
  - itake 6y ago
    You can't compare the 91% vs 76% numbers because the 91% test was performed in the late summer last year between virus waves and in a location with an less-contagious form of the virus. Whereas the JJ virus was tested during the fall 2nd-wave in South Africa when there was a lot of cases and more cases of a higher infection strain. The only fair comparison would be if all of the testing was done at the same time in the same geographic location. source: https://www.youtube.com/watch?v=K3odScka55A&feature=youtu.be https://www.youtube.com/watch?v=K3odScka55A&feature=youtu.be
    - boc 6y ago
      There was a new, recent study that showed that the mRNA vaccines were still 90% effective among healthcare workers during the big surge in December/January period when the variants were certainly present.[1] This doesn't mean the J&J vaccine is bad by any means, but it does show how incredible the new mRNA vaccines have performed. [1] https://www.statnews.com/2021/03/29/real-world-study-by-cdc-shows-pfizer-and-moderna-vaccines-were-90-effective/ https://www.statnews.com/2021/03/29/real-world-study-by-cdc-...
      - ehsankia 6y ago
        From that same study: > The study suggested that even the first dose of vaccine was 80% effective at preventing infection Which is within the error bar of J&J's one dose result in the US (75%). We will have to see the results of the 2-dose J&J trial coming out soon, but I expect that to be around 90% too. It's also worth noting that some places in the world (UK, Canada), have been using 1-dose pfizer regimen to get the most out of their short supply, with possible 2nd shot 3-4 months down the line. Similarly, we could see a delayed J&J booster being given to increase immunity to matching 90%.

balls187 6y ago

"whichever one is available to you" is not an infantile answer. It's a rational answer. Humans are notoriously irrational in their decision making, and focusing on which is better in order to make the best health decision may lead to making a decision that is far worse.

smnrchrds 6y ago
Not the OP, but let's rephrase: if you go to the clinic to get the shot and they tell you they have so many doses of all vaccines available that it's up to you to choose which one to take, and either way, you are going to get the shot today, which one should you choose? And how much does this choice matter in your expected health outcomes?
- josefresco 6y ago
  I would ask the doctor and not trust my ignorance (as a non-medical professional) to provide me the answer. Everything being equal? I'm taking the shot that doesn't require me to come back for a second.
  - smnrchrds 6y ago
    And what would the doctor say? And please don't reply "whatever the correct answer is", because then I will have to ask "what is the correct answer" and we end up in an infinite loop.
    - 35fbe7d3d5b9 6y ago
      The guidance provided so far is that all three shots are equally effective. That's likely what the doctor would say. From my own, semi-informed research: * The effectiveness of J&J is likely under-reported because it was tested during a significant outbreak. * Moderna seems to have slightly higher reports of side effects compared to Pfizer, though unlikely to be statistically significant. * I am a young, healthy person. With that calculus: 1) I'd pick whichever was available to me the fastest. In my area immunizations are by appointment and segmented by vaccine. I'd rather have Moderna tomorrow than wait a week for an appointment for another to open up. 1.a) In the unlikely case that I had a choice between the shots, I'd select J&J, as it has been shown to be safe and effective with one shot. This simplifies my life. In reality, scheduling a vaccine seems to be the hardest. No one of the ~10 or so I've talked to who have had their first shot between January and early March have had the ability to chose. When I received my first dose of Pfizer last month I didn't have a choice of options; I was on four or five call lists and took the one that offered me an appointment. My wife received Moderna because her work coordinated mass vaccinations and that's what they offered. A coworker received J&J because there were leftover doses that needed to be administered. Perhaps that's changed, but as many states open up to 16+ I suspect it'll remain the biggest challenge.

hannob 6y ago

It seems a lot of people don't really want to discuss this, but I think the facts are relatively clear: The mRNA vaccines have an effectiveness above 90% and none of the others comes close to that. Biontech and Moderna are so close to each other that there's probably no argument for either of those. I'd take any approved vaccine without hesitation if it'd be offered to me right now. But if I am free to choose: It'd be Biontech or Moderna.

paconbork 6y ago
I opted for pfizer just because they let you get the second shot a week earlier
da_big_ghey 6y ago
I have been seeing legitimate concern with the response of "i want the better one" or "i want the quicker one" because these are being each obstacle to quick spread of vaccine. But attempting for to say only "just as good" or "no difference" is only creating more mistrust between public with agencies that already having great mistrust from public.
babelfish 6y ago
I received Pfizer, but I would also probably choose Moderna if I had the choice. IIRC a Pfizer shot has 30ml of mRNA and Moderna has 100ml of mRNA. I know that the amount of mRNA injected shouldn't make a difference so long as your body learns the proper immune response, but my monkey brain thinks "more = better".
- mgerullis 6y ago
  Wouldn’t less of the same thing with an almost identical outcome be better? I mean, it’s a liquid being shot into your arm, not chocolate.
- 0xcafecafe 6y ago
  I chose to get Pfizer for the exact same reason. If it was able to get the same effectiveness as Moderna with lesser mRNA it seemed to be an efficient choice (as a programmer :))

maxerickson 6y ago

I had a preference for the mRNA vaccines because the immunity appears to build faster. It's not enough of a difference to wait for one of the others, but it would drive my choice if I had an option. When I made my appointment, the clerk warned me that they only had 2 dose vaccines, apparently enough people wanted the 1 dose that it was worth mentioning it. So it can be pretty situational which one is 'better'.

Taek 6y ago

I've been trying to follow along and I'm not super confident in my answer, but Pfizer and Moderna both seem to be doing incredibly well, either one is a safe choice as "this is the best I can do for myself" AstraZeneca seems to be lagging behind, and what little data I've seen on J&J seems to suggest that it's better than AstraZeneca but still not as effective as Pfizer or Moderna.

pwarner 6y ago

"whichever one is available to you" is still the right answer since as some other comments suggest there isn't enough data, yet. For sure one is likely better than the others. If we had the data we'd make the choice, but it seems it's not possible to know yet. The better one may be the one that protects against the variant that is forming via mutation right now in some person in Iowa. But yeah, we don't know yet. So you can wait until we know more, for sure eventually in retrospect we may see there is a clear vaccine winner. But really today just get one, or wait and see which one is the winner, with the risks associated with waiting. I think that's the free-agent adult pants decision. Also, let's say you get vaccine A today. And in 6 months, it turns out you really wanted vaccine B since it's way more effective it turns out. Why can't you just get vaccine B in 6 months? I imagine if vaccine B is the clear winner, they are going to crank up production on that one as much as they can?

N_A_T_E 6y ago

Its my understanding that the mRNA (pfizer and moderna) had better efficacy numbers from the phase 3 trials than J&J. 94% vs 72% when comparing similar phase 3 trials with >30k participants. I am interested to see if there is any difference in how long the protection lasts for. Hopefully we will get that knowledge as the long term studies continue. https://www.nytimes.com/interactive/2020/health/pfizer-biontech-covid-19-vaccine.html https://www.nytimes.com/interactive/2020/health/pfizer-biont... https://www.nytimes.com/2021/02/27/health/covid-vaccine-johnson-and-johnson.html https://www.nytimes.com/2021/02/27/health/covid-vaccine-john... https://www.nytimes.com/2021/02/27/health/covid-vaccine-johnson-and-johnson.html https://www.nytimes.com/2021/02/27/health/covid-vaccine-john... Disclaimer: I worked on the tech side of the moderna trial so I'm biased.

eCa 6y ago

> I know the "correct" answer is "whichever one is available to you", but let's pretend we're free-agent adults here and put the infantile answers aside for a moment. The way this sentence is worded negatively affects the way the rest of your comment is read. You would have created a better foundation for discussion (I believe/hope) if you had removed all the snark: "I know the answer is 'whichever one is available to you', but lets put that aside for a moment."

y-c-o-m-b 6y ago
I disagree. I think it's a good way to illustrate the bullshit that needs to be curated from some of the armchair expert answers here on a constant basis. People can grow thicker skin and not let a slighly snarky argument undermine a valid discussion. This isn't reddit, there's no reason for the hivemind mentality here. I come here to see discussions around the substance of the content and not ridiculous semantic disputes or someone flexing their "iamverysmart" muscle

UncleMeat 6y ago

> Is there any realistic way to compare which of the vaccine selections available in the USA is better given certain conditions? No. Because the trails were structured differently and measured different things and there is little interest in doing studies comparing the options rather than just administering them to as many people as possible.

dougmwne 6y ago

The Pfizer and Moderna mRNA vaccines seem to have strong evidence of being more protective than other options. The AstraZeneca vaccine has some early evidence of not being protective against the South African variant and has some minor safety concerns around extremely rare blood clotting. As far as I have heard anecdotally, the mRNA vaccines seem to have stronger flu-like symptoms, especially for the second dose. If you are in the USA you should be able to easily choose between the three approved vaccines, so it is relevant to gather good information, just as you would with any medical decision.

DebtDeflation 6y ago
Pfizer, Moderna, and J&J used a prefusion-stabilized version of the spike protein; AZ used the wild spike protein. The former should prove more effective against variants as a result. https://cen.acs.org/pharmaceuticals/vaccines/tiny-tweak-behind-COVID-19/98/i38 https://cen.acs.org/pharmaceuticals/vaccines/tiny-tweak-behi...

wycy 6y ago

Moderna and Pfizer seem to be nearly bit-for-bit identical at the mRNA level, though Moderna seems to have stabilized the mRNA better to be viable at higher temperatures. J&J appears to be slightly less effective with its one dose, but would probably be just as effective as Moderna and Pfizer (if not more) if a second dose were given. J&J simply doesn't need the second dose because 75+% is still considered extremely good. Even though J&J isn't considered one of the "mRNA vaccines", it still functions similarly to the mRNA vaccines. Their adenovirus carries the mRNA, allowing it to be remain stable in your body for longer, building strong immunity from 1 dose.

solosoyokaze 6y ago
A single dose of Moderna or Pfizer is 80% effective: https://www.cnbc.com/2021/03/29/cdc-study-shows-single-dose-of-pfizer-or-moderna-covid-vaccines-was-80percent-effective.html https://www.cnbc.com/2021/03/29/cdc-study-shows-single-dose-...
- wycy 6y ago
  This appears to be a very new finding. I seem to remember earlier studies suggesting single doses of Moderna/Pfizer were between ~53-70% effective. The number 53 sticks out in my memory for some reason. Could be misremembering though. Edit: Looks like the earlier results I was thinking of say 52% effectiveness from 1 dose, but that included people who were infected very shortly after the first dose. > Using the data from the published study of the Pfizer vaccine, Public Health England determined that vaccine efficacy was 89% for 15-21 days after dose 1 – and before dose 2 on day 21. The range was between 52% and 97%. Source: https://globalbiodefense.com/2021/03/20/how-effective-is-the-first-shot-of-the-pfizer-or-moderna-vaccine/ https://globalbiodefense.com/2021/03/20/how-effective-is-the...

bgentry 6y ago

It's unfortunate that you've been downvoted as this is a worthwhile discussion to have. I think the short answer is that we simply don't know yet which one is "better", especially since there are so many dimensions for what can make one vaccine better than the others: - dosing schedule - logistical constraints like refrigeration, shelf life - rate of severe side effects (like allergic reactions) - rate of mild side effects (like the severe cold symptoms I got from the J&J shot) - duration of immunity - effectiveness against emerging variants - effectiveness at preventing hospitalization vs severe disease vs transmission vs infection altogether We just don't have data to fairly compare the vaccines on all these dimensions. The answer from a public health perspective is to get as many shots in as many arms as fast as possible, as long as they have low rates of severe side effects and are reasonably effective. However I agree that it sows distrust to not be honest & upfront about the fact that it's highly unlikely that all vaccines are actually equal, and that we simply don't have the data to know exactly how they differ. That could easily be followed up with a "once we figure out which ones are actually better we'll give additional vaccines and/or booster shots to those that drew the short straw". Pretending they are all equal is only going to further erode trust when we inevitably figure out how they're not actually equal.

sharkweek 6y ago
I'm not going to go deep on this right now because I don't have the emotional will to type out the entire story but my in-laws have kinda fallen off the "trust healthcare professionals" boat over the last couple of years. This pandemic has really shined a light on their lack of trust in institutions, and while they both got the J&J vax, they are proactively sending me and my partner literature about why mRNA is dangerous / should be avoided / how it's all a big plot to... X/Y/Z. They're not crazy, I swear. In fact if you sat and had a conversation with either of them, you'd think they were some intelligent / kind people. But for some reason, I have to spend way more time than I care to combating misinformation they send us to the point where we had a harsh talk recently that we need them to stop bringing it up or we'll cut off communication for a bit. If I had to take a guess... they got to retirement with too much free time on their hands, so they spend all day on their phones reading crap they see on the internet. They might have had their initial biases, but when they see a headline that strengthens the bias they can't get enough.

vmception 6y ago

Bloomberg has really good analysis in their vaccine tracker. Especially all the data about vaccines not offered in the west (for all vaccines they have a timeline of testing, use, and also temperature, and a description of their type and the organizations involved instead of just “China” “Russia” while saying “Oxford” “Pzifer” for others). Worth paying for a subscription during this pandemic. For me, the list in order of preference is: Pzifer Moderna Sputnik V Sinopharm JnJ (steep bell curve to get to this point) I think its helped me, who was already sold on the mRNA ones. But most important to me is how it undermines most of the “plandemic” theories, not that they were ever convincing, only how they never factored in geopolitical realities.

y-c-o-m-b 6y ago

This article has a chart you can refer to: https://www.businessinsider.com/covid-19-vaccines-efficacy-variants-south-africa-uk-brazil-2021-3 https://www.businessinsider.com/covid-19-vaccines-efficacy-v... It includes data on the variants and how the differing vaccines are impacted by those variants. Disclaimer: this is just preliminary data and obviously needs way more research. I've also been following the Israeli studies for Pfizer and that's what lead me to choosing the Pfizer vaccine over the Moderna one. One follow-up question I had is this: is it dangerous to have more than one type of vaccine? Provided it's spaced out long enough (2-6 weeks apart) and there's an abundance in supply of course.

smiley1437 6y ago
For covid vaccines, there is currently a trial in the UK studying the outcomes on alternating doses of different vaccines. A positive outcome would be significantly increase flexibility in scheduling second shots. From what I understand, mixing vaccines is not a new strategy for vaccinations in general (it's called heterologous prime-boost) and can provide enhanced immunity. https://www.advisory.com/daily-briefing/2021/04/01/vaccine-mix https://www.advisory.com/daily-briefing/2021/04/01/vaccine-m...

bluGill 6y ago

There is one real consideration that most of forgotten about: what is your personal allergy situation. For a few people the wrong vaccine is potentially much worse, but what vaccine is wrong is different for each person.

newacct583 6y ago

> There seems to be a very strong urge not to compare any of them as better, which puts users in a position of information asymmetry where they might not make the best health choices for themselves. This is a bad analysis. Disease management is simply not a case where "best health choices for themselves" has any meaning whatsoever. The best choice, the UNAMBIGUOUSLY best choice, for everyone, everywhere, is to get the vaccine that is available first as soon as you possibly can. Period. That's the "best" choice. Imagining that you can do better individually relies on an intuition that everyone else will be following the rules while you cheat. And that's why no one wants to give you answers as to which the "best" vaccine is.

jmull 6y ago

(Note: this is from a US perspective, so I'm leaving AZ, and other vaccines that don't have EUA here out of it.) Your questions would need to be answered by scientific medical research... which hasn't been done. The "strong urge not to compare any of them" is good because there isn't a good basis for doing sound comparisons. Also, even if you somehow knew, for example, that Pfizer was X% more effective or X% safer for you than J&J, but J&J was available now while Pfizer would be available in 4 weeks, you would still need to add the risk of four additional weeks of unprotected exposure to the equation for Pfizer to understand the relative risks. Putting it together: (A) there isn't a sound way to compare the relative efficacy of J&J, Pfizer, and Moderna (especially on an individual basis) (B) waiting will increase your risk of serious problems from covid means "whichever one is available to you" is the right answer (not an "infantile" one -- careful there; you're throwing around a pejoritive, but I'm pretty sure you're the one who has a superficial grasp of the situation.) As more data is collected it may be possible to break things down, e.g., by age group or region (if a particular variant is dominant in a region a particular vaccine is especially effective against that variant), but we'll have to see.

13415 6y ago

If I could choose I'd currently take Pfizer-Biontech. My second choices would be a tie between Moderna and Sputnik V, third choice J&J, last choice currently AstraZeneca because of the lower efficacy and elevated risk of trombosis (which according to the latest German data seems to be fairly high for a vaccine). I cannot choose, though, and will probably get AstraZeneca once it's my turn.