Which is better, Pfizer, Moderna, or Johnson & Johnson?

In the near future, there will be an option for children younger than 12 to get the COVID-19 vaccine. Parents will have the final decision of whether the child gets it or not but it’s important to educate the child on their options of which vaccine they would prefer, Pfizer, Moderna, or Johnson & Johnson. The Pfizer and Moderna vaccines both contain mRNA technology and the Johnson & Johnson is a more traditional vaccine. It is important to know that just as the flu vaccine, the vaccines will become less effective at protecting the person against mild COVID-19 infection, but it will still lessen the symptoms so it is less likely to have a permanent impact on that person’s body and health. The Johnson & Johnson vaccine is the best option because it is the most traditional and the method we are most used to as humans.

Pfizer was the first COVID-19 vaccine to be approved by the FDA in the United States. In America, it is approved for people that are 12 years of age or older whereas, in the European Union, children over 5 years old can receive this vaccine, which is the direction we’re heading. This vaccine is an mRNA vaccine, this means that instead of a traditional vaccine that injects an inactive virus into the body, a piece of mRNA teaches our cells to make a protein that triggers an immune response inside the human body. Our immune system doesn’t recognize the protein that the mRNA created, which triggers it to attack that protein, this process created antibodies that will then be able to attack the COVID-19 virus when it enters the body. 

mRNA vaccines were developed in the 1970s but took years of research to overcome a few challenges, the biggest one being “that mRNA would be taken up by the body and quickly degraded before it could “deliver” its message” (Beyrer, 2021). This problem was solved by advancements in nanotechnology. Scientists found a way to develop fat droplets that wrap around the mRNA that lets it enter the cells and translates into proteins. The differences between the Pfizer and Moderna vaccines are slight. The Pfizer needs to be stored at -94 degrees Fahrenheit, Moderna needs to be stored at around 36 degrees Fahrenheit, and the Johnson & Johnson can be stored at room temperature, making it ideal for mobile vaccine hubs. The symptoms after getting a COVID-19 vaccine are similar across all three vaccine options. The most common side effects people experience are pain at the injection site, tiredness, headache, muscle pain, chills, joint pain, swollen lymph nodes in the same arm as the injection, nausea, and vomiting, and fever. In the case of the mRNA vaccines, more people experienced these side effects after the second dose (U.S. Food & Drug Administration, 2021). The CDC states, “Rare serious adverse events have been reported after COVID-19 vaccination, including Guillain-Barré syndrome (GBS) and thrombosis with thrombocytopenia syndrome (TTS) after Janssen COVID-19 vaccination and myocarditis after mRNA (Pfizer-BioNTech and Moderna) COVID-19 vaccination” (Rosenblum HG, Hadler SC, Moulia D, et al., 2021). Anyone over 12, in the US, can receive the Pfizer vaccine whereas adults over 18 can receive the Moderna. The first mRNA vaccine was tested on rats in 1990 and the second was for rabies tested in 2013. The years spanning between that were used to develop the solutions to the mRNA vaccine, but the question arises why wasn’t the rabies vaccine ever put on the market because they did human trials in 2017 but the vaccine was never released. 

The Johnson & Johnson vaccine is more of a traditional vaccine in that it injects a small bit of the virus (adenovirus) for your body to learn to fight against. It does this by specifically delivering the virus’ DNA to your cells to make the spike protein. An adenovirus acts as a delivery vehicle used to carry the coronavirus genetic material. The adenovirus delivers the little piece of DNA to the cell that will then make the spike protein. After your cells produce the spike protein, your immune system creates antibodies toward the spike protein, protecting you from infection. (Nebraska Medicine, 2021). Adenovirus vaccines, such as the flu vaccine, usually gives the patient a common cold, but the adenovirus cannot replicate so it will not cause COVID-19. Unlike the two mRNA vaccines where the patient isn’t fully vaccinated until two weeks after the second dose, making the whole process a month long, patients that got the Johnson & Johnson vaccine are considered fully vaccinated 14 days after the one dose. Making it ideal for patients who are at higher risk and want to be protected fast. Yale medicine stated that the Johnson & Johnson vaccine had noticeably fewer side effects than the Pfizer and Moderna vaccines. (​​Katella, 2021). 

In recent times, a new variant of COVID-19 emerged, the delta variant. This variant is twice as contagious as other variants and caused more severe symptoms. It is important to keep this in mind when choosing a vaccine because some research has suggested that the vaccines aren’t as effective against the variant as they are over the original coronavirus disease. Research suggests that the Pfizer-BioNTech COVID-19 vaccine is 88% effective at preventing symptomatic COVID-19 virus caused by the delta variant and 96% effective at preventing severe disease caused by the delta variant. The Moderna COVID-19 vaccine is 72% effective at preventing symptomatic COVID-19 virus caused by the delta variant and 96% effective at preventing severe disease caused by the delta variant. Lastly, the Johnson & Johnson COVID-19 vaccine is 85% effective at preventing severe disease with the COVID-19 virus caused by the delta variant, according to data released by Johnson & Johnson. (Mayo Clinic, 2021)

Just as age comes into question when choosing a vaccine for your child, it is important to do our research on which vaccine would be best for those that are 65 years of age or older. They had a large elderly population in the trials on the mRNA vaccines Moderna and Pfizer, there is some evidence to show that it’s similarly effective in the older population. The immune response may not be as good as the younger, less than 65 age group, but did not seem to be that significantly different. (Stiepan, 2021). The Jonson & Jonson is beneficial for adults over 65 because, unlike the mRNA vaccines, you only need to schedule one dose. This is good for those trying to stay in quarantine due to their age.

In conclusion, the Johnson & Johnson vaccine is the most ideal vaccine for anyone over 18 because it has the least amount of side effects, the shortest amount of time until the patient is considered fully vaccinated, and it is the most like a traditional vaccine. MRNA technology has only been studied for 50 years and had only been publicly used in one other emergency scenario, for the ebola virus, and even then, Americans weren’t the ones using this vaccine so it was never approved by the FDA. Adenovirus vaccines, such as the Johnson & Johnson, have been studied for 70 years, and have been FDA approved for other vaccines prior to the COVID-29 outbreak. There is a bit more comfortability knowing that the vaccine has been used for prior illnesses unline the mRNA vaccines. We are the guinea pigs to see the long-term effects of these vaccines and if in the long-run, natural immunity was actually better than receiving the vaccines that seem like we will have to continue getting boosters for for a long time.

References

Beyrer, C. (2021, October 6). The long history of mrna vaccines. Johns Hopkins Bloomberg School of Public Health. Retrieved November 11, 2021, from https://publichealth.jhu.edu/2021/the-long-history-of-mrna-vaccines.  

Stiepan, D. D. (2021, February 1). What older adults should know about being vaccinated for COVID-19. Mayo Clinic. Retrieved November 11, 2021, from https://newsnetwork.mayoclinic.org/discussion/what-older-adults-should-know-about-being-vaccinated-for-covid-19/.  

Mayo Clinic, S. (2021, October 7). Do covid-19 vaccines protect against the variants? Mayo Clinic. Retrieved November 11, 2021, from https://www.mayoclinic.org/coronavirus-covid-19/covid-variant-vaccine.  

​​Katella, K. (2021, November 3). Comparing the COVID-19 vaccines: How are they different? Yale Medicine. Retrieved November 11, 2021, from https://www.yalemedicine.org/news/covid-19-vaccine-comparison.  

Nebraska Medicine. (2021, August 19). How the johnson & johnson covid-19 vaccine works. Nebraska Medicine. Retrieved November 11, 2021, from https://www.nebraskamed.com/COVID/how-the-johnson-johnson-covid-19-vaccine-works.   

Rosenblum HG, Hadler SC, Moulia D, et al. Use of COVID-19 Vaccines After Reports of Adverse Events Among Adult Recipients of Janssen (Johnson & Johnson) and mRNA COVID-19 Vaccines (Pfizer-BioNTech and Moderna): Update from the Advisory Committee on Immunization Practices — United States, July 2021. MMWR Morb Mortal Wkly Rep 2021;70:1094-1099. DOI: http://dx.doi.org/10.15585/mmwr.mm7032e4

FDA. (2021, November 5). Moderna Covid-19 vaccine. U.S. Food and Drug Administration. Retrieved November 11, 2021, from https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/moderna-covid-19-vaccine.