Which COVID-19 vaccine should I get?

Should I try and get an mRNA vaccine? They are better than the others, aren’t they? If I show up at the clinic can I choose?

 These are some of the questions that we didn’t even know we would be so lucky to ask just three months ago. 

The speed at which multiple vaccines to choose from has come about is unprecedented. 

The first genome sequence of a previously unknown virus was published in early January 2020 and the Pfizer and Moderna mRNA vaccines, tested over the summer and fall of 2020, were approved for emergency use in early December. 

These are the quickest vaccines ever developed. Their very speed has raised a lot of questions around their safety. It is true that all previous vaccines have taken years to develop and the cumulative experience of their use over time is reassuring. 

Moderate reactions

Nevertheless the COVID-19 vaccines have been tested in very big trials. As a comparison, the widely used and “uncontroversial” Shingrix vaccine for prevention of shingles was tested in 32,000 participants prior to submission for approval in 2017. The total number of patients in COVID-19 vaccine trials that have reported results so far is 170,000 and growing rapidly. 

The safety results have been reassuring — both in the trial participants and now in millions of people worldwide who have been vaccinated and reported to national monitoring systems. 

Rates of severe side effects, mainly anaphylaxis, have been very rare — a handful in every million vaccinated — and the more common reactions such as arm pain, fever, fatigue and muscle aches have been over very quickly. 

The brief discomfort of COVID-19 vaccines seems to be greater than for the annual flu shot. This probably reflects a combination of both the “prime-boost” two-shot strategy to provoke maximum stimulation of the immune system; and the large group of vaccinees who were recently infected naturally with SARS-CoV-2 and already have a naturally primed immune system ready to react. Maybe the single-shot Johnson & Johnson vaccine will have fewer reactions?

Don’t compare
the numbers

There are now three vaccines available in the USA (Pfizer, Moderna and Johnson & Johnson) and several more globally, with more to come. 

Inevitable comparisons between the different vaccines, using their “headline” efficacy numbers, is a favorite media story at the moment. This has stimulated “vaccine shopping,” which has reached damaging levels in places like Germany, where the UK Astra-Zeneca vaccine sits un-used in warehouses whilst people wait, unprotected, for the Pfizer vaccine. 

The efficacy numbers attached to the two shots is responsible for this: 95% for Pfizer versus 62% for Astra-Zeneca. 

These numbers are a snapshot in time and can’t be compared with each other. 

Different vaccine trials

The Pfizer number was generated from a trial mainly in the USA, where most of the patients were recruited in the summer and fall of 2020. 

The Astra-Zeneca number was reported from a trial that included a substantial mixture of patients from the UK, South Africa and Brazil. 

The Pfizer and Moderna trials closely adhered to the three- or four-week interval between doses, whereas the Astra-Zeneca trial had a less strict timing. 

The different trials measured infection and symptoms in different ways at different time points. 

In more recent trials — for example the Johnson & Johnson and Novavax trials — there were large numbers of infections with new virus variants included as well. 

The efficacy result of each trial is reflective of the performance of the vaccine WITHIN that trial compared with a placebo — but not comparable OUTSIDE of the trial with the other vaccines.

Real-world results

To emphasize this, we have recent large-scale program results from the Scottish National Health Service. 

The Astra-Zeneca vaccine has been 94% effective in reducing hospitalizations so far compared with the Pfizer vaccine, which has been 85% effective. 

This reversal of efficacy rankings in a real-world observation simply emphasizes that both vaccines are great. 

The most important number of all to remember is that in the thousands and thousands of trial participants who received any of the vaccines there were no COVID deaths and almost no hospitalizations for COVID.

So when you have finally managed to find your vaccine appointment after refreshing the sign-up page a hundred times and been booked four weeks hence, don’t worry about which vaccine you will get. Just pick the one with the smallest needle.

 

James Shepherd, MD PhD, lives in Sharon, Conn., and is an Infectious Disease physician and epidemiologist who is on the faculty of the Yale University School of Medicine.

The views expressed here are not necessarily those of The Millerton News and The News does not support or oppose candidates for public office.

Latest News

County comptroller releases special report on federal funding

Dan Aymar-Blair

Photo provided

POUGHKEEPSIE — Dutchess comptroller Dan Aymar-Blair released a special report early last week on federal monies and how they move through the county level, including the disbursement process in the county; how federal funding benefits Dutchess residents and whether any fiscal distribution issues have surfaced locally as a result of actions taken on behalf of the Trump administration.

According to Aymar-Blair’s report, federal programming represents roughly 10% of Dutchess expenditures, not including any COVID-19 assistance. As an illustration of federal- to county-level distribution and spending, in 2023, under the Biden administration, the county received approximately $65 million from the U.S. government with $25 million going toward direct aid in support of such programs as home energy assistance and food stamps. Federal monies were also disbursed — and continue to be directed — toward county-level agencies, programming and supports such as adoption, foster care and child care needs, emergency/disaster assistance, infrastructure development and maintenance, and workforce initiatives.

Keep ReadingShow less
‘Selected Shorts’ comes to Stissing Center

The Stissing Center was bustling just before the show on Sunday, March 9.

Photo by Alec Linden

PINE PLAINS — The Stissing Center was packed on Sunday for an afternoon performance of podcast and NPR series “Selected Shorts.” The sold-out show, which was recorded for national broadcast at a later date, brought a lineup of four accomplished actors and storytellers to the Pine Plains stage to recite a selection of short stories from award-winning authors.

“Selected Shorts,” a product of Manhattan-based performing arts powerhouse Symphony Space, features prominent actors who recite works of short fiction. The full program usually revolves around a theme; Sunday afternoon’s focus was “transformations.”
Comedian, writer and actress Ophira Eisenberg — or “renaissance woman of storytelling,” as Stissing Center Executive Director Patrick Trettenero introduced her — assumed hosting duties, warming up the crowd with jokes about Brooklyn egg prices and doctors with self-esteem issues — “I want a megalomaniac with a god complex and no hobbies.”

Keep ReadingShow less
Connecticut Attorney General Tong reflects on impacts of immigration policy

Connecticut Attorney General William Tong visits with former State Rep. Roberta Willis of Salisbury before his talk on immigration at Trinity Lime Rock Church Thursday.

Photo by Ruth Epstein

LAKEVILLE, Conn. — Attorney General William Tong knows firsthand about the plight of immigrants.

He spoke to a standing-room-only crowd at Trinity Lime Rock Church March 6, which together with those on Zoom totaled 225. The event was hosted by Vecinos Seguros 2, a grassroots organization that works to make sure those without legal status know their rights.

Keep ReadingShow less
Amenia Board funds comprehensive plan update
Town Hall in Amenia on Route 22.
Archive photo

AMENIA — Updating the town’s Comprehensive Plan will proceed following action by the Town Board at its regular meeting on Thursday, March 6, to provide funding for the services of professional town planning consultants.

The committee had suspended its work for several months feeling that its planning would benefit from expert planning advice.
By unanimous vote the Town Board agreed to allocate $37,500 to hire the services of Nexus Creative Design of Mount Kisco, New York, the collaborative arm of Pace University’s Land Use Law Center. Together, the planning experts will work with the Comprehensive Plan Review Committee to facilitate local forums, gathering and interpreting residents’ input regarding visions and aspirations for the town’s future.

Keep ReadingShow less