The primary time I received a Novavax Covid vaccine, it felt nearly subversive.
Over the last few years, each mRNA-based booster I’d gotten — those made by Moderna and Pfizer — had felt like a two-day bout of the flu. I’d gamely booked sick days into my calendar and sucked it up via fevers, complications, and exhaustion, comforting myself with ibuprofen and the information that a minimum of I used to be holding my aged dad and mom secure.
Two and a half years into the pandemic, the Meals and Drug Administration authorised a Covid vaccine made by biotech firm Novavax utilizing older vaccine manufacturing expertise. Licensed for individuals 12 and over, it was almost as efficient at Covid prevention as Pfizer and Moderna’s mRNA vaccines — and, as I famous with nice curiosity, it had fewer negative effects. In 2023, I received one.
The distinction was staggering: Though I felt a bit of weak and shaky for a couple of hours on the evening of my injection, I awakened the following morning feeling blissfully regular, with solely a light soreness in my arm and a smug pep in my step. This yr, there was no query what I’d do — it will be straightforward, breezy Novavax for me.
Greater than half of all individuals who get mRNA boosters have comparable disagreeable short-term negative effects to mine. However unusually, few of them appear to see Novavax as a substitute: As of August, People had acquired 650 million mRNA vaccine doses, in contrast with solely 83,000 Novavax doses. Consultants informed me Novavax has suffered each from its timing and from an unearned popularity as a darkish horse. “There’s this notion that that is some form of second-line vaccine that folks take in the event that they don’t need to get the mRNA vaccines,” says Amesh Adalja, an infectious illness physician and senior scholar on the Johns Hopkins Middle for Well being Safety, “nevertheless it shouldn’t be.”
“They’re equal, and there could also be some benefits to getting it,” he informed me.
Though the worst of the pandemic is lengthy over, there are nonetheless loads of good causes to get a Covid-19 booster. The virus brought on greater than 76,000 deaths in 2023 and almost 41,000 hospitalizations between October 2023 and final April. There’s nonetheless a threat of creating lengthy Covid after an infection, even whether it is decrease than throughout the earliest days of the pandemic.
Nonetheless, greater than half of People don’t plan to get a Covid booster this yr, in response to a latest Pew Analysis Middle survey, and the discomfort they trigger is a giant purpose why. Sixty % of individuals not lining up for a shot mentioned negative effects have been a significant purpose for his or her disinterest.
Perhaps extra individuals would get Covid boosters in the event that they knew what I learn about Novavax: Making the sensible alternative in your and your neighborhood’s well being doesn’t need to really feel like crap.
Why no one thinks of Novavax first
Novavax is constructed in another way from different Covid vaccines, which is a part of why it didn’t enter our vaccine vocabularies till later within the pandemic.
The Moderna and Pfizer vaccines — the primary Covid immunizations the FDA authorised in December 2020 — have been created utilizing expertise that had beforehand solely been utilized in scientific trial settings. The expertise entails encoding genetic blueprints for the novel coronavirus’s spike protein onto fragile mRNA molecules and delivering them to the physique’s muscle cells to provide an immune response.
Just like the mRNA vaccines produced by Moderna and Pfizer, Novavax was created to fight Covid-19. In contrast to them, it’s primarily based on older expertise that mirrors strategies used to provide many different standard vaccines which have been round for many years.
It takes so much longer to create a vaccine that makes use of standard expertise. That explains why the primary model of Novavax wasn’t authorised till August 2022, nearly two years after mRNA vaccines got here available on the market. Additionally it is solely authorised for older kids (age 12 and up) and adults.
“Normally, the primary to the market tends to have lots of benefit when it comes to uptake,” Adalja says. Novavax’s later launch means many individuals might merely not give it some thought after they consider Covid vaccines.
Novavax has much less extreme negative effects than both of the mRNA vaccines
Earlier than mRNA vaccines have been even authorised by the FDA, it was clear their short-term results have been extra extreme than these of different vaccinations that had come earlier than. In early stories, individuals in vaccine trials reported extreme fatigue, headache, and muscle and joint pains that merely didn’t occur with different vaccines.
With time, extra information emerged. The vaccines had been break up into two doses given various weeks aside. In vaccine trials, many adults had short-term negative effects past sore arms, particularly after the second dose. Their signs included fatigue (60 % to 65 %), headache (50 % to 60 %), and fever (11 % to fifteen %) lasting for one to 2 days. For each the Moderna and Pfizer vaccines, post-vaccination signs have been extra frequent in kids and adolescents, and fewer frequent in adults 65 and older.
(Notably, wherever from 1 / 4 to half of people that acquired a saline placebo as an alternative of both Pfizer or Moderna vaccine additionally reported these signs, besides fever — so it’s not completely clear how a lot of the vaccine group’s discomfort was because of the vaccine.)
As soon as most people began getting the vaccines, the complete extent of those negative effects turned clearer. Fatigue, headache, or muscle aches occurred after the second injection in about half of people that participated in a voluntary vaccine security monitoring system, whereas 1 / 4 to a 3rd of these individuals had chills, fever, or joint ache. In a single research, 37 % of healthcare employees who received the vaccines have been sick sufficient within the following couple of days that they needed to miss work.
When Novavax got here on the scene rather less than two years after the mRNA vaccines rolled out, a big research steered it will have milder negative effects. Specifically, fever was much less frequent amongst individuals who received the vaccine, occurring in solely 6 % of individuals after a second dose. Different negative effects have been additionally much less frequent, and all went away sooner than the signs that adopted mRNA vaccines — after a matter of hours moderately than days.
“There are lots of people which are legitimately knocked out for a few days with the mRNA, and also you’re not going to get that with Novavax.”
There’s no massive head-to-head comparability research of each mRNA vaccines and Novavax to quantify simply how massive the variations of their negative effects are. Nevertheless, a small Chinese language research revealed earlier this yr hints at simply how rather more tolerable Novavax is than its mRNA counterparts. Amongst individuals who received the present variations of the Novavax and Pfizer vaccines in late 2022, those that received the Pfizer mRNA vaccine have been six occasions as more likely to have fever and greater than 3 times as more likely to have chills and muscle aches. Solely 2 % of individuals within the Novavax group had every of those signs; the one symptom they reported extra typically than the Pfizer group was fatigue.
Kirsten Lyke, an infectious illness physician and vaccine researcher on the College of Maryland Faculty of Drugs, led a security research on mixing and matching manufacturers of preliminary Covid vaccines and booster doses. Though the research wasn’t designed to match the negative effects of various vaccines, it was clear individuals who received Novavax booster doses had milder negative effects that resolved extra rapidly than these boosted with mRNA vaccines.
“There are lots of people which are legitimately knocked out for a few days with the mRNA, and also you’re not going to get that with Novavax,” she says.
Novavax works in addition to mRNA vaccines
So Novavax causes fewer annoying negative effects than different vaccines. How properly does it shield you from Covid?
When the mRNA vaccines first turned accessible in late 2020, the yardstick specialists used to speak their high quality was their effectiveness at stopping an infection. On the outset, Moderna’s and Pfizer’s vaccines had 95 % vaccine effectiveness, which meant that amongst 100 individuals liable to catching the virus, they saved all however 5 of them from getting contaminated.
Novavax was examined at a unique time, after the virus had developed, and many individuals had already been uncovered to Covid-19. Its preliminary effectiveness was measured at 90 %.
The present proof suggests that folks initially vaccinated with mRNA vaccines who go on to get a Novavax booster are properly lined — in Lyke’s research, they developed antibody ranges properly above the stage wanted to guard individuals from Covid. Though mRNA boosters might result in larger antibody ranges, “larger isn’t essentially higher,” she says.
Different research have steered the antibodies Novavax elicits might dangle round longer than those different vaccines provoke; nonetheless others point out that on the subject of extra real-world outcomes like creating signs after an infection, Novavax is pretty much as good as some other vaccine available on the market.
These research are from 2021 and 2022, and concerned Covid variants which are totally different from those circulating now. More moderen assessments of how good the latest model of Novavax is at stopping Covid an infection and extreme sickness — just like the information the FDA reviewed earlier than approving the 2024-2025 model of the Novavax booster — are from research in mice, not people. Nonetheless, they recommend the newest editions of Novavax are within the ballpark of its earlier variations on the subject of defending us from the virus’ worst. You’ll be able to examine the Novavax web site to discover a pharmacy close to you the place you may get a Novavax vaccine.
Essentially, it’s time to cease worrying about whether or not one vaccine is barely more practical at stopping sure outcomes than others, says Lyke. “At this level, we’re form of past that,” she says. “We now have lots of choices and you may decide and select,” she says, “and also you’re in all probability not going to make a mistaken choice.”