They’re not the same.
Yes, the Pfizer/BioNTech and Moderna Covid-19 vaccines do have many similarities. Yes, they are both mRNA vaccines. Yes, both recently received emergency use authorization (EUA) from the U.S. Food and Drug Administration (FDA) with the Moderna vaccine receiving the EUA on Friday, as Leah Rosenbaum reported for Forbes. Both vaccines may enjoy long walks on the beach as long as they are stored properly. However, there are important differences between the two vaccines that may affect vaccine roll-outs and who can get each.
First the similarities, because as 2020 comes to a close, we don’t want to just dwell on differences in our society. The two vaccines are supposed to work by the same mechanism. Both contain mRNA, which is not like MMMBop, but stands for messenger (small “m”) ribonucleic acid (RNA). Every living cell and microorganism has a collection of genetic material like deoxyribonucleic acid (DNA) or RNA that serve as the library of blueprints for making its protein parts. A cell or microorganism can then make copies of these blueprints or recipes form the library in the form of mRNA. These blueprint copies or mRNA then travel to “factories” in the cell or microorganism called ribosomes. These factories put together the proteins that are specified by these “blueprints,” i.e., the mRNA.
Both the Pfizer/BioNTech and Moderna vaccines include mRNA that is supposed to code for the production of the Covid-19 coronavirus spike protein. If you recall, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) looks like a spiky massage ball. However, rather make you go, “aahhhhhh, that feels good,” these spikes help the virus enter your respiratory tract cells.
However, such mRNA doesn’t just sit by itself in the Pfizer/BioNTech and Moderna vaccines. Cells in your immune system may not recognize or gobble up random pieces of mRNA that are floating around in your body just like you may not eat the sugar, corn syrup, hydrogenated palm kernel oil, fruit juice, citric acid, natural and artificial flavor goo that’s inside Skittles without the candy coating. Therefore, the mRNA in the vaccines is surrounded by a material that will allow your immune system cells to more readily swallow the mRNA. Consider this material to be akin to a candy coating.
Once the mRNA gets inside your immune system cells, the factories inside your cells use the mRNA to start making the SARS-CoV2 spike protein. Not the entire virus but just the spike protein. Once spike protein is made, the rest of your immune system is supposed to go, “WTH is this,” and then mobilize a response against the spike proteins. This hopefully will get your immune system to remember the spike protein and act quickly if and when the real virus covered in spike proteins gets into your body.
So far, there are no clear differences between the efficacy and safety of the two vaccines. During the first several months of their Phase 3 clinical trials, both have registered efficacies of 90% or greater. Neither has had an unacceptable rate of serious side effects. Of course, with the clinical trials still ongoing and as more people in the “real world” get vaccinated with the vaccines, more information will emerge about both vaccines. Remember both are under EUAs and do not yet have the full standard approval that other routine vaccines like the measles- mumps-rubella and seasonal flu vaccines have. A EUA means that the potential benefits outweigh the potential risks under such an emergency situation.
That being said, at present, there are still 5 important differences between the vaccines:
1. The age limits for the vaccines are different.
You may be 16 and beautiful as the song goes but you currently cannot get the Moderna vaccine. To get the Moderna vaccine you have to be 18 years and older, whereas for the Pfizer/BioNTech vaccine you can be 16 years and older. Now that may change in the near future. It isn’t as if being able to legally vote, buy cigarettes, open a bank account in your own name, or get a tattoo has any impact on how either vaccine will work in your body. The age limits are just a reflection of who happened to be enrolled in the clinical trials to date. Moderna has already initiated testing its vaccine in 12- to 17-year-olds.
2. The time in between the first and second doses are different.
Both vaccines involve an initial dose to “prime” your immune system, that is, to tell your immune system, “hey, here’s the spike protein. It’s not what you’re used to seeing. Do your thing.” Then, after waiting a period of time, both vaccines entail a second dose to “boost” your immune response, that is to tell your immune system, “hey remember this spike protein? Well, stop watching Netflix, wake up, and stay alert.” But compared to the Pfizer/BioNTech vaccine where you have to wait 21 days between getting the first and second doses, for the Moderna vaccine, you have to wait for it, wait for it, wait for it, wait an additional week or a total of 28 days before getting the second dose. This affects how a clinic, health department, pharmacy, or other location coordinates its vaccination operations and when you have to return for the second dose. So keep in mind which vaccine you get as a first dose and when you have to return. Don’t rely on others on Facebook or Jake from State Farm to tell you when your second dose should occur because they may have gotten a different type of vaccine.
3. They have different storage requirements.
mRNA is rather fragile so you can’t just keep it in the refrigerator or outside indefinitely. While you can store the Moderna vaccine at -4 degrees Fahrenheit (F), Pfizer’s vaccine requires colder temperatures. In fact, much colder at -94 degrees F. That’s a big difference. The temperature right now in Antarctica is by comparison a balmy -16 degrees F. Picture a weather forecaster saying, “tomorrow will be -94 degrees and Sunny” instead of “tomorrow will be -4 degrees and Sunny.” Which of these will get you to not only stay inside but but hide under your One Direction covers?
To remember this lower temperature, think of the boy band 98 Degrees but the opposite of zero and add 4 degrees, which is two degrees less than six degrees of Kevin Bacon. In other words, remember “boy band opposite of zero plus two less than Bacon.” Or you can just remember -94 degrees F.
Your typical freezer can keep things at -4 degrees F but, unless you’ve bought one to store some very weird food, won’t maintain such a deep freeze -94 degree temperature. This will mean that clinics and other vaccination locations that don’t have special equipment, dry ice, and arrangements to maintain such low temperatures may not be able to hold the Pfizer/BioNTech vaccines. Plus, in order to avoid getting a vaccine that doesn’t work, you may want to check what vaccine you are getting and whether it’s been stored properly.
This doesn’t mean that Pfizer/BioNTech vaccine can’t stay in room temperature at all. Otherwise, vaccinating people inside -94 degree F feezers could be problematic. Imagine a health care professional saying, “Sir and madam, could you please stop shivering and complaining about frostbite so that I can give you the vaccine?” Instead, after you pull the Pfizer/BioNTech vaccine out of the deep freeze and thaw it, you may able to keep it in a refrigerator for up to five days. By contrast, you may be able to keep the Moderna vaccine in a refrigerator longer for up to 30 days and at room temperature for up to 12 hours.
4. The quantity of vaccine in each dose and the amount you can order will differ.
Each dose of the Moderna vaccine will contain more vaccine (100 micrograms) than each dose of the Pfizer/BioNTech vaccine (30 micrograms of vaccine.) Clinical trials haven’t shown much of a difference in how your body may respond to this difference in dose amounts. But the difference has implications when it comes to manufacturing the vaccines, which could affect production schedules.
Another difference is the minimal order that you can place for each vaccine. Just like you can’t order just one grape from Instacart, you won’t be able to just order any quantity of vaccine. For Pfizer, the minimum order is 975 doses. For Moderna, it’s 100 doses. This may not seem like a big deal. But what happens if you are in a location with relatively fewer people like Lotsee, Oklahoma, which may have a lot to see but only two people to visit? They probably won’t need 975 or even 100 doses the vaccine. Or what if the number of people that you have to vaccinate doesn’t quite match up with the order size? These lot sizes could ultimately affect which of the two vaccines are ordered and how much vaccine ends up going to waste.
5. Their containers will hold different quantities of vaccines.
Speaking of matching up and waste, the number of doses in each vaccine vial can make a difference. The Pfizer/BioNTech vaccine will be in vials that hold five doses of the vaccine, whereas the Moderna will come in 10-dose vials. This could affect how many doses you can store and transport if cold or ultra-cold storage and transport are limited. It can affect what’s called “open-vial wastage” as well. Closed vial wastage is when vaccine doses go unused and need to be discarded before the vaccine vials have even been opened. This can occur when vials are damaged, accidentally exposed to too high temperatures, or are stored for too long past the vaccines’ expiration date. Open vial wastage is when doses must be discarded after the vial has been opened. For example, if you open a 10-dose vial and only three people arrive to get vaccinated, you have to chuck the remaining seven doses because you have already contaminated the vial by opening it. Trying to store the remaining doses could be like licking a corn beef hash and then trying to put it back in the fridge. Having more doses per vial increases the potential amount of open vial wastage. For example, with a five-dose vial, you would only have to chuck two unused doses.
Chances are you won’t be able to choose which vaccine you get. It won’t be like a hot dog stand where you can say, “I will have the Pfizer vaccine with some relish,” or “give me the Moderna vaccine with some extra cheese.” While some vaccination locations may get both vaccines, many may get only one type of vaccine or at least be administering one type of vaccine at a given time. So the differences between the two vaccines may have more of an impact on the people delivering and giving the vaccine.
Nevertheless, it is a good idea to be aware of which vaccine you’re getting. Ask and inquire. It’s not clear yet what would happen if you were to accidentally get one dose of a particular vaccine and then a subsequent dose of a different vaccine. Will you get the same protection or potentially have different side effects? Time and more studies may tell.
In the meantime, keep track yourself of which vaccine you get for your first dose so that you can make sure that you get the same type of vaccine for the second dose. Additionally, this will help you know when to return (21 days versus 28 days later) for the second dose. Plus, when you aware of what type of vaccine is being used, you can better observe whether they are being handled properly. Mistakes do happen in any process, so don’t assume that everything will go smoothly. After all, the people handling the vaccines are human and not half-cyborg hedgehogs. And humans and circumstances can be different and are not always exactly the same.
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