Pfizer-BioNTech, Moderna, and Johnson & Johnson/Janssen are the three FDA approved COVID-19 vaccinations in circulation around the world.
All are effective in preventing hospitalization and death from the COVID-19 virus and are likely to decrease transmission risk during breakthrough infections.
The vaccinations are proving effective against the variant strains of COVID-19 but effectiveness differs between specific variants.
Patients are fully vaccinated 2 weeks after their last dose. There is a 4 day grace period prior to the 2nd vaccination recommended date as well as patients must receive the second dose 6 weeks after the first dose to receive the proven benefits of immunization.
Three different COVID-19 vaccines – Pfizer-BioNTech, Moderna, and Johnson & Johnson/Janssen – have been authorized for emergency FDA approval and are currently in circulation throughout the world. All are safe, effective, and reduce the risk of severe illness and death from COVID-19. The Centers for Disease Control (CDC) does not promote one over another. Clinical trials and real-world studies confirm these vaccinations are highly effective against COVID-19 asymptomatic and symptomatic cases, severe disease, and death from the COVID-19 virus. Vaccinated people who do become infected with the SARS-CoV-2 virus demonstrate a reduced viral load, suggesting associated transmission risk is substantially lower than unvaccinated people. Side effects can occur within 7 days after vaccine administration, but are mostly mild and temporary. There is still more to learn regarding vaccinations and high-risk individuals (such as those who are immunocompromised), as well as how long the protection from COVID-19 vaccination may last. As of February 2021, two other COVID vaccines, Astrazeneca and Novavax, were in Phase 3 clinical trials and on the way to FDA emergency approval (Centers for Disease Control and Prevention [CDC], 2021a)
Pfizer-BioNTech’s COVID-19 vaccine is an mRNA 2-shot immunization series, separated by 21 days, and approved for people 12 years and older. In people 16 years or older, the clinical trials demonstrated a 95% effectiveness in preventing laboratory confirmed COVID-19 after 2 doses (CDC, 2021b).
Moderna’s COVID-19 vaccine is also an mRNA 2-shot immunization series, separated by 28 days, and approved for people 18 years or older. In clinical trials, this vaccine was 94.1% effective at preventing laboratory-confirmed COVID-19 infection after 2 doses (CDC, 22021c).
Johnson & Johnson/Janssen’sCOVID-19 vaccine is a viral vector immunization that is approved for individuals 18 years or older and was 66.3% effective at preventing laboratory-confirmed COVID-19 infections in clinical trials, but still very effective in preventing severe disease, hospitalization, and death. Unique to this vaccine, the CDC has found “plausible causal relationship” with thrombosis with thrombocytopenia syndrome (TTS). This is a very rare complication with a rate of 7 per 1 million vaccinated women between 18 and 49 and even less in men of all ages or women over 50 years (CDC, 2021d).
Variants
Investigations continue on the vaccines’ efficacy with emerging variants. As of May 27, 2021, the CDC’s research demonstrated a large degree of protection from the vaccines from known variants (CDC, 2021e). Of note, prevention effectiveness may vary between different variants, and at the time of the CDC’s publication, the “Delta” variant (or SARS-CoV-2 B.1.617.2) was less active and prevalent in the U.S (CDC, 2021e). Today, early studies suggest the Delta variant is responsible for over 50% of cases – highest in locations with low vaccination rates (CDC, 2021f). Nevertheless, the vaccines are still efficacious in preventing severe disease, hospitalization, and death from the Delta variant (CDC, 2021f).
Clinical Considerations
The vaccinations are not interchangeable and patients are advised to continue with the immunization manufacturer of their first dose. The 2nd dose may be administered up to 4 days earlier than the recommended date and as late as 6 weeks after the first dose with sustained effectiveness. Other vaccinations are safe to be administered the same day with any of the COVID-19 vaccines and may be administered without regard to timing. Persons with an active COVID-19 infection should complete the isolation criteria and be completely healed prior to receiving their first vaccination, but should still be encouraged to complete the immunization schedule as soon as possible. If monoclonal antibodies or convalescent plasma were given for treatment for the virus, patients should wait 90 days prior to getting the vaccine. Full vaccine benefits are acquired 2 weeks after the last vaccine of each series, and people are then considered “fully vaccinated” (CDC, 2021g).
To learn more about COVID-19 and earn CE credits, visit the NPACE Learning Center On-Demand catalog and search on Infectious Disease or COVID: https://learn.npace.org/on-demand
The Latest on COVID-19 Vaccinations
Devin Pinaroc, FNP-C
TakeAways
Three different COVID-19 vaccines – Pfizer-BioNTech, Moderna, and Johnson & Johnson/Janssen – have been authorized for emergency FDA approval and are currently in circulation throughout the world. All are safe, effective, and reduce the risk of severe illness and death from COVID-19. The Centers for Disease Control (CDC) does not promote one over another. Clinical trials and real-world studies confirm these vaccinations are highly effective against COVID-19 asymptomatic and symptomatic cases, severe disease, and death from the COVID-19 virus. Vaccinated people who do become infected with the SARS-CoV-2 virus demonstrate a reduced viral load, suggesting associated transmission risk is substantially lower than unvaccinated people. Side effects can occur within 7 days after vaccine administration, but are mostly mild and temporary. There is still more to learn regarding vaccinations and high-risk individuals (such as those who are immunocompromised), as well as how long the protection from COVID-19 vaccination may last. As of February 2021, two other COVID vaccines, Astrazeneca and Novavax, were in Phase 3 clinical trials and on the way to FDA emergency approval (Centers for Disease Control and Prevention [CDC], 2021a)
Pfizer-BioNTech’s COVID-19 vaccine is an mRNA 2-shot immunization series, separated by 21 days, and approved for people 12 years and older. In people 16 years or older, the clinical trials demonstrated a 95% effectiveness in preventing laboratory confirmed COVID-19 after 2 doses (CDC, 2021b).
Moderna’s COVID-19 vaccine is also an mRNA 2-shot immunization series, separated by 28 days, and approved for people 18 years or older. In clinical trials, this vaccine was 94.1% effective at preventing laboratory-confirmed COVID-19 infection after 2 doses (CDC, 22021c).
Johnson & Johnson/Janssen’s COVID-19 vaccine is a viral vector immunization that is approved for individuals 18 years or older and was 66.3% effective at preventing laboratory-confirmed COVID-19 infections in clinical trials, but still very effective in preventing severe disease, hospitalization, and death. Unique to this vaccine, the CDC has found “plausible causal relationship” with thrombosis with thrombocytopenia syndrome (TTS). This is a very rare complication with a rate of 7 per 1 million vaccinated women between 18 and 49 and even less in men of all ages or women over 50 years (CDC, 2021d).
Variants
Investigations continue on the vaccines’ efficacy with emerging variants. As of May 27, 2021, the CDC’s research demonstrated a large degree of protection from the vaccines from known variants (CDC, 2021e). Of note, prevention effectiveness may vary between different variants, and at the time of the CDC’s publication, the “Delta” variant (or SARS-CoV-2 B.1.617.2) was less active and prevalent in the U.S (CDC, 2021e). Today, early studies suggest the Delta variant is responsible for over 50% of cases – highest in locations with low vaccination rates (CDC, 2021f). Nevertheless, the vaccines are still efficacious in preventing severe disease, hospitalization, and death from the Delta variant (CDC, 2021f).
Clinical Considerations
The vaccinations are not interchangeable and patients are advised to continue with the immunization manufacturer of their first dose. The 2nd dose may be administered up to 4 days earlier than the recommended date and as late as 6 weeks after the first dose with sustained effectiveness. Other vaccinations are safe to be administered the same day with any of the COVID-19 vaccines and may be administered without regard to timing. Persons with an active COVID-19 infection should complete the isolation criteria and be completely healed prior to receiving their first vaccination, but should still be encouraged to complete the immunization schedule as soon as possible. If monoclonal antibodies or convalescent plasma were given for treatment for the virus, patients should wait 90 days prior to getting the vaccine. Full vaccine benefits are acquired 2 weeks after the last vaccine of each series, and people are then considered “fully vaccinated” (CDC, 2021g).
Want to know more…
CDC’s COVID-19 Vaccine Effectiveness Research
Talking to Recipients about COVID-19 Vaccination
CDC COVID-19 Vaccine FAQs for Healthcare Professionals
Earn CE credits
To learn more about COVID-19 and earn CE credits, visit the NPACE Learning Center On-Demand catalog and search on Infectious Disease or COVID: https://learn.npace.org/on-demand
References
Centers for Disease Control and Prevention. (2021a, May 27). Different COVID-19 Vaccines. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines.html.
Centers for Disease Control and Prevention. (2021b, June 24). Pfizer-BioNTech COVID-19 Vaccine Overview and Safety. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/Pfizer-BioNTech.html.
Centers for Disease Control and Prevention. (2021c, June 11). Moderna COVID-19 Vaccine Overview and Safety. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/Moderna.html
Centers for Disease Control and Prevention. (2021d, June 23). Johnson & Johnson’s Janssen COVID-19 Vaccine Overview and Safety. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/janssen.html.
Centers for Disease Control and Prevention. (2021e, May 27). Science Brief: Background Rationale and Evidence for Public Health Recommendations for Fully Vaccinated People. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/fully-vaccinated-people.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fmore%2Ffully-vaccinated-people.html.
Centers for Disease Control and Prevention. (2021f, July). COVID Data Tracker Weekly Review. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html. Retrieved on July 14, 2021.
Centers for Disease Control and Prevention. (2021g, July 2 ). Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fvaccines%2Fcovid-19%2Finfo-by-product%2Fclinical-considerations.html#Administration
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