A different kind of COVID vaccine is available. Will it make a difference?

While the rollout of updated COVID-19 vaccines is off to a slow start in Georgia and across the country, another vaccine option is now available — one that is different from the vaccines widely used throughout the pandemic.

The U.S. Food and Drug Administration recently authorized an updated vaccine made by the company Novavax, which differs from the better-known vaccines by Pfizer and Moderna. Novavax is a protein-based vaccine made using a traditional vaccine technology, while the shots made by Pfizer and Moderna are both made with “messenger RNA” technology. The science has been around for decades, but the COVID vaccines became the first mRNA vaccines to be approved for use.

But while public health experts see an opening for a vaccine that uses an older technology for fighting viruses, demand for Novavax appears low and it remains a serious underdog among more popular options.

The mRNA in the vaccines is created in a laboratory and causes a recipient’s cells to make a protein that triggers an immune response. Novavax uses a protein — in this case, a harmless piece of the coronavirus’ spike protein — to train a person’s immune system to recognize and fight back against the real coronavirus. Novavax’s protein-based method has been used for decades in routine vaccinations such as the hepatitis B vaccine.

Novavax first gained approval for its vaccine earlier in the pandemic, but only after Pfizer and Moderna had gained approval and begun distributing shots. Novavax has always trailed well behind the larger makers and even now its updated booster is a distant third.

In Georgia, out of the 17.7 million COVID vaccine doses administered since early in the pandemic, only 3,906 were a Novavax vaccine. It’s a minuscule share of well under 1%, according to data obtained by the Georgia Department of Public Health.

“I think it’s always great to have additional options,” said Jodie Guest, senior vice chair of the Department of Epidemiology at Emory’s Rollins School of Public Health about Novavax, “But I think there’s a familiarity with Pfizer and Moderna, and for people who are most excited and most interested in getting this newest vaccine, those vaccines got there first.”

Even so, public health experts see the potential for the Novavax vaccine and say it deserves consideration. Dr. Jayne Morgan, executive director of health and community education at Piedmont Hospital, said this vaccine can appeal to people who don’t trust the mRNA vaccines or have a medical reason to not take them.

Novavax can work for people who had an allergic reaction or strong side effects with an mRNA vaccine, Morgan said. For those who took an original vaccine or booster from the other manufacturers, it’s fine to switch to Novavax.

Novavax went through the same intense safety testing process as any other vaccine, and it was found to be safe by the FDA.

Novavax appears to have about the same efficacy as other COVID vaccines. A study published in JAMA this month found that the Novavax booster was about 50% effective at preventing COVID symptoms and 31% effective at preventing infection, which is similar to the mRNA vaccines. While they may not prevent infection, all of the updated fall vaccines are doing a good job at preventing severe illness, hospitalization, and death, according to Guest and Morgan.

All three vaccines were reformulated earlier this year to fight the XBB.1.5 variant of the virus. While that’s no longer the dominant variant, preliminary research has shown that the vaccines still offer protection.

Dr. Eric Topol, a physician and scientist who directs the Scripps Research Translational Institute and is a prolific blogger on COVID research, wrote that was interested in getting an updated Novavax COVID vaccine. But with upcoming travel and questions about Novavax’s availability, he told Science, the peer-reviewed academic journal of the American Association for the Advancement of Science, that he decided to make an easier choice, getting a Pfizer booster at a grocery store. He said he still wonders how a dose of Novavax might have been different.

Three years since coronavirus arrived, it has become more complicated to measure the effectiveness of vaccines. The majority of people have been exposed, but in different ways and many have had various combinations of vaccinations. Trials to verify a vaccine’s effectiveness can take all of these things into account. But they would be based on circulating variants at the time, and by the time the study is completed, new variants are circulating. There are also no head-to-head studies comparing different vaccines.

It’s still early in the rollout of the updated vaccines, and issues with distribution and insurance coverage continue to arise.

Uptake of the new vaccines is well below what it was when the vaccines were tweaked last year and 17% of the U.S. population got it. In Georgia, it was only about 11%.

Since the newly updated vaccines were released in September, 293,247 doses of the updated COVID vaccine have been administered in Georgia, which covers about 3% of the population. Only 302 of the vaccine doses were Novavax, according to recent data from the Georgia Department of Public Health.

While Novavax said millions of doses of the updated COVID vaccine have been distributed in the U.S., finding one remains a challenge. Locations and availability listed on vaccines.gov isn’t always up to date. A Georgia Department of Public Health spokeswoman said the department has not yet ordered any doses of the updated Novavax vaccine for local health departments because there have been no requests for it.

Public health experts say it’s not that important which vaccine you get — but that you get an updated shot.

“Right now, is the perfect time to be doing it,” said Guest. “It does appear COVID infections are on their way down. We can hope they will stay this way, but this is a similar trend we’ve seen year after year: they do come down and then go back up later in the fall and beginning of winter.”

About the Novavax vaccine

The FDA approved the updated Novavax vaccine in October 2023 for ages 12 and older.

The Novavax vaccine is a traditional one compared to the other vaccines. Its technology has been used before in vaccines to prevent such conditions as shingles, human papillomavirus (HPV) and DTaP (diphtheria, tetanus and pertussis), among others.

Anyone 12 or older can get the updated Novavax vaccine. Anyone who has previously been vaccinated (with any COVID vaccine) may get one dose at least two months after the first dose. Those who have never been vaccinated should get two doses administered three weeks apart.

People who are immunocompromised may get an additional dose at least two months after their last dose of the updated vaccine.

Source: Yale Medicine