By - MistWeaver80
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Extracted from the paper text:
fully vaxxed breakthrough rate: Pfizer 0.28%, Moderna 0.16%
rate of hospitalization after breakthrough: Pfizer 13.3%, Moderna 12.7%
mortality rate: not given aside from "no significant difference"
**edit:** My own math:
derived fully vaxxed hospitalization rate: Pfizer 0.037%, Moderna 0.020%
or: ~~Pfizer 3.7 per 100,000, Moderna 2.0 per 100,000~~
Pfizer 3.7 per 10,000, Moderna 2.0 per 10,000
Compared to the difference between mRNA vaccines and antigen vaccines generally, this doesn't seem very significant.
This is important! It's not that it isn't significant scientifically and should inform vaccine production decisions in the future, but for the average person it's important for them to know they are still extremely well protected if they got Pfizer.
Unlike what the news article headline does to most readers.
Yeah even OP headline was bad
Article that he posted has a way better one
>COVID-19: Moderna vaccine may reduce infection risk more than Pfizer
News article would be, "People who received Pfizer vaccine X times more likely to die than those that got Moderna"
Antivaxxers: "see it says likely to die if you takr the vaccine!"
Sensationalism gets clicks
Well thats frustratingly already outdated then unfortunately, is there an already known reason to think it would be different for omicron? Obviously because of unknown unknowns we need more data, but I'm trying to work out how optimistic to be.
Yes, because many vaccinated and boosted people are getting omicron. The break through infection rate is much higher than delta, so the breakthrough hospitalization and mortality rates are far more important indicators.
Everyone in my circle of friends is fully vaccinated and boosted... I'm just getting over COVID and I'm the last one to get it. Most likely omicron as it's the dominant variant in my area. None of us were hospitalized but it did knock each of us down for a few days. It looks like I'll have a bit of a cough afterwards. I definitely credit the vaccine with making it this mild. The few people I know who have had it that weren't vaccinated were knocked flat for weeks.
It's all anecdotal, but I'm sure the vaccine helped.
It's been going around everywhere around me. Everyone i personally know who's had it recently probably had omicron and all were vaccinated. My wife and I came down with it within a day of each other and it lasted about 2 weeks. The worst symptoms were about 2-4 days. Day 2 and 3 were my worst then just cold symptoms- head congestion and mucus, weak and tired, had a cough near the end for about 3-4 days.
All in all, not great or enjoyable but I'm thankful I had a vaccine as I know our hospitals are full right now with it and nearly every person- like 99.9% - hospitalized with it in our area right now was unvaccinated based on last stats.
It’s also important to note that Moderna increases heart issues particularly for men under 30. While it’s still incredibly rare it’s important to note I think
Just a reminder that significance is not equal to effect size, but a measure of certainty that the two numbers represent different distributions.
That being said I would also disagree than nearly double the breakthrough rate isn’t a large effect size.
This study isn’t comparing to non-vaxxed, so implicitly making this connection isn’t really relevant.
I came here to find this response. Significance is only part of the equation: effect size matters, especially with huge sample sizes.
This is good to know, especially since Pfizer is the only vaccine available in my local area in Florida. Moderna was - and is - rare and hard-to-get, which got worse after people realized it was "more effective" (i.e. higher demand), so my mom and I ended up getting Pfizer jabs instead.
I think the data shows that it's better to have *a* vaccine, even if it's Pfizer, than no vaccine at all.
>even if it's Pfizer
I think this is vastly overstated, and the research bears this out. As another commenter noted, from a pharmacodynamic and epidemiological point of view, this is interesting data, but from a consumer point of view, Pfizer isn't any different from Moderna.
The big difference is between mRNA and antigen vaccines such as J & J, which isn't given in these data.
J&J was the only option in my area for a long while, so it's aggravating that not only did get what appears to be the weakest vax in the trio, I can't find data to figure out how much worse it is.
I did get boosted with Pfizer, so I'm rocking that cross-vax bonus.
Actually I remember me waiting for those researches examining cross-vaccine possible benefits, wonder if now there are any high quality studies on the matter..
Do you know where I can find that data / those studies? I'm struggling to find it myself and just assumed they were equally effective
Good question, I tried to find something definitive myself and found only some small data sets, nothing as huge as what this study looked at. It looked like the breakthrough rate for J & J might be about twice that of Pfizer, maybe a little less.
That's true of nearly everything. Good doctors will tell you the best treatment is "the one you're going to use".
As an example, spray sunblock performs worse that PROPERLY APPLIED rub on sunblock. And for maximum efficacy you need to do two coats (to catch missed spaces) and rub in the spray on sunblock too. However, for a lot of people the choice is spray sunblock one coat or nothing. So dermatologists push the spray sunblock to people.
This is the same reasoning with masks. A properly fitted N95 gives the best protection but any mask covering the nose and mouth gives protection to some degree, just not as good. So if you harp on N95 or properly fitted not made for kids, it becomes N95 for adults or nothing, instead of a mask worn by everyone who can wear a mask getting some percentage of protection.
When I got vaccinated in spring 2021 in Alberta, we actually had problems with people refusing to be vaccinated if they found out it was Moderna instead of Pfizer. Because Pfizer was approved first, everyone wanted it. They had to mention that you should take ANY vaccine that is available when your appointment occurs.
I believe the earliest studies had Pfizer performing better than Moderna. However, Pfizer was earlier and it seems it was easier for Pfizer to score better because of it. Because of the different time periods, people shouldn't have directly compared the two then.
Moderna is a larger dose, that attributed to better marginal results over time. If you got an equal dose of Pfizer you would get a relatively similar looking result.
In practicality, they're very similar regardless of how they were applied; the end result is heavily protected person. The biggest margins of error are always on a per patient status, as no two people will be infected or have an immune response the same way.
What does fully vaxxed breakthrough rate mean exactly? Whether they got Covid in a specific time frame? As this number seems so ridiculously low, because I know so so many people that got their booster and weeks later contracted covid. It just does not seem to add up to me. Thanks in advance!
Good question, in the study they say:
>A breakthrough case is when the disease develops in someone who has been fully vaccinated against it.
Let's assume that means that the person has received 2 doses, and then later got a booster once it was recommended.
Keep in mind that with epidemiology the relationship between the overall numbers and anecdotal experience is likely to vary widely. Vaccine or not, your personal chance of catching a disease is always going to be greater if you're in unprotected contact with lots of sick, contagious people. That's related to the concept of "viral load."
And for people who aren't in that kind of environment, they may not see any cases develop at all. Not even 0.28%.
It's significant, it's just a small effect size.
Significant means something different to the statistically literate and the general population.
You're both right.
Statistical significance versus clinical significance.
Didn’t the moderna vaccine have 3x the dose of Pfizer? I read somewhere that Pfizer kept the dosage lower to minimize side effects for a more rapid approval process. It makes sense that moderna would work better.
Yes Moderna is 100ug for both doses and a 50ug booster while Pfizer is a 30ug for both doses and 30ug booster
Here's a μ if you need it.
Save that μ for later, thanks.
win key + ;
symbols tab, language symbols tab (last tab), last symbol in the third row.
Pfizer took the minimum effective dose methodology.
Moderna took the maximum tolerated dose methodology.
As a person who got 3 jabs of Moderna I can vouch for them nailing the maximum tolerated dosage.
I also got three Moderna. #1 nothing. #2 Felt like a dump truck fell upon my person for about 4 days. #3 Nothing.
Same here, but the truck only visited me for one day.
2 Pfizer and a moderna booster. The 2 Pfizer all I had was a bruised injection site. The moderna booster shot recently had me with a very mild fever and some occasional chills the night of and the following day.
I did have 1 strange side effect from the moderna booster that I haven't heard others mention and that is painful swelling near but below the armpit. My best guess is a case of swollen lymph nodes but I just found it surprising and alarming at first honestly. I wonder if anyone else has experienced this particular side effect?
My armpit was super swollen for a couple days from my booster shot.
My wife had similar lymph node swelling. It was odd but went away after a week or so. Not uncommon side effect from what we researched.
I got Pfizer Pfizer Moderna and 3 times nothing, not a single thing. Hope it worked.
I had 3* moderna.
2- 1 whole day feeling crap
3- caught covid at the same time so impossible to tell
Oh so the moderna booster was more? I thought Pfizer would have had more, since that initial 2 doses of pfizer were less than the 2 doses of moderna
It's .25 for Moderna booster and .3 for Pfizer booster. Pfizer booster is the same dose as the initial two doses.
Pfizer also has to be reconstituted in the vial (we inject normal saline into the vial and mix it up a bit), but they're in the process of rolling out a version that we don't need to reconstitute.
Source: I vaccinate.
There is no Moderna for kids in the US.
Yes I was confused where they were getting 0.25 for Moderna but they are referencing mL instead of mRNA content (which was the point of this discussion, comparing the mRNA content)
Edit: mods removed my higher level comment for calling out someone not knowing the difference between volume and active ingredient.
For anyone reading this, Moderna's booster is 50 micrograms / 0.25ml. Pfizer's booster is 30 micrograms / 0.30ml.
They're nearly the exact same vaccine. They even buy the precursors from the same company. This was part of the strategy for figuring out the vaccine so quickly. Moderna and Pfizer worked together to Gary their schedules to see which worked better. When they both worked very well they just said "give them to everybody".
Naproxen is dosed that high because it binds more tightly to human serum albumin than ibuprofen. Naproxen that’s bound to albumin doesn’t function until it is released from albumin. Albumin bound drug acts like a reservoir to slowly release free drug. It’s why you don’t have to take naproxen as frequently as ibuprofen. A natural slow release mechanism.
Yes, as the only thing that differs beyond the dose is the lipid used in them, but they are close. The other difference that might affect efficacy is the time between doses — 3 vs 4 weeks.
Pharmacokinetics is complicated, Moderna use a different way of delivery the mRNA in the cells than Pfizer.
It is absolutely possible, and even probable if you ask me, that the way Moderna use is just more efficient in delivering intact mRNA to the cells.
There isn't necessarily a linear connection between the quantity of antigen exposition and immune response.
During the Astrazenca trial they basically randomly discovered that having a longer time frame between the first and the second dose produced way better result than the standard "3 weeks".
> During the Astrazenca trial they basically randomly discovered that having a longer time frame between the first and the second dose produced way better result than the standard "3 weeks".
Isn't this the case with most vaccinations? more time between gives more time for the body to build up the response. If I recall the 3 weeks interval was to get them into approval faster than using the typical longer interval between first and second doses for a vaccine.
British Columbia, Canada did 8 weeks between first and second shots of the vaccines in order to get more single vaccinations into more folks faster than with a 3 week interval plus known science around vaccinations supported a longer interval between doses
> British Columbia, Canada did 8 weeks between first and second shots of the vaccines in order to get more single vaccinations into more folks faster than with a 3 week interval plus known science around vaccinations supported a longer interval between doses
But this was likely because of supply and logistical issues paired with public health implications. It may have made sense to get more people 50-80% efficacy in a time when we were supply limited.
Was unaware of that. I did read an article about a study that said people who had Moderna vaccines also tested higher for antibody levels than that of Pfizer. I just assumed it was because it was a larger dose.
Thanks for throwing down some knowledge.
So I spent some time digging into papers on the vaccines before deciding I was comfortable getting them. The delivery mechanism -- nanolipid particle or NLP -- used in the Pfizer vaccine was one not designed with this vaccine in mind as it was from a previous product of theirs and was orginally designed to optimize delivery to the liver. The NLP used to deliver the Moderna vaccine was specifically optimized to deliver it intramuscularly (i.e. at the injection site). My understanding is that successful intramuscular delivery is the accepted best practice for triggering the desired immune response for most if not all vaccines, and certainly this is the case for both Pfizer and Moderna. I suspect this could play a large role in why Moderna is coming out on top
Wait, you did your own research, but instead of watching YouTube you read peer reviewed scientific research papers?
Yeah, that didn't follow the course I expected for an "I did my research" post.
He had us in the first half, not gonna lie.
I did the same thing- read every paper and talked to everyone I know with a background in medicine to discuss the papers and came to the same conclusion you did. So many people were worried about the fact that these vaccines used mRNA but the LNPs were the real breakthrough since previous efforts had been ineffective or had the potential to cause toxicity.
All in all I was really impressed with the LNP research Moderna did for this vaccine and decided that if I had the choice- that was the one I wanted to get. In the end the Moderna vaccine was first one available to me and almost a year later I’m really glad that was the one I got.
I read an article a long time ago, I think pre eua for either, that Pfizer tried to find the lowest dose of their vaccine to cause a robust immune response where as moderna tried to find the highest dose of their vaccine that didn’t cause severe side effects…so if that’s true, it would make sense that moderna has worse/more common side effects and is more effective, but I read it way too long ago to refind it now.
I heard something like this too, but I can’t find a proper source for this. Do you remember where you read it?
Got Covid November 2020, got the Moderna vaccine April/may 2021. The first dose of Moderna wrecked me more than Covid ever did.
I have also read an article that claimed evidence of people who previously had covid were experiencing more severe side effects from the vaccines compared to people who hadn’t yet contracted it.
Is an all-Pfizer boosted person at the same level as an all-Moderna boosted person?
Doubt it. The Moderna doses (100 ug for primary two doses which is 3.3x the Pfizer dose, 50 ug for booster which is 1.6x the Pfizer dose) are all obviously larger than the Pfizer doses (30 ug each for the primary doses and booster).
There’s already data out that [combining 1 dose of Pfizer with 1 dose of Moderna in the primary vaccination sequence produces better immune response than 2 doses of Pfizer](https://www.reuters.com/business/healthcare-pharmaceuticals/mixing-pfizer-astraz-covid-19-shots-with-moderna-gives-better-immune-response-uk-2021-12-06/) and comparing the just the primary vaccination sequence [Moderna’s protection against hospitalization stayed around ~91% after 4 months while Pfizer’s dropped to 77%](https://www.yalemedicine.org/news/covid-19-vaccine-comparison). My guess is we’ll see a similar trend with all-Moderna boosted vs all-Pfizer boosted.
OK, then. Moderna for Shot 4 / Booster 2, it is!
You’re still very well protected with Pfizer!
This Moderna Master Race is making me feel inferior now.
I've heard their antibodies are bigger and longer!
I got 2 Pfizer’s and then a Moderna booster. I didn’t feel great for about 1.5 days after the Pfizer shots. Moderna it was about 4 days and I had weird additional symptoms on top of feeling like I had the flu like terrible vertigo and numb lips. Every time I see a post like this, I’m grateful that I got that Moderna booster since I’m high risk… but I’m hesitant to get it again.
I had the same cocktail as you but the booster had 0 side effects other than feeling slightly more tired/headachy than usual the next night. Funny how it affects people so differently.
Doesn't matter dose amount. The drug activity is still different. You can have one drug with 1E5 vg/mL and one drug with like 1E15 vg/mL and both can be equally effective because of how they work. Same thing with say aspirin dose vs acetaminophen vs ibuprofen vs naproxen.
Doesn't mention if data is age adjusted. Older people tended to get Pfizer since it was available first and older people were authorized first.
I'd like to see a breakdown of demographics too and health conditions, but this would be a small subset from organizations using comprehensive PHRs. Might take a while for that data, and confounded by folks getting boosters from the other provider (ie Moderna to Pfizer or vice versa).
>Dr. Xu noted, “We compared recipients of these two vaccines while accounting for patient risk factors, different approval time, and varying time from vaccination.”
It looks like they controlled for patient-level factors like age.
My concern is that the vaccines might have been administered at different rates in different places. Since this study only looked at November of 2021, it's possible that the effect they found is actually a result of COVID being more prevalent in the areas that got Pfizer leading to greater exposure. I'd be more confident if they'd also included county or state-level controls.
Older adults who received their vaccine in early 2021 would have had both vaccines available to them. Both Moderna and Pfizer were available by mid December 2020 - Moderna was approved only a week after Pfizer. The only people who are likely to be affected by Pfizer being available earlier are healthcare workers and people in nursing homes.
I thought there were some early supply issues too, not just regulatory, so that a large % of first-month shots in arms were Pfizer. Certainly in the UK they gave more Pfizer than Moderna for a sustained period of time, skewing towards older populations.
As someone else has pointed out, the researchers controlled for age so it is unlikely that age is the explanatory factor here.
So how do I fair being double Pfizer and booster Moderna?
Probably better than people who didn't mix according to Israel
Any Pfizer-Pfizer Moderna bros in the houseee!!!!????
I am! I purposely did it that way because I wanted to mix it up, Incase one was different it would give my immune system two slightly different reactions.
I’m planning on getting Moderna next. I had Pfizer for my first two. I feel like a trainer, “gotta catch ‘em all!”
Same here. Did the booster kick your ass too? My boyfriend and I are both healthy and in our 20s - we felt like crap for 3 days. Absolutely worth it! Just wasn’t expecting that level of a difference from the Pfizer second dose, which was one evening of aches.
My 2nd Pfizer dose was much worse than my Moderna booster
I got double Moderna with that Pfizer chaser.
I've received three doses of the Moderna vaccine, and I've now ruled out any potential lovers that may have been tainted with a lesser inoculation. Together, my future-husband and I shall continue the Moderna master race.
Moderna Master Race. Think I found my new band name.
CAPITAL_CUNT and the Moderna Master Race. I'm definitely going to that concert.
I also had two Pfizer shots and a Moderna booster. My kid caught Covid (got 2 Pfizer shots but wasn’t old enough for a booster). Even though I was taking care of her (I masked when around her) and had been in close contact before she got symptoms I never got it. She had symptoms for about 8-9 days, but I tested negative (PCR test) on day 9, and never had symptoms. Same with my husband who had the same vaccines that I did.
I did the same and I’ve wondered if it would be more immunity than pfizer booster since the moderna booster was a half dose of the original 2 shots.
Our Swiss cheese is aligned. We fit together like two puzzle pieces. I had shot 1-2 moderna, pfizer booster.
Edit: omicron found a way through the holes. Covid+, just fatigue and nausea.
> Our Swiss cheese is aligned
Does it get any better than that?
I am 30 with no comorbidities and double vaxxed and boosted and got Covid. I felt about the same as I did when I had pneumonia a few years prior.
Hope you’re feeling better 🍀
Thanks! I am. Only lingering effect is fatigue but I am not sure if that is because I had Covid or because I did nothing for 10 days straight.
And what about us, monsters, with two astrazeneca and one moderna?
Ye same, nowadays people ask me if I’m boosted and I tell them yes.
They get really confused tho when I tell them I was vaxxed twice and I’m boosted.
Johnson, Pfizer and then I have corona right now. I just need to get moderna and then my gauntlet will be complete.
I've got a proper cocktail. Janssen + moderna and then 5 months later, the Pfizer booster.
We're likely doing better than those who had three shots of the same vaccine. As /u/Hughjarse noted elsewhere in this thread:
> Its best to get different vaccines. This graph is from research done in Australia, only refers to chance of death though:
> Australian vaccines used were Astrazeneca, Pfizer and Moderna. You can clearly see the greatest benefit comes from mixing your shots.
I'm in this boat having had my moderna booster in December.
All I can say personally is that after sharing a small home with someone that is on day 5 of symptoms having tested positive 3 days ago. I am still negative according to a PCR and two RAT tests later and having done all I could to avoid covid for the last two years I feel like I am currently dancing with the devil but quietly confident.
Got the full Moderna and booster. Currently positive for Covid nine days after testing positive initially cause that five day quarantine is horseshit, and just have a slight itch in my throat and very mild cough. Glad I got Moderna.
I’m day 9 positive after 3 full Moderna’s. I have a headache and fatigue like a mother fucker.
Me too. Plus the dizziness and brain fog.
I got all 3 Moderna, but I also have 2 kids under 2yo, so I have no idea if I have or had covid because a headache and fatigue are just my norm.
I was double vaxxed Pfizer and Moderna boosted and contracted Covid in early January. My first symptom was a sore throat and I felt way worse than I expected given my age and vaccination status.
Starting have some more lower back pain again and then slightly feverish tonight. Symptoms just keep going and coming back again. It's really annoying.
Care to share? With my a priori risk I feel like I’m in a similar boat as you
Got first two with Moderna, Pfizer booster. Currently have a mild case of Covid.
That's my anecdote for today.
That was me two weeks ago. Double Moderna and Pfizer booster. Caught it but it was SUPER mild. Less than my usual colds mild. The only major difference at this point is I’m getting out of breath super easily now, which has never happened with colds or flus.
And everyone was clowning me for getting Moderna over Pfizer... suck it.
Is this study outdated? I don't think this study takes omicron into account
I read in an above thread that it was done for delta, with plans to do similar research for omicron
it's really easy to be outdated with this kind of stuff - so it likely is a little bit.
The article says the data for this analysis was taken when Delta was the main variant and quotes the corresponding author of the study as saying they will conduct a similar research for the Omicron variant. While currently (and hopefully forever only) found in bats in South Africa, the NeoCov variant may be more lethal and more transmissible if it makes the leap to humans ([https://www.jpost.com/health-and-wellness/coronavirus/article-694885](https://www.jpost.com/health-and-wellness/coronavirus/article-694885)). I don't know, but if it can be that the effectiveness of for-human vaccines can be tested in bats against diseases, a similar study should be initiated asap on the NeoCov variant in bats.
Moderna all the way baby! But, they did kick my ass. I had Covid in November 2020, before vaccine. And the vaccine was mild compared to that hell.
How’s the booster though. Just was an article here earlier saying moderna even says there booster not as effective. Regardless got my 3/3 moderna today. Hope to not get knocked out
I got wrecked for the first moderna shots, but the booster didn't slow me down at all except for the massive pain at the injection site that last days. That sucked but the lady that stuck me apologized so maybe it was stabber error. It felt really awful getting that jab. And I usually can handle needles very well.
Hence my Moderna booster.
It’s also worth noting that for teenage boys and men in their early 20’s there is a roughly 3 times increased risk of myocarditis (heart inflammation) with the Moderna vaccine compared to Pfizer (although the risk of both is small).
All I know is the Moderna vaccine fucked me up every time. You know it's good when you got the night sweats.