September 11, 2024 – Social media platforms light up minutes after FDA announcement permit of the updated Novavax COVID-19 vaccine just before Labor Day weekend. It was the last three vaccines for 2024-2025 and the news was welcomed with joy by many.
“This is awesome!” one Reddit user exclaimed, while others posted “Yes!!” and “Bravo!” In All About Novavax, a non-public Facebook group with over 1,000 members, many reposted the FDA announcement and commenced sharing once they expect approval. Another group, which had submitted petitions to the FDA urging the agency to not delay Novavax's approval for this yr, posted “We did it!” and “Success!” after the announcement.
In terms of doses administered, Novavax lags far behind Moderna and Pfizer's COVID vaccines, coming in last place. Estimates vary, but as of August 10, greater than 400 million Pfizer doses, greater than 251 million Moderna doses and 83,047 Novavax doses have been administered within the U.S., in line with data scientist.
But for a lot of, Novavax is no 1 – the one COVID vaccine they’d consider. This enthusiasm for Novavax isn’t latest. As early as 2022 News reports described a type of Novavax fan club – a term that irritates some – and it still exists.
What is the explanation for this passionate support of Novavax? It is an advanced and private matter.
It is a “traditional” vaccine
Some say they like Novavax since it is a more traditional vaccine in comparison with Pfizer and Moderna's vaccines, that are made using messenger RNA technology, said Dr. William Schaffner, an infectious disease doctor at Vanderbilt University Medical Center in Nashville and spokesman for the Infectious Diseases Society of America.
Some persons are still skeptical about mRNA technology, he said, still viewing it as latest, regardless that “it's no longer new because we've already administered millions and millions of doses.”
Still, “Novavax is made in a much more traditional way, and that reassures those who are nervous about the mRNA vaccine,” Schaffner said. “It takes a protein part of the virus, combines it with an immune system stimulant, an adjuvant, and then it's injected and stimulates the immune system.” Flu vaccines are made in the identical way.
“The mRNA vaccine is indeed a blueprint [for the protein]which is then injected into the body; the body produces the protein and then the immune system responds to it.”
One of the advantages of mRNA vaccines over traditional vaccines is that they are easier and faster to produce, Schaffner said. This allows mRNA vaccines to be updated a little faster than traditional vaccines, allowing them to keep better pace with changing variants, he said.
The tradition appeals to Sam Biller, 58, of Tampa, Florida. He said he is choosing Novavax again this year after first getting a Johnson & Johnson vaccine and then a previous Novavax shot because he prefers what he calls Novavax's “proven technology.”
If the “traditional” aspect of the Novavax vaccine convinces people to get vaccinated, Schaffner is all for it, as interest in updated vaccines has waned recently. According to the CDC 22.9% of adults in the United States have received the updated COVID-19 vaccine in 2023–2024.
Plus: fewer side effects
Another major advantage of the Novavax vaccine is that it generally has fewer side effects in the short term, says Dr. Peter Chin-Hong, professor of medicine and infectious disease specialist at the University of California San Francisco School of Medicine.
“For short-term side effects such as fever, myalgia (muscle pain), headache, in the studies – [although] There are no direct comparisons – fewer participants in the Novavax trials reported this than those in the Pfizer or Moderna trials.”
Other studies have also shown that mRNA vaccines most reactive. Some Researchers compared people who received an mRNA vaccine as a first booster and either Novavax or an mRNA vaccine as a second booster. They found that the Novavax group had fewer side effects but higher infection rates. No differences in cellular immune responses were found between the two groups.
According to Chin-Hong, the immune system stimulant used in the Novavax vaccine explains why it causes fewer severe side effects compared to other “conventional” vaccines.
“With conventional vaccines, the adjuvant is what matters most,” he said.
Novavax’s adjuvant is known as Matrix-M and comes from Connections within the bark of a soapbark tree. Chin-Hong said Novavax's adjuvant is “not known to cause as many unwanted effects” as some others, such as the adjuvant in the shingles vaccine.
Judy, 74, a retiree from Northern Virginia who asked to use only her first name, had received seven mRNA vaccinations before switching to Novavax in May.
“The first six were Pfizer,” she said in an email. “Every single dose left me partially incapacitated for a number of days,” with fatigue, a sore arm, headache, body aches and malaise for two to three days. The seventh shot was Moderna, after her pharmacy ran out of Pfizer doses.
“Moderna really kicked my butt,” she said.
She was again prepared for side effects when she chose Novavax in May, but was surprised.
“I had a really limited response; I had a slight fever and a slight headache, but no sore arm. I went to bed sooner than usual and regardless that I used to be drained the following day, I got up, away from bed and prepared for my coffee,” she said.
Adam Van Bavel, 45, of Baltimore, said he suffers from long Covid and struggled with symptoms for two to three days after the mRNA vaccines, including high fever, chills, headache and a stuffy nose. The Novavax shot left pain only where the needle went in. He calls it an “easy decision.”
Each time he got the mRNA vaccine, “I used to be out of commission for a day,” recalled Paul Hennessy, 34, an entertainment project manager in Los Angeles. After switching to Novavax twice last year, he was fine the next day, he said.
Rare allergic reactions: PEG
Some people are at risk of a severe allergic reaction associated with the Pfizer or Moderna vaccines. Both mRNA COVID vaccines use polyethylene glycol (PEG) as a stabilizer. PEG is also found in foods, cosmetics, and other products. Severe allergic reactions to PEG are rare but do occur.
Although the cause of these reactions has been debated, according to some Research.
Still, Moderna and Pfizer are warning anyone who has had a severe allergic reaction to any ingredient in their COVID vaccines not to get vaccinated.
Vaccine Scorecards
There is a lively debate on social media about the “better” COVID vaccine for this year to prevent infection and fight the “right” variant.
In early June, the FDA advised vaccine manufacturers that this year's formula should include monovalent vaccines against JN.1. The agency then stated that the preferred JN.1 strain was the KP.2 strain.
This year's Novavax vaccine targets JN.1, the “parent strain” of the variants currently in circulation, according to the company, and “has demonstrated robust cross-reactivity with viruses of the JN.1 lineage, including KP.2.3, KP.3, KP.3.11 and LB.1.”
The updated mRNA vaccines from Moderna and Pfizer target the KP.2 strain.
“Antibody data show that the Novavax JN.1 spike vaccine and the Moderna/Pfizer KP.2 vaccine have comparable levels of virus neutralization of currently circulating variants,” said Matthew Frieman, PhD, professor of viral pathogen research at the University of Maryland School of Medicine in Baltimore. “There were no differences in clinical protection between the mRNA and protein vaccines, demonstrating that they’re all effective and protect against severe disease and hospitalization.”
Novavax advocates on a mission
Don Ford, a Los Angeles activist, has been advocating for Novavax for two years, organizing letter-writing campaigns and sending a petition urging the FDA and CDC to approve the Novavax vaccine for 2024-2025. Ford said he favors Novavax for himself and his family, which includes a cancer patient.
“We have been very aggressive,” he said of his efforts. He wrote to the FDA's Vaccines and Related Biological Products Advisory Committee (VRBPAC) requesting the opportunity to provide public oral comments if permitted.
After Novavax received approval, he added the headline “Success!” to the online materials.
Next: Finding the right shot
Soon after approval, those looking for a Novavax vaccine began posting on social media, asking where they could find it this year and offering tips. They know from experience that they often have to search for a long time to find the vaccine and that there is a lack of awareness about the vaccine.
Distribution, Schaffner reminds us, has nothing to do with the FDA or CDC, but solely with the company. According to Novavax, the vaccine will be available “in 1000’s of locations across the country, including retail stores, local grocery stores and independent pharmacies.”
Peter Liepmann, MD, 70, a family doctor in Pasadena, Calif., and his wife are insured by a health insurance company that doesn't stock Novavax, so they decided to pay for their preferred vaccine out of pocket last fall. And they had to look. “We had to go searching to search out a small, independent pharmacy that had it,” he said. “Most of the large chains said they’d it, but they didn't do it.”
After calling half a dozen places, he found it.