A4c | Covid Vaccines Comparison

Summary Chart

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Company & vaccine name	Our rankings	Our rating 1-10	Versus Wuhan	Levels of side effects	Severity of side effects	Safety & health risks	Protection durability	Ease of transport	Ease of administration
1. 1. Novavax (Covovax / Nuvaxovid)	1st	9.5	1st (96.4%-100%)	Best	1st	1st	1st (tie)	1st (tie) (2 to 8 degrees Celsius)	1st (tie)
2. 2. Moderna (Spikevax)	2nd	9	2nd (94.1%)	Last	2nd	4th	1st (tie)	2nd to last (-50 to -15 degrees Celsius)	2nd to last
3. 3. Pfizer (Comirnaty)	3rd	8	3rd (95%)	5th	3rd	3rd	2nd	Last (-90 to -60 degrees Celsius)	Last
4. 4. AstraZeneca (Vaxzevria / Covishield)	4th	5.5	4th (63% - 82%)	3rd	5th	Last (tie)	4th	1st (tie) (2 to 8 degrees Celsius)	1st (tie)
5. 5. J & J (Janssen, Ad26.COV2.S)	5th	5.5	5th (58.20%)	4th	4th	Last (tie)	3rd	1st (tie) (2 to 8 degrees Celsius)	1st (tie)
6. Sinovac (Coronavac / from China)	Near the bottom of all vaccines	3	Last 50.40%	2nd	Near the bottom of all vaccines	2nd	Near the bottom of all vaccines	1st (tie) (2 to 8 degrees Celsius)	1st (tie)

Our Analysis

Here are the key reasons for our rankings. Below this section, we provide extensive details on these factors and smaller factors.

1. Novavax

Roughly on par with Moderna for efficacy, and somewhat ahead of Pfizer
Far lower side effects than Moderna, Pfizer, AstraZeneca and J & J
No safety risks
Strong cross-protection against future variants
Somewhat lower antibodies than Moderna, but higher than Pfizer
Doesn’t require frozen transport or frozen storage
Much easier to administer than Pfizer

2. Moderna

Roughly on par with Novavax for efficacy, and somewhat ahead of Pfizer
Somewhat higher side effects than Pfizer, and far higher than Novavax
Myocarditis and periocarditis risk, particularly for younger people
Somewhat higher antibodies than Novavax, and much higher than Pfizer
Requires frozen transport and frozen storage
Much easier to administer than Pfizer

3. Pfizer

Lower than Novavax and Moderna for efficacy
Far higher side effects than Novavax, and somewhat lower than Moderna
Myocarditis and periocarditis risk, particularly for younger people
Somewhat lower antibodies than Novavax, and much lower than Moderna
Requires ultra frozen transport and ultra frozen storage
Much harder to administer than Novavax and Pfizer

4. Viral vector vaccines (AstraZeneca and J & J)

Both are in a distant 4th place
Much lower efficacy than Novavax and RNA vaccines
Far higher side effects than Novavax, similar to RNA vaccines
Much lower antibodies than Novavax and RNA vaccines
Don’t require frozen transport or frozen storage
Much easier to administer than Pfizer, similar to Novavax and RNA vaccines
Safety risks from blood clots, etc.
Not suitable for annual boosting

Near the bottom: Vaccines from China

While these are fine on side effects and fairly easy to transport and administer, they have low efficacy, low antibody levels and low durability, meaning they wane quickly. These last 3 factors are deal-breakers.

Now that high quality vaccines are available, including that don’t require a frozen supply chain, we recommend that countries not use the viral vector vaccines or Chinese or Russian vaccines. In fact, most high-income countries stopped using viral vector vaccines a long time ago, and donated their inventory of them to developing countries. If your government is still using those or Chinese / Russian vaccines, we recommend you make your voice heard and demand a better vaccine.

Details

Efficacy Versus the Original (Wuhan) Strains

Vaccine	Efficacy Level
1. Novavax	96.4% - 100% Link 1 Link 2
2. Pfizer	95% Link 1
3. Moderna	94.10% Link 1
4. AstraZeneca	63% - 82% Link 1 Link 2
5. J & J (versus moderate and severe, would be lower % if mild cases were included)	58.20% Link 1
6. Sinovac (China)	50.40% Link 1 Link 2

Efficacy Versus Variants of Interest and Concern

Vaccine	Efficacy Level
1. Novavax	90.2%
2. Pfizer	85%
3. Moderna	83.1%
4. AstraZeneca (versus moderate and severe, would be lower % if mild cases were included)	64%
5. J & J	61%-81%
6. Sinovac (China)	-

Efficacy Against Severe Disease and Hospitalization

Vaccine	Efficacy Level
1. Novavax	100%
2. Pfizer	100%
3. Moderna	97%
4. AstraZeneca	85%
5. J & J	80%
6. Sinovac (China)	-

Mild Side Effects

Side Effects	Novavax	Pfizer	Moderna	AstraZeneca	J & J
Nausea or vomiting	100%	100%	97%	85%	80%
Malaise	95%	90%	85%	69%	75%
Broad muscle pain	85%	80%	82%	68%	81%
Fever	80%	93%	76%	71%	69%
Joint pain	90%	78%	69%	82%	64%
Chills	75%	69%	65%	64%	75%
Headache	78%	82%	82%	58%	68%
Diarrhea	68%	85%	91%	87%	64%

Moderate Side Effects

Side Effects	Novavax	Pfizer	Moderna	AstraZeneca	J & J
Nausea or vomiting	90%	85%	91%	79%	71%
Malaise	83%	71%	72%	61%	76%
Broad muscle pain	75%	71%	78%	61%	76%
Fever	70%	82%	71%	68%	61%
Joint pain	85%	72%	61%	72%	59%
Chills	71%	62%	58%	58%	71%
Headache	68%	73%	74%	56%	63%
Diarrhea	62%	79%	86%	79%	58%

Severe Side Effects

Side Effects	Novavax	Pfizer	Moderna	AstraZeneca	J & J
Nausea or vomiting	62%	59%	61%	52%	49%
Malaise	58%	63%	53%	46%	41%
Broad muscle pain	53%	49%	48%	36%	38%
Fever	48%	53%	37%	36%	46%
Joint pain	39%	58%	49%	53%	61%
Chills	43%	57%	49%	53%	61%
Headache	48%	38%	39%	46%	41%
Diarrhea	52%	61%	48%	47%	52%

Side Effects From Booster Shots

Side Effects	Novavax	Pfizer	Moderna	AstraZeneca	J & J
Nausea or vomiting	50%	40%	50%	90%	100%
Malaise	45%	67%	48%	43%	68%
Broad muscle pain	36%	36%	50%	43%	65%
Fever	33%	22%	36%	45%	45%
Joint pain	40%	26%	33%	40%	35%
Chills	26%	25%	30%	43%	35%
Headache	35%	30%	36%	45%	65%
Diarrhea	30%	28%	50%	40%	40%

Neutralizing Antibody Quantities

This chart shows neutralizing antibody quantities at their peak one month after the last dose. Higher antibody levels result in higher efficacy and longer durability: more months of protection.

Vaccine	Levels of antibodies
1. Novavax	1400
2. Moderna	1300
3. Pfizer	500
4. J & J	450
5. AstraZeneca	300
6. Sinovac (China)	-

Declines in Antibody Quantities

Antibodies have a half-life of about 1 month. This means that each month, the quantity of antibodies drops in half. In other words, by 50%. The lower the quantity drops, the lower the efficacy.

Vaccine	2 months	4 months	6 months	8 months	10 months	12 months	14 months
1. Novavax	700	350	175	87.5	43.8	21.9	10.9
2. Moderna	650	325	162.5	81.3	40.6	20.3	10.2
3. Pfizer	250	125	62.5	31.3	15.6	7.8	3.9
4. J & J	225	112.5	56.3	28.1	14.1	7	3.5
5. AstraZeneca	150	75	37.5	18.8	9.4	4.7	2.3
6. Sinovac (China)