How Does Novavax Compare to Pfizer and Moderna Vaccines?

Santa Barbara Infectious Disease Expert Explains Difference Between Newest COVID Vaccine and mRNA Mainstays

Dr. Lynn Fitzgibbons describes the effect the BA.5 Omicron variant has had on Santa Barbara health and the recently approved Novavax vaccine. | Courtesy Cottage Health

It’s coronavirus Year Three, and as the BA.5 Omicron subvariant increases the rate of disease, medical technology is breaking through once again. On Tuesday, the Centers for Disease Control and Prevention (CDC) endorsed the Food and Drug Administration’s emergency approval of Novavax, a new COVID-19 vaccine that used a more old-fashioned method in its development, one that might be embraced by anyone leery of the Pfizer and Moderna mRNA vaccines. CDC Director Rochelle Walensky stated on Tuesday that the Novavax vaccine would become available in the coming weeks.

In an interview with the Santa Barbara Independent, Dr. Lynn Fitzgibbons, infectious disease expert at Cottage Health, explained the vaccines, their efficacy, and what to expect next in the incrementally evolving pandemic.

How is Novavax different from the mRNA vaccines?

Novavax vaccine works in a different way than the current vaccines. It uses the spike proteins themselves, in the form of nanoparticles, to trigger an immune response. It uses the spike proteins themselves so our body can recognize and fight the virus when we are exposed to it in the future.

It’s different from the Pfizer and Moderna vaccines, which use the new technology of mRNA to send a recipe of the spike protein into the body, a piece of its mRNA, and then rely on our own body to make the spike protein, and then train the immune system.

Novavax is a more traditional approach that has been used for long time for other infections, in Hepatitis B and shingles, for example.

We know there is a group of people who were less comfortable with adopting the new mRNA technology, given its relatively short tenure. We now have a whole population who have experience with the mRNA vaccines, but there’s a group of people who are eagerly waiting for this approval. There’s a lot of enthusiasm to have another option in the toolbox.

Novavax COVID-19 Vaccine | Credit: Novavax

Are we back to where we were before the COVID vaccines? Breakthrough infections are getting past the vaccines, yet they’ve given us such a sense of security that life has returned to a pre-pandemic normal: big crowds, no masks.

The virus continues to evolve, but thankfully, with vaccines, it’s causing fewer cases of severe disease. It is increasingly infectious, and we see it continue to cause missed days of work or summer camp, alterations to vacation plans.

When we’re talking about reinfection, I think our region has had a convergence of one of the Omicron subtypes followed by a second Omicron subtype. This has given us a nontraditional spike plateau all summer.

People who had one of the other Omicron subvariants in the last couple of months are still vulnerable to BA.5 [pronounced “B A dot 5”], which is the most common variant right now. It’s very infectious, and it’s accelerating week over week in our community. As in other communities, the BA.5 surge locally will peak and eventually have a downturn once the majority of people who are vulnerable, and would be affected, have been affected.

We think that in our region, BA.2.12.1 actually caused the majority of local spikes in April and May. Right as that started to decrease in June is when BA.5 was entering the scene. It picked up steam, and right now, it’s very likely BA.5 is three-quarters of the infections circulating in our community.

There’s a huge amount of infection in the community now, but I think everyone has to set their own level of risk tolerance: How worried are you about catching COVID? What are the implications for the next few days or next few weeks? These considerations factor into whether we wear a mask or are around a big crowd.

Hopefully, within about six to eight weeks, the amount of disease should be going down.

Are boosters effective?

We’re enjoying the effect of BA.5 causing a generally less severe surge, in part because so many in our community are vaccinated and boosted. We know the vaccines and boosters are not perfectly protective against catching COVID. But there’s a good amount of data that shows that boosting immune response with vaccines really does improve the body’s ability to fight BA.5.

As an infectious disease physician, when I look at the death rates through the Omicron wave and compare those among the unvaccinated to the fully vaccinated with or without a booster, there is a clear mortality or death risk that’s higher in those who are unvaccinated than for anyone else who is vaccinated, unfortunately.

For this reason, I continue to strongly recommend a booster or a second booster to my patients, family, and friends, especially if they are at a moderate to high risk of severe disease. It’s a top priority.

Novavax announced it’s working on a vaccine against one of the earlier Omicron strains, and Pfizer and Moderna are also targeting Omicron in new vaccines.

In the licensing data for Novavax, the clinical trials were actually from before Omicron. There’s significant interest in adjusting the formulation to include more specific Omicron proteins. The mRNA vaccine can be altered quickly, and both Pfizer and Moderna have confirmed an Omicron-specific vaccine is well underway, perhaps as early as the fall.

We’re doing everything we can to be prepared for a fall vaccination campaign before the winter surge. The booster we will likely be offered in the fall will most likely be an Omicron-specific vaccine. It’s likely to be a slightly different and more focused vaccine.

Whether or not you get a booster this summer, I would encourage us all to listen carefully for new fall vaccine recommendations and to get the new Omicron vaccine if eligible and recommended.

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