COVID-19

Is a booster dose the same with Moderna or Pfizer vaccine?

“Pfizer or Modern”? “Modern or Pfizer”? When you type the name of one of the two vaccines in a search engine, the name of the other appears in the process, a sign of the questions from the French at the time of the booster dose, who no longer know which serum to use. vote. “It can be Moderna or Pfizer, indiscriminately,” “it’s the same thing,” Health Minister Olivier Véran told franceinfo on Friday.

Less than ten days before school holidays, the rampant wave of the fifth coronavirus wave casts a gloomy shadow over the holidays. The head of government, Jean Castex, asked the French to limit their social interactions before Christmas, but the government is mainly focused on vaccination. And if you are preparing your imminent opening to children, for the moment, you especially want to put the package on the rollout of the booster dose in the general population. But before injecting into the arms, into the heart, the two vaccines do not inspire the same feelings. For those 18 and over (who do make a date), there is a rush to Pfizer, while Moderna is pretty shunned. So between the two messenger RNA (mRNA) sera, is it kif-kif bourricot?

Modern advantage for efficiency

In the context of an epidemic outbreak caused by the Delta variant, and while the Omicron variant has already been detected in at least 38 countries, some wonder if, among the two anti-Covid mRNA vaccines, one is more protective than the one. other. “These two vaccines are ‘twin sisters’, they are based on the same technology and have a comparable effectiveness, close to 95%,” says the Ministry of Health.

But according to the scientific literature, the advantage would be for Moderna at this point. “Several studies conducted under real-world use conditions tend to show slightly higher vaccine efficacy for Spikevax [Moderna] compared to Comirnaty [Pfizer-BioNTech], whose efficacy is already very good, which confirms the interest of Spikevax, particularly in people at severe risk of Covid-19 “, indicates the High Health Authority (HAS) in an opinion published on November 8.

An advantage that Moderna would also retain over time, thanks to an efficiency that would decline less rapidly over the months than its competitors. A study published in the journal Science on November 4 followed a sample of 780,000 US military veterans for six months. The observed results confirm that the Pfizer, Janssen and Moderna vaccines lose their effectiveness over time, but in different proportions. Six months after the second dose (or the Janssen dose), the Janssen, Pfizer, and Moderna vaccines showed 13.1%, 43.3%, and 58% protection against infection, respectively. And at the same time it offered a level of protection against serious forms and death of 73% for Janssen, 84.3% for Pfizer and 81.5% for Moderna.

Pfizer Advantage for French Membership

Despite these figures, Moderna arouses distrust and it is Pfizer that wins the support of the French. On reserve platforms, the timelines are not the same depending on whether you brand Moderna or Pfizer as a preference for your booster dose. If for the first, it is possible to find a schedule in Paris during the week, for the second, you have to be patient, with the first availability shown in 2022, sometimes not before April or May. In question, stocks: while 85% of the available Pfizer doses have already been injected, only 41% of the Moderna doses delivered to France have been administered.

Why such a gap? At the source of mistrust, the risks of myocarditis, an inflammation of the heart muscle, are increased with Moderna’s vaccine. EPI-PHARE, the scientific interest group led by the National Agency for Drug Safety (ANSM) and Cnam, has carried out a “new pharmacoepidemiology study to characterize the risk of myocarditis and pericarditis with mRNA vaccines in subjects aged 12 to 50 years in France “. And if this study, published in early October, “confirms the existence of a rare risk of myocarditis with an mRNA vaccine, particularly in young people aged 12 to 29 years, this risk is higher with the Spikevax vaccine” by Moderna, says the ANSM.

For this reason, the HAS recommends, in its opinion of November 8, “for the population under 30 years of age and when available, the use of the Comirnaty vaccine.” [Pfizer] either a first vaccination or a booster ”. Previously, on October 6, HAS launched the campaign for the third dose only with Pfizer, pending the opinion of the European Medicines Agency (EMA) on the use of Moderna as a booster dose.

A different dose

Another difference between the two serums: their dose. The Moderna is more dosed than its near twin Pfizer. If a dose of the former must be diluted with 0.9% sodium chloride before injection and contains 100 micrograms of antigens, a dose of the latter contains only 30 micrograms and is injected neat.

And when it comes to vaccinating the very young, the differences tip the balance in favor of Pfizer, the first EMA- and HAS-approved vaccine for ages 12-17 in France. It is even the only vaccine authorized a few days ago for the vaccination of children between 5 and 11 years old, which could begin in mid-December for 360,000 children “at risk” of developing severe forms of the virus. And “if possible at the end of the year” for the others, “on a voluntary basis,” announced Jean Castex, while the executive continues to wait for the “green lights” from the HAS and the National Advisory Committee on Ethics (CCNE). .

For this young audience, the dosage will not be the same. It will be “three times less than the dose used in adults”, with only “10 micrograms of antigens”, underlined in franceinfo Professor Daniel Floret, pediatrician and vice president of the technical committee of vaccinations of the HAS. The government has already organized the logistics, since “the first delivery of Pfizer vaccines with a dilution suitable for children will take place on December 13,” said Olivier Véran. To date, more than 12 million French people have already taken their booster dose, and Olivier Véran expects that “on December 30, more than 15 million French people will have had it.”

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