The Differences Between the Vaccines Matter

[Celerity]

Yes, all of the COVID-19 vaccines are very good. No, they’re not all the same.

https://www.theatlantic.com/health/archive/2021/03/pfizer-moderna-and-johnson-johnson-vaccines-compared/618226/



Public-health officials are enthusiastic about the new, single-shot COVID-19 vaccine from Johnson & Johnson, despite its having a somewhat lower efficacy at preventing symptomatic illness than other available options. Although clinical-trial data peg that rate at 72 percent in the United States, compared with 94 and 95 percent for the Moderna and Pfizer-BioNTech vaccines, many experts say we shouldn’t fixate on those numbers. Much more germane, they say, is the fact that the Johnson & Johnson shot, like the other two, is essentially perfect when it comes to preventing the gravest outcomes. “I’m super-pumped about this,” Virginia’s vaccine coordinator told The New York Times last weekend. “A hundred percent efficacy against deaths and hospitalizations? That’s all I need to hear.”

The same glowing message—that the COVID-19 vaccines are all equivalent, at least where it really counts—has been getting public-health officials and pundits super-pumped for weeks now. Its potential value for promoting vaccination couldn’t be more clear: We’ll all be better off, and this nightmare will be over sooner, if people know that the best vaccine of all is whichever one they can get the soonest. With that in mind, Vox has urged its readers to attend to “the most important vaccine statistic”—the fact that “there have been zero cases of hospitalization or death in clinical trials for all of these vaccines.” The physician and CNN medical analyst Leana Wen also made a point of noting that “all of the vaccines are essentially a hundred percent” in this regard. And half a dozen former members of President Joe Biden’s COVID-19 Advisory Board wrote in USA Today, “Varying ‘effectiveness’ rates miss the most important point: The vaccines were all 100% effective in the vaccine trials in stopping hospitalizations and death.”

There’s a problem here. It’s certainly true that all three of the FDA-authorized vaccines are very good—amazing, even—at protecting people’s health. No one should refrain from seeking vaccination on the theory that any might be second-rate. But it’s also true that the COVID-19 vaccines aren’t all the same: Some are more effective than others at preventing illness, for example; some cause fewer adverse reactions; some are more convenient; some were made using more familiar methods and technologies. As for the claim that the vaccines have proved perfectly and equally effective at preventing hospitalization and death? It’s just not right. These differences among the options could matter quite a bit, in different ways to different people, and they should not be minimized or covered over. Especially not now: Vaccine supplies in the U.S. will soon surpass demand, even as more contagious viral variants spread throughout the country. In the meantime, governors are revoking their rules on face masks, or taking other steps to loosen their restrictions. It’s tempting to believe that a simple, decisive message—even one that verges on hype—is what’s most needed at this crucial moment. But if the message could be wrong, that has consequences.

The idea that all of the vaccines are pretty much the same, in that they’re perfect at preventing COVID-19 hospitalizations and death, got its legs on social media. The USA Today op-ed by the former members of the Biden team illustrated this by linking to a data table found on Twitter. Created by the infectious-disease doctor Monica Gandhi, it showed a variety of trial results for six different vaccines. One column was rendered in canary yellow—“Protection from hospitalizations/death”—and every cell read “100%.” A similar table, tweeted out a few days earlier by the dean of Brown University’s School of Public Health, Ashish Jha, conveyed the same idea through a grid of zeros—as in, zero people hospitalized, zero people dead. The prominent physician and researcher Eric Topol followed with his own clinical-trial data summary featuring a column of 100 percents. “That is impressive!” he wrote across the top. All told, their posts would be retweeted about 15,000 times. The data were indeed suggestive of an encouraging idea. Based on the numbers so far, we can expect the vaccines to provide extremely high levels of protection against the most dire outcomes. Still, we don’t know how high—and it’s clear they won’t uniformly cause hospitalizations and deaths from COVID-19 to disappear in vaccinated people.

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