Covid 19 Vaccine Comparison


Pfizer BioNtech


Johnson & Johnson

Oxford – Astra Zenca



On December 11, 2020, this became the first COVID-19 vaccine to receive an FDA EUA, after the company reported positive clinical trial data, which included news that the vaccine was up to 95% more effective than a placebo at preventing symptomatic disease. But the Pfizer-BioNTech vaccine has had strict requirements involving how the vaccine is stored. For instance, it has required shipping in ultra-cold temperature-controlled units (-94 degrees Fahrenheit). In mid-February, the company submitted new data to the FDA demonstrating the stability of the vaccine at temperatures more commonly found in pharmaceutical refrigerators and freezers. Approval would make the vaccine easier to distribute.


Moderna vaccine was the second one authorized for emergency use in the U.S.—it received FDA EUA on December 18, 2020, about a week after the Pfizer vaccine. Moderna is also an mRNA vaccine, using the same technology as the Pfizer-BioNTech one and with a similarly high efficacy at preventing symptomatic disease. There are two key differences: The Moderna vaccine can be shipped and kept in long-term storage in standard freezer temperatures, and stored for up to 30 days using normal refrigeration, making it easier to distribute and store. Also, the Moderna vaccine was slightly less effective in clinical trials—about 86%—in people who are 65 and older.


On February 27, 2021, the FDA granted emergency use approval for a different type of vaccine, called a carrier, or virus vector, vaccine. In comparison to the Pfizer and Moderna vaccines, this one is easier to store (in refrigerator temperature), and requires only a single shot, both of which could make it easier to distribute and administer. Analysis released by FDA in late February showed that the vaccine may reduce the spread of the virus by vaccinated people.

This vaccine, which is currently being distributed in the United Kingdom and other countries, is distinguished from some of its competitors by its lower cost—it’s cheaper to make per dose, and it can be stored, transported, and handled in normal refrigeration for at least six months. Some countries temporarily suspended use of this vaccine in March after a small number of recipients developed blood clots, although the European Medicines Agency (EMA), which monitors the safety of medicines, among other things, stated that there is “no indication that vaccination has caused these conditions.” The WHO and EMA continue to endorse the vaccine.


This Vaccine has been shown to be effective not only against COVID-19, but also against the mutations that have emerged in Great Britain and, to some extent, South Africa (although in late January, efficacy against the latter was found to be less than 50% against severe illness). While the other breakthrough vaccines have been either mRNA or vector platforms, the Novavax vaccine is yet another type, called a protein adjuvant. It is also simpler to make and can be stored in a refrigerator.


Emergency use in the U.S. and other countries

Emergency use in the U.S. and other countries

Emergency use in the U.S. and other countries

Not available in the U.S., but approved for emergency use in other countries

Still completing clinical trials 

Recommended for

Anyone 16 and older. Pfizer-BioNTech is still testing the vaccine in kids ages 12-15.

Adults 18 and older. Moderna is still testing the vaccine in children ages 12-17.

Adults 18 and older. The company also expects to start testing the vaccine on children.

Adults 18 and older

The vaccine is being studied in adults ages 18-84


Two shots, 21 days apart

Two shots, 28 days apart

Single shot. In November, Johnson & Johnson announced it would launch a second Phase 3 clinical trial to study using two doses, two months apart, to see if that regimen will provide better protection.

Two doses, four to 12 weeks apart

2 doses, three weeks apart

Common Side Effects

Chills, headache, pain, tiredness, and/or redness and swelling at the injection site, all of which generally resolve within a day or two of rest, hydration, and medications like acetaminophen. (If symptoms don’t resolve within 72 hours or if you have respiratory symptoms, such as cough or shortness of breath, call your doctor.) On rare occasions (as in, 11 cases in 18 million vaccinations), mRNA vaccines have appeared to trigger anaphylaxis, a severe reaction that is treatable with epinephrine (the drug in Epipens®). 


Similar to the Pfizer vaccine, side effects can include chills, headache, pain, tiredness, and/or redness and swelling at the injection site, all of which generally resolve within a day or two. On rare occasions, mRNA vaccines have appeared to trigger anaphylaxis, a severe reaction that is treatable with epinephrine (the drug in Epipens®). 


Fatigue, fever headache, injection site pain, or myalgia (pain in a muscle or group of muscles), all of which generally resolve within a day or two. It has had noticeably milder side effects than the Pfizer and Moderna vaccines, according to the FDA report released in late February. No one suffered an allergic reaction in clinical trials for the vaccine, according to the company.

Tenderness, pain, warmth, redness, itching, swelling or bruising at the injection site, all of which generally resolve within a day or two.

While the Novavax vaccine is still being studied, earlier signs show no adverse effect

How it works

This is a messenger RNA (mRNA) vaccine, which uses a relatively new technology. Unlike vaccines that put a weakened or inactivated disease germ into the body, the Pfizer-BioNTech mRNA vaccine delivers a tiny piece of genetic code from the SARS CoV-2 virus to host cells in the body, essentially giving those cells instructions, or blueprints, for making copies of spike proteins

Similar to the Pfizer vaccine, this is an mRNA vaccine that sends the body’s cells instructions for making a spike protein that will train the immune system to recognize it. The immune system will then attack the spike protein the next time it sees one (attached to a real SARS CoV-2 virus).

This is a carrier vaccine, which uses a different approach than the mRNA vaccines to instruct human cells to make the SARS CoV-2 spike protein. Scientists engineer a harmless adenovirus (a common virus that, when not inactivated, can cause colds, bronchitis, and other illnesses) as a shell to carry genetic code on the spike proteins to the cells (similar to a Trojan Horse). The shell and the code can’t make you sick, but once the code is inside the cells, the cells produce a spike protein to train the body’s immune system, which creates antibodies and memory cells to protect against an actual SARS-CoV-2 infection.


Similar to the Johnson & Johnson’s vaccine, this is a carrier vaccine, made from a modified version of a harmless adenovirus. The final product contains the spike protein found in SARS-CoV-2. When that protein reaches the body’s cells, the immune system mounts a defense, creating antibodies and memory cells to protect against an actual SARS-Cov2 infection.


Unlike the mRNA and vector vaccines, this is a protein adjuvant (an adjuvant is an ingredient used to strengthen the immune response). While other vaccines trick the body’s cells into creating parts of the virus that can trigger the immune system, the Novavax vaccine takes a different approach. It contains the spike protein of the coronavirus itself, but formulated as a nanoparticle, which cannot cause disease. When the vaccine is injected, this stimulates the immune system to produce antibodies and T-cell immune responses.

How well it works

95% efficacy in preventing COVID-19 in those without prior infection. The researchers report that the vaccine was equally effective across a variety of different types of people and variables, including age, gender, race, ethnicity, and body mass index (BMI)—or presence of other medical conditions. In clinical trials, the vaccine was 100% effective at preventing severe disease.

94.1% effective at preventing symptomatic infection in people with no evidence of previous COVID-19 infection. The vaccine appeared to have high efficacy in clinical trials among people of diverse age, sex, race, and ethnicity categories and among persons with underlying medical conditions (although as mentioned above, the efficacy rate drops to 86.4% for people ages 65 and older)

72% overall efficacy and 86% efficacy against severe disease in the U.S. can be stored at normal refrigeration temperatures for at least three months, making its distribution considerably easier than the authorized vaccines made by Moderna and Pfizer-BioNTech, which require two doses and must be stored at frigid temperatures.

AstraZeneca updated its data analysis of its phase 3 trials in March, showing its vaccine to be 76% effective at reducing the risk of symptomatic disease 15 days or more after receiving the two doses, and 100% against severe disease. The company also said the vaccine was 85% effective in preventing COVID-19 in people over 65.

UK Phase 3 Results: 89.3% Efficacy. The study enrolled more than 15,000 participants between 18-84 years of age, including 27% over the age of 65. The primary endpoint of the UK Phase 3 clinical trial is based on the first occurrence of PCR-confirmed symptomatic (mild, moderate or severe) COVID-19 with onset at least 7 days after the second study vaccination in serologically negative (to SARS-CoV-2) adult participants at baseline.

How well it works on Virus Mutation

So far, the Pfizer-BioNTech vaccine has been found to protect against the variant that was first detected in Great Britain (B.1.1.7), but it may be less effective against the variant first detected in South Africa (B.1.351).

Some research has suggested that Moderna’s vaccine may provide protection against the B.1.1.7 and B.1.351 variants. Researchers are still studying this. 

This vaccine’s effectiveness has been shown to offer protection against the B.1.1.7 variant. According to the analyses the FDA released in late February, there was 64% overall efficacy and 82% efficacy against severe disease in South Africa, where the B.1.351 variant was first detected.    


 So far it seems to work better against the mutation that emerged in Great Britain than the one that emerged in South Africa. A paper in early February (not yet peer-reviewed) cited 74.6% efficacy against the B.1.1.7 variant. However, the vaccine did not protect as well against mild and moderate cases in people infected with the B.1.351 variant. Therefore, South Africa halted its rollout while scientists continue to study whether the vaccine can prevent severe illness and death in people infected with this variant.



Novavax’s report of 89.3% efficacy in January covered both the original coronavirus and the B.1.1.7 variant. But results showed only 49% efficacy against the B.1.351 variant. Novavax has said it plans to begin clinical development of a vaccine specifically targeted to B.1.351.


CDC (center of disease control) Requirements

the Centers for Disease Control and Prevention (CDC) requires vaccination sites to monitor everyone for 15 minutes after their COVID-19 shot, and for 30 minutes if they have a history of severe allergies or are taking a blood thinner. 

the CDC requires vaccination sites to monitor everyone for 15 minutes after their COVID-19 shot, and for 30 minutes if they have a history of severe allergies. 

Sources: Yale Medicine, Centers of disease control and prevention, U.S. Food and Drugs Administration, Pfizer,  Novavax, New York Times,

Collected and Penned  By: Padma Edirisinghe