Medical Examiner

What Good Is the Novavax Vaccine?

The latest addition to the arsenal of shots has something to offer.

A healthcare worker prepares a dose of Novavax
A healthcare worker prepares a dose of Novavax JEROEN JUMELET/Getty Images

On Tuesday, the Centers for Disease Control and Prevention finally authorized the Novavax vaccine. The vaccine, which was developed by an American biotechnology company in Maryland, had previously been approved in other places such as Canada, Australia, and the European Union.

The two-dose shot is recommended for adults 18 and older and is the fourth approved vaccine in the United States. Although the vaccine isn’t in pharmacies quite yet—it might not be until August—the Biden administration has already secured 3.2 million doses.

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Another vaccine might not sound very useful at this point in the pandemic, particularly because like its predecessors, it’s not tailored to the new variants of the virus. But there are a few reasons you might consider getting the shot.

First, a little background on this new jab: Novavax trials were conducted on adults in the U.S. and Mexico from December 2020 through the middle of 2021. They found that two doses of the shots were 90.4 percent effective in preventing mild, moderate, or severe COVID-19 . For comparison, the original Moderna clinical trials that prompted the emergency use authorization in December 2020 found that a two-dose series of the vaccine was 94.1 percent effective in preventing COVID-19 disease. Pfizer was authorized for emergency use around the same time, and trials showed 95 percent efficacy in adults. It’s important to note that these numbers are now lower considering circulating variants . But the point is, Novavax seems to perform about as well as the other vaccines.

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If you’re one of the 26 to 37 million U.S. adults who haven’t been vaccinated at all, public health officials are hoping this vaccine might be the one for you. Unlike Moderna or Pfizer, it’s not an RNA vaccine, which teaches your body to make a harmless spike protein, so your immune system can get practice fighting off the virus. Adenovirus vector vaccines, like Johnson and Johnson’s, also do a version of this but by using a harmless version of a different virus to make the spike proteins. By contrast, Novavax uses a decades-old method that involves injecting pieces of the spike protein directly, along with a compound to tell your immune system to get to work practicing.

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This protein-based approach is the basis of many other vaccines, like HPV and tetanus shots. This different approach makes it more accessible for those who might be allergic to RNA vaccines (though this is pretty rare). It also may be more palatable to people who are just skeptical of RNA vaccines, though as Stanford University associate professor of biology Michael Lin notes, whether or not they will get the Novavax vaccine is the “million-dollar question.”

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Then there’s the fact that side effects seem to be less common with Novavax than Pfizer or Moderna (a full breakdown is available here). In particular, the rate of myocarditis seems to be lower with Novavax, at 6 cases per 40,000 (0.015 percent if you don’t want to do the math).* For the Moderna shot that rate is 0.03 percent in original clinical trials; with the Pfizer it’s 0.02 percent in original trials.

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If you’ve already been vaccinated, you might consider getting Novavax as a booster. According to Lin, Novavax can be administered to those who have received a few doses of other COVID vaccines. Why bother mixing and matching vaccines? Different kinds of vaccines used together can potentially provide better protection against COVID—think of it as learning an attack strategy taught by two or three separate teachers. “When you vaccinate, you’re trying to train your body to recognize a particular piece of information, in this case the COVID spike protein, so that when you’re infected your body will be able to mount an antibody attack against it,” Jonathan Staben, a family medicine physician for Multicare Rockwood Clinic, explained. (The clinic was one of more than 100 sites that participated in the Novavax clinical trials). “In general, it’s been found that mixing and matching have advantages in terms of broader coverage and activation of different arms of the immune system,” Lin said.

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Various  studies have found that Novavax is a safe, effective booster. Experts noted that the FDA is unlikely to release guidance on it anytime soon, but that hasn’t stopped people before.

As for our global vaccine arsenal, it’s just good to have more options available. This new one has some clear advantages. It’s relatively easy to refrigerate. Plus, “novavax has the potential to scale to very large numbers in terms of producing vaccine doses,” Michael Mina, an immunologist and chief scientific officer at EMed, said. “They have demonstrated they can get the technology built for low dollars, which could make it hopefully available all over the world along with some of the other vaccines. I think it’s good to have a whole new technology that’s out there.”

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In terms of what comes next: like Moderna and Pfizer, Novavax is also developing a vaccine targeting omicron to serve as better boosters. (Anthony Fauci has advised going ahead and getting a booster sooner rather than waiting for the bespoke versions, though.) Novavax is also working on a flu-COVID combo shot that Lin is particularly excited about.

“Every fall, you would get a COVID-19 update with a flu update,” Lin said. “That seems to be the long-term way to go, both for convenience and for public health.” Maybe someday getting a Novavax jab will be part of our regular routines.

Correction, July 24, 2022: This article originally misstated the percentage of people in Novavax trials who had myocarditis.

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