Vaccine Efficacy and Administration

Moderna mRNA-1273

 Administration

The Moderna vaccine is administered via two intramuscular injections 28 days apart.The injection consists of 100 micrograms of mRNA vaccine diluted with normal saline in a 0.5mL injection⁴.

Efficacy

From results released from the Phase 1 study, patients given the therapeutic dose of the vaccine had a mean antibody level much higher than that of human convalescent serum⁵. On November 20, 2020, Moderna announced in a press release that Phase 3 trial results indicate that their vaccine is 94.1% efficacious against COVID-19 infection⁶. The mRNA-1273 Phase 3 trial data has yet to be published at the time of this post.

 Pfizer BNT162b2

Administration

The Pfizer vaccine is administered over 2 intramuscular injections that are 21 days apart. Low, mid, and high doses in a 0.5mL injection (250 μg/0.5 mL) are still being tested and specific dosages once the drug is released to market is to be determined⁷. 

 Efficacy

Within Phase 1-2 interim trial results, the Pfizer vaccine showed substantially greater concentration of antibodies in comparison to human convalescent serum⁸. On November 18, 2020, Pfizer announced in a press release that their Phase 3 trials demonstrate a 95% efficacy rate in prevention of COVID-19 infection⁹. The BNT162b2 Phase 3 trial has yet to be published at the time of this post.

Novavax NVX-CoV2373

 Administration

To administer the vaccine to patients, healthcare providers will need to have training in the administration of intramuscular (IM) injections. In addition, the facilities will need to  have an organized database in place that states the date when the patient receives the first dose and the date when the second dose should occur (21 days after). Each injection volume is approximately 0.5-0.6mL.

Efficacy

Efficacy has been measured in early Phase 1-2 trials by comparing ELISA IgG antibody levels of vaccinated individuals to human convalescent serum (serum of patients that have recovered from COVID-19) in order to evaluate potential protection from COVID-19. The studies have shown that at day 35, vaccinated individuals had antibody levels 4 to 6 times greater than the mean convalescent serum¹.

 Johnson & Johnson Ad.26.COV2.S

 Administration

Phase 3 studies has been conducted with adults 18 years of age or older. The vaccine is delivered via intramuscular injection with a dosage of 1.0mL. This vaccine is only one dose per patient².

Prepared in collaboration with graduate students at Keck Graduate Institute (Claremont, CA): Kaljit Atwal, Paola Montes, Joseph Nguyen, Alice Wen

References

1. Keech, C., E., Robertson, A., Cho, I., & Albert, G. (2020). Phase 1–2 Trial of a SARS-CoV-2 Recombinant Spike Protein Nanoparticle Vaccine. The New England Journal of Medicine.
2. Janssen Pharmaceutical Companies. A Study of Ad26.COV2.S for the Prevention of SARS-CoV-2-mediated COVID-19 in Adults (ENSEMBLE 2). Available from: https://clinicaltrials.gov/ct2/show/NCT04614948.
3. (n.d.). Johnson & Johnson Posts Interim Results from Phase 1/2a Clinical Trial of its Janssen COVID-19 Vaccine Candidate. from https://www.jnj.com/johnson-johnson-posts-interim-results-from-phase-1-2a-clinical-trial-of-its-janssen-covid-19-vaccine-candidate
4. ModernaTX, Inc..A Study to Evaluate Efficacy, Safety, and Immunogenicity of mRNA-1273 Vaccine in Adults Aged 18 Years and Older to Prevent COVID-19. Available from: https://clinicaltrials.gov/ct2/show/NCT04470427?term=vaccine&cond=covid-19&draw=5.
5. Anderson, E., & Al., E. (2020, November 24). Safety and Immunogenicity of SARS-CoV-2 mRNA-1273 Vaccine in Older Adults: NEJM, from https://www.nejm.org/doi/full/10.1056/NEJMoa2028436?query=featured_home.
6. Moderna Announces Primary Efficacy Analysis in Phase 3 COVE Study for Its COVID-19 Vaccine Candidate and Filing Today with U.S. FDA for Emergency Use Authorization. (n.d.) from https://investors.modernatx.com/news-releases/news-release-details/moderna-announces-primary-efficacy-analysis-phase-3-cove-study
7. BioNTech SE.Study to Describe the Safety, Tolerability, Immunogenicity, and Efficacy of RNA Vaccine Candidates Against COVID-19 in Healthy Individuals. Available from: https://clinicaltrials.gov/ct2/show/NCT04368728?term=vaccine&cond=covid-19&draw=3.
8. Sahin, U., Muik, A., Derhovanessian, E., Vogler, I., Kranz, L., Vormehr, M., . . . Türeci, Ö. (2020, September 30). COVID-19 vaccine BNT162b1 elicits human antibody and T H 1 T cell responses. Retrieved from https://www.nature.com/articles/s41586-020-2814-7.
9. Pfizer and BioNTech Conclude Phase 3 Study of COVID-19 Vaccine Candidate, Meeting All Primary Efficacy Endpoints. (n.d.). Retrieved from https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-conclude-phase-3-study-covid-19-vaccine.