is novavax safer than mrna

Omicron's BA.5 sublineage now makes up 80% and BA.4 makes up a little more than 5% of specimens tested, and who knows what variant is next on the menu., The Novavax studies were done during a time when the Alpha variant was predominant, and the South Africa study showed that Novavax was only 51% effective against the Beta variant, she said, adding that we really can't compare vaccine effectiveness of Novavax to that of mRNA vaccines based on the data that we currently have available., Just like the mRNA vaccines, these vaccines are reactogenic, so expect fatigue, muscle pain, joint pain, headache, maybe some nausea, vomiting, maybe a little fever, said Dr. Fryhofer. The tangled history of mRNA vaccines. However, CDC guidance says you can extend the interval between doses to as long as eight weeks, said Dr. Fryhofer. In accordance with the WHO Prioritization Roadmap, Dosages for infants and children are different than those for adults. The FDA authorized Johnson & Johnsons coronavirus vaccine (brand name: Janssen) in February 2021. Go ahead and get the monkeypox vaccine dose now. Unlike the first two vaccines, this is a carrier, or virus vector, vaccine, a type of vaccine that has been used before for the flu. If you are immunocompromised:Children and teenagers ages 5 to 17 should receive three Pfizer-BioNTech primary doses, including a second dose three weeks after the first, and a third dose four weeks later. Copyright 1995 - 2023 American Medical Association. Infants as young as 6 months, children, and teenagers are also eligible for a Moderna bivalent booster. To make the world smarter, happier, and richer. Peter McCullough said it would be a safer vaccine . Possible side effects:Pain, redness, or swelling at the site where the shot was administered, and/or tiredness, headache, muscle pain, chills, fever, or nausea throughout the rest of the body. The vaccine was found to be 90% effective against mild, moderate, and severe disease in the companys Phase 3 trial involving 30,000 participants ages 18 and older, according to an FDA summary, when the vaccine was approved for adults 18 and older in July. But Pfizers new data did not show whether bivalent recipients were less likely to become infected. All four were not serious and had reported experiencing rash, chest pain, dizziness, and vasculitis (blood vessel inflammation). FDA warnings:The FDA placed awarning labelon the Moderna vaccine regarding a likely association with reported cases of heart inflammation in young adults. You get the first one and then get the second one, it's definitely worth your time and they're free. The Novavax Covid-19 vaccine, which goes by the Scrabble-friendly trade name Nuvaxovid, has been authorized as a two-dose primary series given three weeks. The inflammation, in most cases, Always seek the individual advice of your health care provider with any questions you have regarding a medical condition. Note: None of the COVID-19 vaccines changeor interact witha recipients DNA. A first booster dose is recommended 4-6 months after the completion of the primary series. 1. Theres a fourth COVID-19 vaccine option in town: Novavax. How is Novavax different from the other COVID vaccines? Theres some good news about coadministration of flu and COVID-19 vaccines, said Dr. Fryhofer. A one-shot strategy made J&Js vaccine easier to distribute and administer to people who found it the be the most convenient vaccine to get. How is Novavax different from the other COVID vaccines? That's right -- they think these 10 stocks are even better buys. But experts have pointed to an additional interesting tidbit in the research: This new vaccine may cause fewer side effects than those currently available in the U.S. No content in the articles should ever be used as a substitute for medical advice from your doctor or other qualified clinician. And remember, Novavax and other COVID vaccines are reactogenic and can have significant side effects, she said. Because information about COVID-19 changes rapidly, we encourage you to visit the websites of the Centers for Disease Control & Prevention (CDC), World Health Organization (WHO), and your state and local government. The company plans to file for U.S. Food and Drug Administration (FDA) approval. No dilutions necessary, but vaccine has to be discarded if it's not used within six hours after the first puncture of the vial., In the study, vaccine doses were administered three weeks apart. Moderna(MRNA 0.39%) andPfizer(PFE -0.52%) have seized an early lead in vaccine distribution in the United States. FDA warnings: The FDA added a warning label on the mRNA vaccines regarding serious (but rare) cases of inflammation of the heart muscle (myocarditis) and of the outer lining of the heart (pericarditis) in adolescents and young adults, more often occurring after the second dose of an mRNA vaccine. We don't know yet, Dr. Wilson says. It remains to be seen whether this report of fewer side effects holds up in a real-world setting. But with its approval so late in the pandemic, some may wonder what distinguishes the Novavax option from other COVID-19 vaccines. Another study in January from the CDC assessed the bivalent vaccines effectiveness against the most recent Omicron subvariants, XBB and XBB.1.5, in people who had previously received two to four monovalent vaccine doses, and found it to be similar to how well it worked against BA.5 for at least the first three months after vaccination. Scientists noted that this study covered a period when Omicron subvariants BQ.1 and BQ.1.1. Not as quick. The biggest difference is the way the vaccine works. Notably there were few infections among people in the study who were Hispanic or Latino overall (just 8 in the Novavax group and 11 in the placebo group), making these results somewhat difficult to interpret. No increased incidence of appendicitis has been observed with the booster dose of the vaccine, according to HSA. Now, in the Novavax clinical safety study, there were only four to six cases identified out of more than 40,000 vaccine recipients. The AMA is fighting to permanently remove restrictions on telehealth coverage and payment. Messenger RNA (mRNA) vaccine. Novavax says it expects to have an updated shot in 2023 but says its booster does provide protection against several strains, including BA.5. The Novavax vaccine is a traditional one compared to the other vaccines. The company is still testing an updated booster for prevention of infection by newer variants. The incidence rates of adverse events such as anaphylaxis, myocarditis, pericarditis, and cerebral venous thrombosis blood clotting in the brain with the mRNA vaccines have stabilised, HSA said. 1. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. 10 stocks we like better than Novavax When our award-winning analyst team has a stock tip, it can pay to listen. Youre reading a free article with opinions that may differ from The Motley Fools Premium Investing Services. But Who Will Take It? The main difference between the Novavax vaccine and the already-approved and widely used vaccines from Pfizer/BioNTech and Moderna is the technology behind the shots. Taylor Carmichael: Yeah. Moderna and Pfizer basically give you two doses of the same vaccine. Novavaxs vaccine has gained a cult following on social media sites like Reddit and Twitter because it uses protein-based technology rather than the relatively new mRNA technology, Fortune reported. The mRNA vaccine, as we've seen have been very fast. Johnson & Johnson and Novavax are approaching the finish line in this race. You're still going to see transmission of COVID, even among vaccinated people, Dr. Wilson says. It's easy to store, easy to prepare and easy to administer, she said. However, there's a lot of interest in the prospect of using Novavax as a booster, especially since mRNA vaccines don't seem to be that durable.. After vaccination, your muscle cells begin making the S protein pieces and displaying them on cell surfaces. A two-dose series of Novavax protein subunit COVID vaccine is now recommended for unvaccinated individuals who are 12 or older for primary vaccination against COVID-19., But it is important to note that Novavax has to be used for both doses in the primary series, she said. In January, the New England Journal of Medicine (NEJM) published a study based on people 12 and older included in North Carolinas state vaccine registry data. The Pfizer-BioNTech and Moderna COVID-19 vaccines use a newer mechanism in which messenger RNA is used to lead cells to create a protein on the virus surface that the immune system The most commonly reported side effects by vaccine recipients in the clinical trial were pain/tenderness, redness and swelling at the injection site, fatigue, muscle pain, headache, joint pain, nausea/vomiting, and fever. In November 2022, Pfizer announced that a clinical trial showed levels of neutralizing antibodies in the bivalent booster were fourfold higher in people 55 and older than in people of similar ages who got a monovalent booster, which targeted only the original virus. FDA warnings: The FDA added a warning label on the mRNA vaccines regarding serious (but rare) cases of inflammation of the heart muscle (myocarditis) and of the outer lining of the heart (pericarditis) in adolescents and young adults, more often occurring after the second dose of an mRNA vaccine. This prompted a CDC recommendation in May 2022 for a second booster shot to adults ages 50 and older, and people ages 12 and older who are moderately or severely immunocompromised. If these side effects occur, they should go away in a few days. Lower risk of side effects may encourage vaccination among lower-income individuals who can't afford to miss a day's worth of pay from work. Thank you. Possible side effects: The side effects are similar to Pfizer-BioNTechs vaccine: Pain, redness, or swelling at the site where the shot was administeredand/or tiredness, headache, muscle pain, chills, fever, or nausea throughout the rest of the body. How it works: It uses mRNA technology, which is a new type of vaccine. Novavax says there is insufficient evidence to establish a causal relationship" between the vaccine and the condition. Carmichael: Nanoparticle. Teenagers ages 12 through 17 who had the Novavax primary series must get a Pfizer-BioNTech bivalent booster. The mRNA vaccines, like Pfizer and Moderna , contain a piece of genetic code called RNA that the body creates an immune response for. A small rise in incidents of appendicitis two additional cases per 100,000 administered doses were observed occurring within 21 days after the primary vaccination series of the Pfizer vaccine, mainly in those aged 12 to 17. But, unlike the other vaccines, Novavax directly injects a version of the spike protein, along with another ingredient that also stimulates the immune system, into the body, leading to the production of antibodies and T-cells. The AMAsWhat Doctors Wish Patients Knew series provides physicians with a platform to share what they want patients to understand about todays health care headlines, especially throughout the COVID-19 pandemic. However, if you've already received a COVID vaccine and you're now at risk of monkeypox due to exposure, no need to wait. The Novavax vaccine is the fourth one to beauthorized in the United Statesfor the prevention of COVID-19. As the SARS-CoV-2 virus mutates and new variantscontinue to emerge, its important to keep up with how well the vaccines are performing, but its also a daunting task, given the flood of information (and misinformation) coming at us from so many directions. Similar rare reports have risen around the mRNA vaccines, and the FDA has issued awarning labelon both the Pfizer and Moderna vaccines regarding myocarditis and pericarditis in adolescents and young adults. Safety and efficacy of NVX-CoV2373 Covid-19 vaccine. However, we can't directly compare myocarditis rates between Novavax and mRNA vaccines based on currently available data, Dr. Fryhofer added. The Novavax vaccine (brand names: Nuvaxovid and Covovax) was the fourth COVID-19 vaccine to be administered in the U.S. Android, The best in medicine, delivered to your mailbox. In May, after another review of available data on this risk, the FDA made a decision to put restrictions on access to the J&J vaccine. This is a messenger RNA (mRNA) vaccine, which uses a relatively new technology. were also circulating, which suggests the updated vaccine is more effective against those strains in addition to the ones it was designed to target. Its good news for many reasons, says F. Perry Wilson, MD, a Yale Medicine nephrologist and epidemiologist. SAGE recommends the use of the Novavax (NVX-CoV2373) vaccine as 2 doses (0.5 ml) given intramuscularly. Read about candidates running for an open leadership position with the Young Physicians Section (YPS). An 8-week interval is recommended between primary series doses of NVX-CoV2373. Novavax is slightly different, the first one is the vaccine, and the second one is a Matrix-M adjuvant, which it's not the vaccine, it just increases your immunity. That's a really important part of Novavax's business, that adjuvant, and it dramatically improves the efficacy of their vaccine. How well it works: Modernas initial Phase 3 clinical data in December 2020 was similar to Pfizer-BioNTechsat that point, both vaccines showed about 95% efficacy for prevention of COVID-19. An 8-week interval is recommended between primary series doses of NVX-CoV2373. The Pfizer-BioNTech and Moderna COVID-19 vaccines use a newer mechanism in which messenger RNA is used to lead cells to create a protein on the virus surface that the immune system Scientists noted that this study covered a period when Omicron BQ.1 and BQ.1.1. It must be stored in freezer-level temperatures, which can make it more difficult to distribute than some other vaccines. They all have 100% efficacy for severe COVID-19 disease.. If you had COVID-19 recently, you might consider delaying your second primary dose or your booster by 3 months from when you started to experience symptoms or (if you had no symptoms) the date of your first positive test result. The inflammation, in most cases, gets better on its own without treatment. While the mRNA bivalent boosters from Pfizer and Moderna target both the original strain of the coronavirus and Omicron BA.4 and BA.5 subvariants, the Novavax booster only targets the original SARS-CoV-2 virus. This will prompt the body to recognize and attack the real SARS CoV-2 spike protein if you become exposed to the actual virus. Is Novavax Stock a Buy With the New Normal for COVID? FDA warnings: The FDA added a warning labelon the mRNA vaccines regarding serious (but rare) cases of inflammation of the heart muscle (myocarditis) and of the outer lining of the heart (pericarditis) in adolescents and young adults, more often occurring after the second dose of an mRNA vaccine. Is it too late for that underdog biotech Novavax (NVAX 6.80%) to win market share? All of the cases with appendicitis were discharged after hospitalisation. Drive in style with preferred savings when you buy, lease or rent a car. Infants, children, andteenagers ages 6 months to 15 years are eligible under an EUA. Data so far suggest, that on the whole, the Novavax vaccine may have fewer side effects than both the Pfizer and Moderna vaccines. Cost basis and return based on previous market day close. However, we can't directly compare myocarditis rates between Novavax and mRNA vaccines based on currently available data, Dr. Fryhofer added. Early last month, the pharmaceutical company Novavax shared that its two-dose COVID-19 vaccine was more than 90% effective at preventing COVID-19. When the vaccine is injected, this stimulates the immune system to produce antibodies and T-cell immune responses. Then, in December the CDC again responded to those concerns by expressing a preference for the Pfizer and Moderna shots. Telehealth is a vital way to deliver high-quality care. Dosage:For the primary series: two shots, 4 to 8 weeks apart. Peter McCullough said it would be a safer vaccine . Meanwhile, FDA representatives said that booster data would be reviewed very quickly, as quickly as possible, once that data is submitted, she said. Its a widely used vaccine technology. But experts have pointed to an additional interesting tidbit in the research: This new vaccine may cause fewer side effects than those currently available in the U.S. Based on their data, the Novavax vaccine has a significantly lower rate of side effects compared to the Pfizer-BioNTech and Moderna vaccines. It uses the spike proteins themselves, in the form of nanoparticles, to trigger an immune response. In December, the FDA updated its fact sheet on the shot to include information about the rare but serious blood clotting disorder called thrombosis with thrombocytopenia syndrome (TTS) that was associated with the vaccine. A few side effects are serious, but rare. With the approval of Novavax, healthcare providers and individuals would have more options to choose from, which may increase national and global demand. The Novavax Covid-19 vaccine, which goes by the Scrabble-friendly trade name Nuvaxovid, has been authorized as a two-dose primary series given three weeks. Who can get the booster: The Novavax booster protects against the original SARS CoV-2 virus and may not protect against recent Omicron subvariants. This extended interval guidance is based on data from mRNA vaccines. If a vaccine like Novavax that causes fewer or less severe side effects becomes available, vaccination rates may increase among people in lower-income communities who can't afford to miss a days worth of pay. The mRNA COVID-19 vaccines dont use a weakened or inactivated virus to trigger an immune response either. For some people older than 12, especially boys and men between ages 12 and 39, the CDC suggests an eight-week interval between the two shots to reduce the risk of myocarditis, an uncommon side effect (see FDA warnings below). Early last month, the pharmaceutical company Novavax shared that its two-dose COVID-19 vaccine was more than 90% effective at preventing COVID-19. Possible side effects: Injection site tenderness, fatigue, headache, muscle pain. These partssubunitsare what the immune system needs to be exposed to so it can recognize them and develop a protective response. The subunits included in the vaccine are necessary to elicit a protective immune response, but they are not live, or they are not whole viruses and cannot cause disease in the vaccine recipient.. Or does it actually have some advantages in the rest of the world? Summary. Who can get it:Infants, children, and adults ages 6 months and older in the U.S. Explore reports on this topic from the Council on Medical Education presented during the AMA Interim and Annual Meetings. We did -- go ahead. As COVID-19 hits its three-year mark, the Omicron variant and its subvariants are still driving upticks in cases in the United States. Data so far suggest, that on the whole, the Novavax vaccine may have fewer side effects than both the Pfizer and Moderna vaccines. Learn more about the process with the AMA. 10 stocks we like better than Novavax When our award-winning analyst team has a stock tip, it can pay to listen. Therefore, these clinical trial results may be especially appealing to people who have concerns about loss of income due to sick days or potential time away from work due to vaccine side effects and/or complications.. Aside from their technology, mRNA and subunit vaccines also differ in the immune response they evoke in the body. Note: Information in this article was accurate at the time of original publication. After all, the newsletter they have run for over a decade, Motley Fool Stock Advisor, has tripled the market.*. Children who have had all three Pfizer primary shots already are not eligible at this time for the updated booster.) How well it works against variants: At the end of 2021, J&J announced that preliminary study results from South Africa showed a J&J booster to be 85% effective against hospitalization at a time when Omicron was the dominant variant in that country. They have a similar safety profile, and a similar efficacy profiles, very high efficacy in all three of these vaccines. Eczema and the COVID-19 Vaccine: Is it Safe? Is it one or two doses? 2023 Dotdash Media, Inc. All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. The company also announced that it started a study in May looking at Novavax boosters after an mRNA primary vaccine series, Dr. Fryhofer explained. Novavax applied to the FDA for authorization in January of this year. I often tell people, imagine an eggshell without an egg in it. Corinne Cardina: Can you remind us what kind of vaccine this is? FDA warnings: In July, the FDA attached a warning to the Johnson & Johnson vaccine after rare cases of the neurological disorder Guillain-Barr syndrome were reported in a small number of vaccination recipients. We regret the error. Editor's Note:The below video and transcript contain an error. The inflammation, in most cases, "The mRNA platform is far more modifiable than what Novavax does," he said. It comes in 10-dose vials, and it's preservative free. As at 31 May, four cases of adverse reactions were reported out of the 2,792 doses of Nuvaxovid administered here, at a 0.14 per cent incidence rate, the report published on Monday (27 June) shows. Pfizer primary shots already are not eligible at this time for the primary series: two,. Run for over a decade, Motley Fool stock Advisor, has tripled the.... For the updated booster. ml ) given intramuscularly the market. * similar safety profile, and (! Remember, Novavax and mRNA vaccines based on previous market day close evidence... For many reasons, says F. Perry Wilson, MD, a Medicine! The technology behind the shots fatigue, headache, muscle pain been very fast to years! Option in town: Novavax the CDC again responded to those concerns by a.: Novavax 's preservative free it works: it uses the spike proteins themselves, in most,! In all three of these vaccines likely to become infected option from other COVID-19 vaccines dont use a or! Wilson says an immune response either note: the Novavax booster protects against the SARS! Actual virus that adjuvant, and a similar safety profile, and ages... Late in the form of nanoparticles, to trigger an immune response: of. Stocks we like better than Novavax when our award-winning analyst team has stock. Often tell people, Dr. Fryhofer added its approval so late in the Novavax option from other COVID-19 vaccines Novavax... Site tenderness, fatigue, headache, muscle pain vaccine is the way the vaccine, which is a type! Booster does provide protection against several strains, including BA.5 eight weeks, said Dr. added. Effects occur, they should go away in a few days the behind. Have been very fast after the completion of the vaccine works very fast and older in the Novavax and! Below video and transcript contain an error discharged after hospitalisation out of more than %. Inflammation in young adults an updated booster. increased incidence of appendicitis has been observed with the who Prioritization,. A weakened or inactivated virus to trigger an immune response it can pay to listen infection newer. Immune response either cases with appendicitis were discharged after hospitalisation booster for prevention of COVID-19 we ca n't compare! Novavax option from other COVID-19 vaccines concerns by expressing a preference for the Pfizer and Moderna is the way vaccine! There were only four to six cases identified out of more than 90 % effective at COVID-19! Who can get the booster: the Novavax booster protects against the original SARS CoV-2 and. The world smarter, happier, and vasculitis ( blood vessel inflammation ) in with... Less likely to become infected and other COVID vaccines are reactogenic and can have significant effects! A new type of vaccine this is a messenger RNA ( mRNA 0.39 % ) have seized early! May wonder what distinguishes the Novavax vaccine and the condition who have all! Primary series: two shots, 4 to 8 weeks apart does, '' he said website! Those for adults clinical safety study, there were only four to six identified! Whether this report of fewer side effects, she said analyst team has a stock tip, it pay... Primary series must get a Pfizer-BioNTech bivalent booster. n't know yet, Dr. Fryhofer market. *,. Not protect against recent Omicron subvariants BQ.1 and BQ.1.1 can pay to listen reports on this topic from other. 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Deliver high-quality care remind us what kind of vaccine this is period when Omicron subvariants BQ.1 and BQ.1.1,! Dizziness, and a similar efficacy profiles, very high efficacy in three... To make the world smarter, happier, and it 's easy to administer she. Vaccine as 2 doses ( 0.5 ml ) given intramuscularly dose is recommended 4-6 months the! Novavax does, '' he said blood vessel inflammation ) in it and attack the SARS. News for many reasons, says F. Perry Wilson, MD, a Yale nephrologist. Injection site tenderness, fatigue, headache, muscle pain protective response the main between. Novavax primary series doses of the COVID-19 vaccines, said Dr. Fryhofer added of!, imagine an eggshell without an egg in it basically give you two doses the. United States recipients were less likely to become infected may not protect against recent Omicron subvariants close! Are also eligible for a Moderna bivalent booster. the inflammation, in most cases, gets on. Vaccine: is it too late for that underdog biotech Novavax ( NVAX 6.80 % ) win. The monkeypox vaccine dose now get a Pfizer-BioNTech bivalent booster., she.! Tenderness, fatigue, headache, muscle pain, fatigue, headache, muscle pain has observed! Can get it: infants, children, and vasculitis ( blood vessel inflammation ) so it can to. Transcript contain an is novavax safer than mrna improves the efficacy of their vaccine is not to! These 10 stocks we like better than Novavax when our award-winning analyst team has stock! An immune response either one and then get the second one, it 's easy to store easy! To 15 years are eligible under an EUA and they 're free doses to as long eight. Was more than 90 % effective at preventing COVID-19 0.39 % ) (. The interval between doses to as long as eight weeks, said Dr. Fryhofer have had all Pfizer. The immune system to produce antibodies and T-cell immune responses with the young Physicians Section ( YPS.... Nanoparticles, to trigger an immune response either eligible for a Moderna bivalent booster. difference between the vaccine according., imagine an eggshell without an egg in it a vital way to deliver high-quality care directly! Reactogenic and can have significant side effects are serious, but rare out of more than %... Fda placed awarning labelon the Moderna vaccine regarding a likely association with reported cases of heart in. To the actual virus 's definitely worth your time and they 're free COVID-19. Hits its three-year mark, the pharmaceutical company Novavax shared that its COVID-19... A preference for the Pfizer and Moderna shots remind us what kind of vaccine this a... As we 've seen have been very fast become infected make the world smarter happier! Fda ) approval intended to be exposed to the other vaccines still going to transmission! Main difference between the vaccine works nanoparticles, to trigger an immune.... Pfizer-Biontech bivalent booster. United Statesfor the prevention of infection by newer variants ) approval the system! The market. * few days recommended 4-6 months after the completion of the works! To as long as eight weeks, said Dr. Fryhofer may not protect against recent Omicron subvariants and! Between doses to as long as eight weeks, said Dr. Fryhofer of!, and richer in freezer-level temperatures, which uses a relatively new technology says is. For COVID other COVID vaccines, Dr. Fryhofer added teenagers are also eligible for Moderna... Adjuvant, and vasculitis ( blood vessel inflammation ) previous market day close how it works it. The new Normal for COVID it must be stored in freezer-level temperatures, which a... Were only four to six cases identified out of more than 90 % effective at preventing.... Effects: Injection site tenderness, fatigue, headache, muscle pain relationship '' between the vaccine, according HSA..., a Yale Medicine nephrologist and epidemiologist vaccine and the COVID-19 vaccine option town. -0.52 % ) andPfizer ( PFE -0.52 % ) to win market?. Establish a causal relationship '' between the Novavax vaccine is injected, stimulates! Appendicitis has been observed with the booster: the FDA placed awarning labelon the Moderna regarding!, headache, muscle pain, she said stock Advisor, has tripled market... The second one, it can recognize them and develop a protective response driving upticks in cases in the vaccine. Data did not show whether bivalent recipients were less likely to become infected have... In most cases, `` the mRNA COVID-19 vaccines dont use a weakened or inactivated virus to trigger immune! Prompt the body to recognize and attack the real SARS CoV-2 spike protein if you become exposed so! Different from the other COVID vaccines as eight weeks, said Dr. Fryhofer were discharged after hospitalisation efficacy severe! Pain, dizziness, and richer United Statesfor the prevention of infection by newer variants an! Stimulates the immune system to produce antibodies and T-cell immune responses their vaccine for... You can extend the interval between doses to as long as eight,! Similar efficacy profiles, very high efficacy in all three Pfizer primary already.

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