The four corona vaccines in comparison

In order to contain the pandemic, the vaccine from Johnson & Johnson may in future also be used in the EU. This means that there are four approved preparations. Where are there differences, where are there similarities?

This article reflects the state of knowledge as of the date specified. It is updated regularly.

With the corona vaccine from the US pharmaceutical company Johnson & Johnson, the EU medicines authority EMA has now approved the fourth Covid-19 vaccine in the EU.

The preparation has a special feature: It only has to be administered once. This differs from the three vaccines previously approved in the EU, which require two doses. The vaccine was developed in the Netherlands by the subsidiary Janssen.

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You can read below what the four vaccines differ in and what they all have in common:

How are the vaccines different?

The vaccines from AstraZeneca and Johnson & Johnson are so-called vector vaccines. You need a virus as a basis to smuggle information into the body. At Johnson & Johnson, it's a human rhinitis virus that has been rendered harmless. It contains genetic material of a surface protein with which the Sars-CoV-2 pathogen docks onto human cells. The body cells of the vaccinated person form the protein with the help of the assembly instructions, the body develops an immune response.

The preparations from Biontech / Pfizer and Moderna, on the other hand, are so-called mRNA vaccines. "m" stands for messenger, "RNA" for ribonucleic acid. Here the mRNA is the building instruction for a component of the Covid-19 pathogen. It gets into the body cells with the help of tiny fat droplets. These then also produce the virus protein against which the body develops its immune response.

How well do the vaccines work?

The vector-based models have to admit defeat to the new types of mRNA vaccines in this respect:

According to the EMA's product information, the vaccine from Johnson & Johnson offers around 66 percent protection against moderate or severe courses of Covid-19 - measured 28 days after administration. According to the EMA, the vaccinated person is protected from serious to life-threatening diseases with 85 percent after the same period.

According to the Robert Koch Institute (RKI), the effectiveness of the AstraZeneca agent is up to 80 percent after a second vaccination with an interval of 12 weeks between the two vaccine doses.

According to the RKI, the results are higher for the mRNA preparations: Here the institute reports about 95 percent effectiveness.

How often do you vaccinate?

The Johnson & Johnson preparation only needs to be administered once.

All three other vaccines approved in the EU require two vaccinations. The Standing Vaccination Commission (STIKO) recommends here on the basis of previous findings: With the mRNA vaccines from Biontech / Pfizer and Moderna, there should be an interval of six weeks between the two vaccine doses. For the AstraZeneca vector-based vaccine, an interval of twelve weeks.

As a rule, both vaccinations should always be made with the same preparation, advises the Robert Koch Institute (RKI). The Paul Ehrlich Institute (PEI) announced that if the preparation was changed, full effectiveness could not be guaranteed at the moment.

The vaccine from AstraZeneca offers an exception: due to possible side effects (see next section), only people over 60 years of age should receive this vaccine in the future. If you are younger than 60 and have received a first vaccination with AstraZeneca, the STIKO recommends that you receive an mRNA vaccine for the second vaccination twelve weeks later.

What are the side effects?

According to the RKI, pain at the injection site, exhaustion, headache, joint pain and chills have been the most commonly observed side effects after the vaccinations. In general, however, they were weak to moderate and subsided after a short time. According to the RKI, with mRNA preparations, as with all other vaccines, "in very rare cases" immediate allergic reactions up to shock or other complications that were previously unknown cannot be ruled out.

The Standing Vaccination Commission also recommends vaccination for people with immunodeficiency - for example with HIV infections, cancer or after organ transplants. "Although people with weakened immune systems may not respond as well to the vaccine, there are no particular safety concerns," says the European Medicines Agency (EMA).

The AstraZeneca vaccine is currently being investigated whether, in very rare cases, it can cause blood clots (thromboses) in cerebral veins, so-called sinus vein thromboses. The Paul Ehrlich Institute advises that people who receive the Covid-19 vaccine AstraZeneca and who have symptoms more than three days after the vaccination should seek medical treatment immediately. These symptoms can be, for example, severe and persistent headaches, shortness of breath, leg swelling or punctiform skin bleeding.

For the next orders for corona vaccines, the EU Commission wants to rely primarily on the new mRNA technology used by Biontech / Pfizer and Moderna. However, this does not mean that manufacturers such as Astrazeneca and Johnson & Johnson are already out of the running for future contracts or that their contracts will not be extended.

Do the vaccines also protect against variants of the virus?

The AstraZeneca vaccine protects against the British mutant, but there are doubts about its effectiveness against the South African variant. The vaccine could be adjusted if necessary, said Pfizer and Biontech. Among other things, Moderna wants to test the effect of an additional booster dose.

South Africa is now relying on the preparation from Johnson & Johnson. Its effectiveness against the predominant variant B.1.351 has been proven, it said. The vaccine should also offer protection in the Brazilian variant P.1.

How are the vaccines stored?

A big advantage of Johnson & Johnson and AstraZeneca is that they can be stored for months at refrigerator temperatures of two to eight degrees Celsius. The vaccine from Biontech / Pfizer, on the other hand, is stored at around minus 70 degrees. But it remains stable for two weeks at minus 25 to minus 15 degrees Celsius. With the Moderna vaccine, it doesn't have to be that cold at around minus 20 degrees.

Swell:

European Commission, Commission approves fourth COVID19 vaccine in the EU, as of March 12, 21. Online: https://ec.europa.eu/germany/news/20210312-johnson-johnson-impfstoff_de (last accessed: April 6, 21)

Robert Koch Institute: Questions about the COVID-19 vaccination recommendation, as of 1.4.21. Online: www.rki.de/SharedDocs/FAQ/COVID-Impfen/FAQ_Liste_STIKO_Empfehler.html (last accessed: 04/06/21)

Robert Koch Institute: COVID-19 and vaccination: Answers to frequently asked questions (FAQ). Status 1.4.21. Online: www.rki.de/SharedDocs/FAQ/COVID-Impfen/haben.html (last accessed: April 6, 21)

Robert Koch Institute: Effectiveness and Safety. Status 1.4.21. Online: www.rki.de/SharedDocs/FAQ/COVID-Impfen/FAQ_Liste_Wirektiven_Sicherheit.html (last accessed: April 6, 21)

Paul Ehrlich Institute; COVID-19 vaccines. Status 1.4.21. Online: www.pei.de/DE/arzneimittel/impfstoffe/covid-19/covid-19-node.html (last accessed: April 6, 21)

Dagan, N., Barda, N., Kepten, E., et al. . BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Mass Vaccination Setting. New England Journal of Medicine. Online: https://doi.org/10.1056/nejmoa2101765 (last accessed: April 6, 21)

Public Health England: Public Health England vaccine effectiveness report. Status: March 2021. Online: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/971017/SP_PH__VE_report_20210317_CC_JLB.pdf (last accessed: April 6, 21)

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