Choosing the Right COVID Vaccine Booster: BNT vs. Moderna for Adults

Q: Choosing the Right COVID Vaccine Booster: BNT vs. Moderna for Adults

Hello： The BNT vaccine contains only the "prototype strain mRNA" of the COVID-19 virus, while the Moderna next-generation bivalent vaccine contains both the "prototype strain mRNA" and the "Omicron BA.1 variant RNA." Given the current prevalence of the Omicron variant of the COVI

COVID-19 vaccine

Hello, doctor.
Today the news reported that individuals aged 18 and older who meet the criteria can choose any next-generation vaccine for their booster shot.
I have already received three doses: AZ, BNT, and BNT.
After seeing this news, I am considering choosing BNT as my fourth dose (since I did not experience any side effects from BNT).
However, will choosing BNT as my fourth dose provide sufficient protection? How does it compare to the Moderna next-generation bivalent vaccine in terms of efficacy? Thank you, doctor.

Niming, 20~29 year old female. Ask Date: 2022/10/27

Dr. Lin Zhebin reply Family Medicine

Hello: The BNT vaccine contains only the "prototype strain mRNA" of the COVID-19 virus, while the Moderna next-generation bivalent vaccine contains both the "prototype strain mRNA" and the "Omicron BA.1 variant RNA." Given the current prevalence of the Omicron variant of the COVID-19 virus, the Moderna next-generation bivalent vaccine is expected to provide better protection, and it also offers protection against the Omicron BA.4/BA.5 variants.

Reply Date: 2022/10/27

More Info

When it comes to choosing a COVID-19 vaccine booster, particularly for adults who have already received multiple doses, it's essential to consider the type of vaccine and its efficacy against the currently circulating variants. In your case, you've received three doses: AstraZeneca (AZ), followed by two doses of the Pfizer-BioNTech (BNT) vaccine. Now, you're contemplating a fourth dose of the BNT vaccine.

The BNT vaccine you are considering is a monovalent vaccine, which means it contains the mRNA that encodes for the original strain of the SARS-CoV-2 virus. On the other hand, the Moderna bivalent vaccine includes mRNA for both the original strain and the Omicron variant (specifically BA.1). Given the current landscape of COVID-19, where Omicron variants are predominant, the bivalent vaccines are generally expected to provide better protection against these variants compared to the monovalent vaccines.

Research has shown that bivalent vaccines tend to elicit a more robust immune response against the circulating variants, including Omicron subvariants BA.4 and BA.5. Therefore, while the BNT vaccine will still offer some level of protection, it may not be as effective as the Moderna bivalent vaccine in preventing infection or severe disease caused by these variants.

Moreover, it's important to note that the immune response from vaccines can wane over time. After receiving your last dose, the protective antibodies may decrease, which is why booster doses are recommended. If you choose to receive the BNT vaccine as your fourth dose, it will still contribute to your overall immunity, but it may not provide the optimal level of protection against the current variants compared to the bivalent options.

In addition to the type of vaccine, other factors should be considered when choosing a booster. These include your personal health history, any previous side effects from vaccines, and the current COVID-19 situation in your area. If you experienced no side effects from the BNT vaccine, that is a positive aspect to consider. However, it is crucial to weigh this against the potential benefits of the bivalent vaccine.

In summary, while opting for the BNT vaccine as your fourth dose is a valid choice, it may not provide the same level of protection as the Moderna bivalent vaccine against the currently circulating Omicron variants. If possible, consulting with your healthcare provider about your specific situation and the latest recommendations can help you make an informed decision that aligns with your health needs and the evolving nature of the pandemic.

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