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My Vaccine is Better Than Yours!

Natalia Pasternak, PhD

Disclosures

August 16, 2021

As a science communicator, I am often asked which is my favorite vaccine for COVID-19. I usually answer that there is indeed a vaccine technology that is closest to my heart, but as a responsible citizen in a public health emergency, personal preferences must give way to the public good.

I'm a geneticist by training, so I have a soft spot for genetic vaccines. I participated in the research of genetic vaccination platforms, and they are the ones I am most familiar with. When this family of technologies reached the market with Pfizer-BioNTech and Moderna, I was thrilled.

As a health communicator, though — and I believe the same applies to every clinician in a doctor's office — we have to be very careful about how to communicate such preferences. There can be no vaccine darling during a health emergency. All vaccines approved by the main regulatory agencies proved to be safe and effective for COVID-19. And all vaccines were tested for their power to prevent illness — and especially serious illness — hospitalization, and death. And guess what?

They all delivered.

They are similar in their capacity to prevent people from getting severely ill or dying. And this is what we need to convey to the population at large, and especially to the vaccine sommelier who refuses any vaccine other than the one they perceive to be the best.

The Vaccine Sommelier

When choices abound and there is availability, selecting the vaccine that you deem best is appropriate, but always with medical expertise, and not based on social media hype.

The reality in most parts of the world, though, leaves no room for such privilege. Vaccinating fast and vaccinating many is the priority. All vaccines are needed, and there is no way a single manufacturer is going to be able to meet the global demand.

It is up to us, then, scientists and doctors, to explain to our friends, relatives and patients that they should get whatever vaccine is available in their country, and as soon as possible. The saying "No one is safe until everyone is safe" still stands.

So when people come to you saying that they prefer a particular vaccine, take the time to explain how all the vaccines were tested and why it is pointless to try to compare results of separate clinical trials. Trials have been conducted under different conditions, in different countries, and in different transmission conditions and presence of virus variants. The only way to get a fair comparison would be to run a trial comparing two vaccines, as we do in noninferiority trials, when the goal is to prove that a new vaccine is not inferior to the existing one.

Honesty and transparency are essential too; there is no need to pretend that all vaccines are absolutely equal. We still don't know that, and of course some are bound to be better for specific populations, or even better in general. This information will be useful in the future.

Studies show a tendency of finding better effectiveness of the genetic vaccines in preventing transmission, and fewer cases of breakthrough infections. But that doesn't mean that for the emergency purpose of keeping people out of the hospital and the cemetery, the others are not effective.

They all work.

And by the way, talking about third doses when a considerable portion of the world's population is still waiting for a first or second dose is reckless and inhumane.

When people are starving, we feed them. After the crisis, we can afford to consider new cuisine types and appetizing spicing. During the pandemic, the world needs emergency intervention. First, we vaccinate everyone with all the vaccines available. Then we can decide which vaccine is best for each country, considering different distribution, storage, and manufacturing capacity. But in the meantime, we can't afford to delay protection any longer.

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About Dr Natalia Pasternak
Natalia Pasternak, PhD, has a bachelor's degree in biology from the University of Sao Paulo, and a PhD and postdoctoral fellowship in microbiology (bacterial genetics) at the Institute of Biomedical Sciences. In 2018, she founded the Instituto Questão de Ciência in Brazil, the first Brazilian institute for the promotion of skepticism and critical thinking. She is the publisher of Questão de Ciencia magazine; a columnist or contributor for O Globo newspaper, CBN radio, and The Skeptic magazine (UK); and a fellow of the Committee for Skeptical Inquiry (US). Currently, she works as a Visiting Scholar at the Center for Science and Society at Columbia University in New York, NY (US) and is a visiting professor at the Public Administration School at Fundação Getulio Vargas, São Paulo.

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