What if you had your choice of COVID-19 vaccine? Differences are small, but they do exist

If you get the choice, which COVID-19 vaccine should you choose? For now, experts are clear: The best vaccine is the one about to go into your arm. But as the vaccine supply grows, Americans eventually might find someone asking, “Which vaccine do you want?”

COVID vaccine differences: What to know about Pfizer, Moderna, J&J

The answer for most people will still be “Whatever’s available.” But there are differences that could play a role, though doctors are unanimous that all three authorized vaccines work extremely well to protect against severe disease, hospitalization and death.

A shot now is better than waiting for a different shot, said Dr. Kathryn Edwards,  scientific director of the Vaccine Research Program at Vanderbilt University’s School of Medicine. It likely benefits the individual and society alike by lowering the overall spread of the disease.

Beyond that, there are small trade-offs when it comes to the current vaccines. In general, Pfizer-BioNTech and Moderna vaccines require two doses and are somewhat more effective. Johnson & Johnson requires one dose and is somewhat less likely to cause side effects.

J&J’s “one and done” aspect is a selling point for many.

What to expect before and after getting a COVID-19 vaccine, an illustrated guide

Pedro Betancourt works at the airport in Miami and “can’t take chances,” he said. His choice would be “Johnson & Johnson due to a convenient one shot.” But he said he wasn’t picky because he and his wife had gotten COVID-19, which he described as “mild but scary.”

Right now, “I hope everyone takes the vaccinations seriously so that we can begin moving forward to normalcy,” he said.

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Effectiveness: Check efficacy rates

Overall, Pfizer-BioNTech and Moderna had slightly higher efficacy rates in clinical trials than J&J.

That’s enough for Tom Cavanagh of Lexington Park, Maryland. Given the choice, he’d choose either of them but would be open to all.

“Having been in the U.S. military, I have gotten many vaccines without having a bit of knowledge, so I will take the vaccine that I can get and hope for the best,” he said.

One way to approach this could be deciding if you’re someone at high risk of getting very sick or dying from COVID-19 or if someone in your family is, said Hilda Bastian, a health scientist who writes on COVID-19 vaccines.

People in that group might choose the Pfizer-BioNTech or Moderna vaccines.

For someone who doesn’t have anyone at home at high risk, and isn’t at high risk themselves, that slightly better effectiveness wouldn’t matter as much. The ease of the one-shot J&J vaccine could be more important.

“They might think, ‘As long as I’m doing my bit for the community, if it’s enough for that, then that would be enough for me,’” Bastian said.

Immunity: How fast does it work?

How quickly the vaccines’ protection kicks in and how long it lasts are still being worked out. No long-term data is available because none of the vaccines are more than a year old.

The vaccines don’t give immediate protection because there are biological limitations at work, said Dr. Otto Yang, a professor of medicine and associate chief of infectious diseases at UCLA’s David Geffen School of Medicine.

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