The coronavirus vaccine by Moderna has been authorized by the Food and Drug Administration, setting in motion a massive effort to distribute nearly 6 million doses across the country starting this weekend.

The approval of a second vaccine to inoculate Americans against the deadly COVID-19 virus will accelerate the pace of a national campaign to provide the public with a new method of protection from the disease that has upended lives everywhere.

It also raises new questions about vaccine choice

Dose #1 of Pfizer-BioNTech COVID-19 vaccine in syringe during press event held at Queen's Medical Center. December 15, 2020
On Friday the Food and Drug Administration authorized the coronavirus vaccine by Moderna for emergency use. Cory Lum/Civil Beat/2020

Hawaii is expected to receive 36,000 doses of the Moderna vaccine in addition to nearly 46,000 doses of the Pfizer vaccine, according to Hawaii Health Department Director Dr. Libby Char.

This gives Hawaii 86,000 vaccine doses by the end of the year.

The Pfizer vaccine will initially be given to Hawaii’s health care workers, while the Moderna vaccine will be distributed to residents and staff of the state’s long-term care facilities.

Eventually, Hawaii residents will have a choice over which vaccine they want to receive, said Brooks Baehr, spokesman for the DOH. But in the near term, while vaccine supply is limited, choice of vaccine will not be possible, he said.

“These two vaccines appear largely identical in terms of efficacy from what we see so far,” said Dr. Tarquin Collis, an infectious disease specialist at Kaiser Permanente Hawaii. “These are really two different color M&Ms from my standpoint.”

The Pfizer and Moderna vaccines have more similarities than differences.

Both vaccines require two doses. Pfizer requires the doses to be administered exactly three weeks apart. Moderna says its second dose should be spaced 28 days after the first.

And both vaccines use mRNA technology — a state-of-the art development in modern medicine.

Here’s how it works: the vaccines direct cells in the human body to produce a protein that resembles the part of the COVID-19 virus that binds to cells. When the body starts to make this protein, the body reacts by generating antibodies.

“There are some real advantages to the mRNA platform,” Collis said. “Among the most important is that there’s no need for live virus in this delivery system, which is nice.” 

“A lot of the vaccines that are coming down the pike — AstraZeneca and Johnson & Johnson — do require live virus, which is not particularly problematic and has proven safe so far,” he said. “But this one does not involve any live virus.”

Logistically, the Moderna vaccine could be a better bet for Hawaii.

That’s because the Moderna vaccine is easier to store and handle than the Pfizer vaccine, which requires ultra-cold freezer storage at 70 degrees Celsius below zero.

Moderna’s vaccine can be stored in normal freezers, making it more accessible to small, rural health facilities that lack the requisite temperature controls. 

“These are really two different color M&Ms from my standpoint.” — Dr. Tarquin Collis

The Moderna vaccine’s efficacy against COVID-19 is 94.1%, according to a review by the FDA. The agency found the Pfizer vaccine to be 95% effective. 

Experts say the difference is negligible.

There were 30,000 participants in a clinical trial for the Moderna vaccine. Half of them were given a placebo and the rest received the actual vaccine. 

All told, 11 of the 15,000 people who received the vaccine contracted COVID-19. None of them developed serious symptoms.

The Pfizer clinical trial included 42,000 people, about half of whom received the actual vaccine. The rest were given a placebo. 

Just eight people given the real vaccine contracted COVID-19 during the trial.

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