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Welcome to “Pandemic Problems,” a column of advice from The Chronicle’s engaging journalists that aims to help Bay Area residents solve their pandemic-related puzzles – personal, practical or professional. Send your questions and concerns to [email protected].
Today’s question is posed by Kellie Hwang of The Chronicle.
Dear consulting team: I have heard that the Moderna vaccine is only 85% effective for the elderly. This seems low (compared to 95% or 96%). Is this also true for the Pfizer vaccine?
Dear reader:
As vaccines roll out across the country, your question is very relevant, especially because older people are more vulnerable to serious illnesses linked to COVID-19. California lowered the cut-off age for vaccinations from 75 to 65 on Wednesday, giving that larger group priority access.
The vaccines manufactured by Pfizer-BioNTech and Moderna are the only two approved to date in the United States. In clinical trials, the Pfizer-BioNTech vaccine had an overall efficacy rate of 95%, while that of Moderna was 94.1%.
According to an analysis of the Moderna vaccine trial in the New England Journal of Medicine, patients aged 18 to 65 showed an efficacy of 95.6%, while the rate was 86.4% for those over 65. years. Pfizer, on the other hand, reported that the efficacy was over 94% in people over 65.
Monica Gandhi, infectious disease specialist at UCSF, said if the effectiveness rate of Moderna vaccine in older people was slightly lower in the trial, the difference was “not substantial” and could equalize with time.
She cited several reasons for the lower rate, including the fact that the test group in this age group was smaller than the others, as well as the possibility that the effect was a matter of “luck.”
Gandhi said older patients might not have got the same response as younger ones “due to immune system fatigue”. However, she added, “It could be that this group, when followed for longer, would have the same rate of effectiveness, but Moderna quickly reported on their findings, as did Pfizer on behalf of the advisability of obtaining an authorization. “
But Gandhi said the “slightly reduced efficacy” for the 65-and-over age group seen in Moderna’s short-term outcome trial shouldn’t lead to long-term implications.
“We need to see if the immune response in the elderly remains robust over time, and all of this data will be available,” she said.
She pointed out that an evaluation of the Moderna vaccine that showed long-term efficacy, especially the concentration of neutralizing antibodies, was as robust in people over 70 as it was in 55 to 70 year olds. On Tuesday, the company announced that immunity to the vaccine is expected to be good for about a year.
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For Moderna vaccine, the second dose should be given at least 28 days after the first dose, and 94.1% efficacy started 14 days after the second dose. For Pfizer vaccine, the dose interval is 21 days and efficacy began seven days after the second dose.
Gandhi said the elderly should continue to take COVID-19 precautions for at least 14 days after receiving their second dose, and said waiting a whole month should provide more confidence to participate in more risky activities.
Experts continue to collect data on people vaccinated, so we should know more in the future about the effectiveness of vaccines.
So the bottom line? Go get vaccinated when it’s your turn.
“Everyone should absolutely be vaccinated, especially those who are older,” Gandhi said. “This 86.4% efficacy rate is still incredibly robust and exciting and means the vaccine is working well.”
Kellie Hwang is a writer for the San Francisco Chronicle. Email: [email protected] Twitter: @KellieHwang.
“Pandemic Problems” is written by Annie Vainshtein and Kellie Hwang, members of the Chronicle’s advisory team, combining in-depth reports and advice from Bay Area experts to help elicit answers and find a way forward.
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