Great news: Moderna's two-dose COVID-19 vaccine 94% effective -- and can stop its spread

Want the good news first, or the bad news? How about the great news? The Food and Drug Administration released the data on Moderna’s emergency-use authorization (EUA) for its COVID-19 vaccine this morning, and it has nothing but great news. The two-dose regimen results in 94% efficacy in producing an immune response against the virus, almost identical to that of Pfizer. Even on the first dose, the efficacy rate would normally satisfy FDA approval requirements.

Unlike Pfizer’s vaccine trials, however, Moderna has evidence that its vaccine can stop people from spreading the virus as well:

Moderna’s Covid-19 vaccine is 94 percent effective at preventing symptomatic illness and appears to prevent the spread of the virus as well, according to documents released Tuesday. …

The high efficacy of the Moderna vaccine was noted after two doses given 28 days apart. This is about the same level of effectiveness as the Pfizer-BioNTech vaccine.

But there is also evidence that just one dose of Moderna’s may stop the virus’s spread. A second document published on the FDA website shows asymptomatic infection was reduced by 63 percent after the first shot.

That’s not to say that Pfizer’s vaccine doesn’t do the same thing. However, their trials apparently didn’t address the question of immune carriers, or at least not to the extent where the data allowed for a conclusion on the question. Pfizer and Moderna will continue their trials to move from EUAs to outright approval, and so we can expect that question to be answered at some point. The FDA seems assured that Moderna has already answered that question with its vaccine trials, which should accelerate a return to normality as more people access the Moderna vaccine, at least.

The initial efficacy rate is also similar to Pfizer’s. Normally, a vaccine has to show somewhere upward of 50% efficacy for FDA approval, so both of these would succeed on just one dose. However, the FDA has already indicated that it will enforce the two-dose requirement as a condition of the EUA, which seems reasonable under pandemic conditions, if costly, as it means that the number of people reached will be halved (theoretically, anyway) until we see fully ramped-up production.

That may not be as much of a problem as one might think, however. Here’s the bad news, from a new survey from Kaiser Family Foundation, but even that’s tinged with some improvement:

  • With the launch of the KFF COVID-19 Vaccine Monitor, a new KFF survey finds an increase in the share of the public saying they would definitely or probably get a vaccine for COVID-19 if it was determined to be safe by scientists and available for free to everyone who wanted it. This share now stands at 71%, up from 63% in a September survey conducted in partnership with ESPN’s The Undefeated. Following on the heels of the presidential election and promising news about several COVID-19 vaccine candidates, the new survey finds an increase in the share who say they would get vaccinated across racial and ethnic groups, and among both Democrats and Republicans (willingness to get vaccinated among independents has not changed).
  • About a quarter (27%) of the public remains vaccine hesitant, saying they probably or definitely would not get a COVID-19 vaccine even if it were available for free and deemed safe by scientists. Vaccine hesitancy is highest among Republicans (42%), those ages 30-49 (36%), and rural residents (35%). Importantly, 35% of Black adults (a group that has borne a disproportionate burden of the pandemic) say they definitely or probably would not get vaccinated, as do one third of those who say they have been deemed essential workers (33%) and three in ten (29%) of those who work in a health care delivery setting .
  • Among those who are hesitant to get a COVID-19 vaccine, the main reasons are worries about possible side effects (59% cite this as a major reason), lack of trust in the government to ensure the vaccines’ safety and effectiveness (55%), concerns that the vaccine is too new (53%), and concerns over the role of politics in the development process (51%).

As has been repeatedly noted, vaccines don’t save lives — vaccinations save lives. If a quarter of the public remains hesitant, that means efforts to get to induced herd immunity might fall short and transmission rates will remain high — at least at first. We’re already seeing some small movement toward immunization in this series without vaccinations taking place at all. Now that they have begun, the results should soon be evident, and that may build more confidence in the vaccines and the process.

For some, the question might well be more of access than desire. The first round of the Pfizer vaccine and its 40 million doses will focus mainly on health-care workers and nursing-home residents. Assuming Moderna gets its EUA on Thursday as expected, the US will have tens of millions of doses more than it got from Pfizer to distribute, which means plenty of people in Phases 1B and 2 might get their opportunity to vaccinate. Those decisions might well change toward vaccination when the question becomes acute rather than academic — and the option is to roll the dice on getting infected instead.

Still, 27% resistance isn’t actually all that bad, considering the novelty of the disease and the vaccine. If that translates into actual participation over the next three months, that will still mean a rapid decrease in transmissibility for COVID-19, and that will save many lives in 2021. We are finally seeing the light at the end of the tunnel.