From the Guidelines
The mRNA COVID-19 vaccines (Pfizer-BioNTech/Comirnaty and Moderna/mRNA-1273) should be administered as a primary series of two doses, with the specific dosing interval and number of doses depending on the individual's age, immunocompromised status, and previous COVID-19 vaccination history, as outlined in the most recent guidelines from the Advisory Committee on Immunization Practices 1.
Key Recommendations
- For individuals aged 6 months to 4 years, the primary series consists of 2 doses of Moderna (0,4-8 weeks) or 3 doses of Pfizer-BioNTech (0,3-8,11-16 weeks) 1.
- For individuals aged 5 years and older, the primary series consists of 2 doses of Moderna (0,4-8 weeks) or 2 doses of Pfizer-BioNTech (0,3-8 weeks) 1.
- For immunocompromised individuals, a third primary dose is recommended, with the specific dosing interval depending on the individual's age and previous COVID-19 vaccination history 1.
- Booster doses are recommended for eligible individuals, typically given at least 2 months after completing the primary series or previous booster 1.
Administration and Screening
- The vaccines should be administered intramuscularly in the deltoid muscle.
- Before administration, providers should screen for contraindications, including severe allergic reactions to previous doses or components.
Vaccine Efficacy and Safety
- The mRNA COVID-19 vaccines have been shown to be highly effective in preventing COVID-19, with efficacy rates of 95% for Pfizer-BioNTech and 94.5% for Moderna 1.
- Common side effects include injection site pain, fatigue, headache, muscle pain, and fever, typically resolving within 1-2 days.
Special Populations
- Patients with cancer, including those participating in oncology clinical trials, should be prioritized for COVID-19 vaccination, as the benefits of vaccination are likely to far outweigh the risks of vaccine-related adverse events 1.
- Patients with psoriatic disease should receive an mRNA-based COVID-19 vaccine as soon as it becomes available to them, unless contraindicated 1.
From the Research
mRNA Vaccines for Disease Prevention
The administration of mRNA vaccines, such as Pfizer-BioNTech (Comirnaty) and Moderna (mRNA-1273), has been recommended for disease prevention, particularly against COVID-19. The key characteristics of mRNA vaccines include:
- Ability to give rise to non-toxic, potent immune responses 2
- Potential to design and upscale them rapidly, making them excellent vaccine candidates during pandemics 2, 3
- More than 90% protective efficacy against symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection alongside tolerable safety profiles in clinical trials 2, 4
Recommendations for Administration
The recommendations for administering mRNA vaccines include:
- Rapid design, generation, manufacturing, and administration, offering strong potential to be used against various diseases in the future 3, 5
- Optimization of mRNA design, intracellular delivery, and applications beyond SARS-CoV-2 prophylaxis 5
- Use of lipid nanoparticles and other non-viral delivery vehicles to enhance vaccine effectiveness 5
- Consideration of novel technologies enabling rational antigen design, innovative vaccine delivery strategies, and vaccination regimens to yield potent novel vaccines against a wide range of pathogens 6
Safety and Efficacy
The safety and efficacy of mRNA vaccines have been demonstrated in various studies, including:
- Real-world evidence following the deployment of global vaccination campaigns utilizing mRNA vaccines, which has bolstered clinical trial evidence and further illustrated that this technology can be used safely and effectively to combat COVID-19 2
- Systematic reviews on the efficacy and effectiveness of COVID-19 vaccines, which have shown that new vaccination technologies can have more than 90% efficacy against SARS-CoV-2, regardless of the technology used 4
- Adverse reactions ranging from mild to moderate, and good immunogenicity observed for all vaccine types 4