The Centers for Disease Control and Prevention  authorized the use of a new vaccine for COVID-19, offering another option for people who may have been hesitant about getting vaccinated.

Here, Jason Pogue, PharmD., clinical professor of pharmacy at University of Michigan College of Pharmacy, provides some answers about the Novavax COVID-19 vaccine.

What's different about the Novavax vaccine?

The currently available vaccines (both the Moderna and Pfizer mRNA vaccines and the Johnson & Johnson vaccine) work by introducing the genetic instructions for the spike protein of SARS-CoV-2 into the body.

The spike protein is then made within our cells, which ultimately stimulates an immune response. These are both relatively new technologies.

Novavax uses a more established method of vaccination, where the spike protein is produced outside the body and then injected into us.

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This mechanism of vaccination has been used for many vaccines over the years including some flu vaccines and the hepatitis B vaccine, so it has more of a track record.

Additionally, the Novavax vaccine includes an adjuvant, or enhancer, which helps further stimulate the immune system to recognize the protein being injected and develop a more robust immune response.

It is a nice option for people who are currently unvaccinated because they were not comfortable with the mRNA/viral vectored vaccines, given that they were novel technologies.

How well does the Novavax vaccine protect against infection, severe disease and death?

We know that the Novavax vaccine stimulates a robust immune response, and the results in the clinical trial leading to its approval were quite positive, with vaccine efficacy of around 90% against infection.  In the trial, all four cases of severe disease occurred in the placebo arm.

What about Novavax efficacy against Omicron?

While the Novavax vaccine performed well in the clinical trials against infection, it's important to note that this was largely during the alpha wave, earlier in the pandemic. We would anticipate that efficacy against Omicron infection with the two-dose primary series to be decreased compared to this, as has been demonstrated with the mRNA vaccines, which are also less protective against Omicron infection.

Importantly, efficacy against severe disease, hospitalization, and death has held up quite well against Omicron with the mRNA vaccines. While we do not currently know that this will be the case for the Novavax vaccine, it is anticipated.

If you already received one of the other vaccines, can you get Novavax as a booster?

Currently, the Novavax COVID-19 vaccine is only authorized as a two dose primary series, so this cannot be used as a booster.

However, it is currently being studied as a booster – both as a monovalent booster (a booster against one variant) and as a bivalent booster (a booster against two variants), including the original SARS-CoV-2 spike protein and BA.5 – for all patients, including those who received one of the mRNA vaccines. Therefore, stay tuned for the recommendations this fall for boosters, as Novavax may find itself in the mix.

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