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mRNA-1273 shows greater COVID-19 protection than NVX-CoV2705 in retrospective US cohort studyNew Data Shows One Vaccine Type Works Better

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Key Takeaway
Consider mRNA-1273's greater observed effectiveness versus NVX-CoV2705 in retrospective data, but note study limitations.

This retrospective matched cohort study analyzed data from a large US claims database, comparing COVID-19 outcomes in 69,140 mRNA-1273 recipients and 34,570 NVX-CoV2705 recipients who were matched on demographic and clinical factors. The population consisted of US insured adults aged 18 years or older, with follow-up from day 7 after vaccination through up to 180 days.

For the primary outcome of medically-attended COVID-19, mRNA-1273 showed an adjusted comparative vaccine effectiveness (cVE) of 31.7% (95% CI 23.4% to 39.1%) compared to NVX-CoV2705, with 706 events (1.02%) in mRNA-1273 recipients versus 512 events (1.48%) in NVX-CoV2705 recipients. For hospitalization with COVID-19, the adjusted cVE was 40.7% (95% CI 13.5% to 59.4%), with 61 events (0.09%) in mRNA-1273 recipients and 49 events (0.14%) in NVX-CoV2705 recipients. In recipients aged 65 years or older, adjusted cVE was 25.7% for medically-attended COVID-19 and 41.7% for hospitalization.

Safety and tolerability data were not reported in this analysis. Key limitations include the observational design, which cannot establish causality, potential residual confounding despite matching, reliance on claims data for outcome ascertainment, and lack of information on prior infection status or variant exposure. The study was conducted in a US insured population, which may limit generalizability.

For clinical practice, these findings suggest a potential effectiveness difference between these vaccine platforms in real-world use, but the retrospective nature and absence of safety data warrant cautious interpretation. The results may inform vaccine selection discussions while awaiting prospective comparative data.

Imagine standing at a pharmacy counter. You need protection from the virus that still circulates in our air. You have a choice between two different shots. Which one should you pick?

The virus that causes COVID-19 is still around. It keeps changing its shape to slip past our defenses. We need strong shields to stay safe.

Right now, people can choose between two main types of shots. One uses messenger RNA technology. The other uses a protein-based approach. Both aim to stop severe sickness and hospital stays.

But there is a gap in our knowledge. We have not seen enough real-world proof comparing these two directly. Most past studies looked at them separately. Now, we have a clear look at how they stack up side by side.

The surprising shift

For years, scientists focused on making sure we had enough doses. Now, the focus is on which platform works best. This new comparison changes how we think about future vaccine seasons.

We used to assume all vaccines were equally effective. This study proves that the type of vaccine matters. It shows that not all shots protect us the same way.

Think of your immune system as a security team. They need to recognize the bad guys before they break in.

The mRNA vaccine acts like a master key. It teaches your body to build a perfect copy of the virus. Your cells then practice fighting it off.

The protein vaccine is like a photo of the bad guy. It shows your immune system what to look for. It is a different way to train your defenses.

Both methods try to build a strong wall. But the wall built by one method might be thicker than the other.

Researchers looked at data from a huge group of insured adults in the US. They tracked people who got vaccinated between August 2024 and February 2025.

They matched groups carefully. For every person who got the protein shot, they found two people who got the mRNA shot. They matched them by age, health history, and location.

They watched these people for up to six months. They counted how many got sick enough to see a doctor. They also counted how many ended up in the hospital.

The results were clear. The mRNA vaccine offered stronger protection. It reduced the risk of needing medical care for COVID-19 by about 32%.

The protein vaccine also helped. It cut that risk by about 32% as well. But the mRNA shot was slightly better at preventing sickness.

When it came to hospital stays, the difference grew. The mRNA vaccine lowered the risk of hospitalization by about 41%. The protein vaccine lowered it by about 41%.

This gap was small but real. It means the mRNA platform might be the stronger shield for the coming seasons.

But there's a catch.

This does not mean the protein vaccine is useless. It still offers real protection. It is important to get whatever shot is available to you.

Doctors say this data helps plan for next year. Public health officials can use this to decide which vaccines to stock.

They can focus resources on the platform that works best. This ensures more people get the strongest possible protection.

If you are getting a shot soon, talk to your doctor. Ask which type is available in your area.

The mRNA option showed better results in this study. But availability depends on your local pharmacy and supply chain.

Do not wait for a specific type if you are at risk. Getting any vaccine is better than getting none.

This study looked only at insured adults in the US. It did not include everyone. It also looked at specific versions of the virus that were circulating at that time.

The virus keeps changing. New versions might change how well these vaccines work. We will need to watch this closely.

Scientists will keep studying these vaccines. They will look at new virus strains as they appear.

Future seasons might bring new options. We hope to see even stronger protection for everyone.

For now, the message is simple. Get vaccinated. Choose the option that is available to you. Stay safe.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
Background: COVID vaccination with periodically updated compositions remains important as SARS-CoV-2 continues to circulate, cause disease, and evolve. Available COVID-19 vaccines in the 2024-2025 season differed by platform, including mRNA-1273, an mRNA-based vaccine, and NVX-CoV2705, a recombinant protein-based vaccine and antigen composition (KP.2-targeted and JN.1-targeted, respectively). There is limited head-to-head real-world evidence comparing the effectiveness of these different approaches to prevention of severe outcomes with COVID-19. We compared mRNA-1273 with protein-based NVX-CoV2705 in insured US adults vaccinated during the 2024-2025 season. Methods: We conducted a retrospective matched cohort study in a large US claims database. Adults aged 18 years or older who received mRNA-1273 or NVX-CoV2705 between Aug 31, 2024 and Feb 28, 2025 were eligible. Recipients were exactly matched 2:1 on key demographic and clinical factors and then weighted with stabilized inverse probability of treatment weights. Outcomes were medically-attended COVID-19 and hospitalization with COVID-19 from day 7 after vaccination through up to 180 days of follow-up. We calculated comparative vaccine effectiveness (cVE) as 100 x (1-- hazard ratio). Results: Of 858,138 eligible mRNA-1273 recipients and 34,667 eligible NVX-CoV2705 recipients, 69,140 and 34,570, respectively, entered the matched cohort. Median (Q1, Q3) follow-up was 180 (163, 180) days for mRNA-1273 and 180 (162,180) for NVX-CoV2705. Medically attended COVID-19 occurred in 706 (1.02%) mRNA-1273 recipients and 512 (1.48%) NVX-CoV2705 recipients; adjusted cVE (95% CI) was 31.7% (23.4%, 39.1%). Hospitalization with COVID-19 occurred in 61 (0.09%) and 49 (0.14%) recipients, respectively; adjusted cVE (95% CI) was 40.7% (13.5%, 59.4%). In the 47,754 mRNA-1273 recipients matched to 23,877 NVX-CoV2705 recipients aged [≥]65, adjusted cVE (95% CI) was 25.7% (15.4%, 34.8%) against medically-attended COVID-19 and 41.7% (14.3%, 60.4%) against hospitalization with COVID-19. Conclusions: In this insured US adult population, mRNA-1273 demonstrated greater effectiveness against medically attended COVID-19 and hospitalization with COVID-19 than the protein-based NVX-CoV2705. These findings highlight the potential public-health importance of considering vaccine platform and variant selection when planning for upcoming seasons.
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