Novavax is here to fight COVID: What you should know about the vaccine

Fall is here, which means respiratory viruses like flu, RSV and COVID are expected to continue to spread as the weather cools and more people gather indoors.

Fortunately, we have vaccines in stock to prevent respiratory viruses from developing into serious illness. In addition to flu vaccines for the general public and RSV vaccines for older adults and pregnant women, new COVID vaccines from Pfizer-BioNTech, Moderna and Novavax are available this season to reduce the risk of hospitalization.

That means adults have a choice of which COVID vaccine they receive: an mRNA vaccine from Moderna or Pfizer, or Novavax, a protein-based vaccine that fights the virus in a more “traditional” way. All three have been approved by the US Food and Drug Administration. While Moderna and Pfizer have been widely used in recent years, the Novavax vaccine has become increasingly popular.

Novavax, a protein-based vaccine, is an option for those who don't want or can't take an mRNA vaccine. Novavax could also be of interest to those looking to experiment with the “mix-and-match” approach of COVID boosters to potentially boost the immune response.

“Even though mRNA vaccines dominate the COVID vaccine market, it remains important to have multiple different types of technologies against different pathogens, as each may have specific use cases,” says Dr. Amesh Adalja, an infectious disease expert and senior scientist at the Johns Hopkins Center for Health Security, said in an email.

Here's everything we know about Novavax this year. Plus, read more about the at-home flu vaccine that will be available next year and how to order more free COVID tests online.

How is Novavax different from Pfizer and Moderna?

Novavax is a protein-based vaccine that people associate with a “traditional” vaccination approach. This is compared to mRNA technology, which does not use dead or weakened viruses as part of the vaccine, but instead uses the genetic code to instruct the recipient's immune system to respond.

However, Adalja said calling Novavax traditional might be a “misnomer” as it brings its own innovation. Novavax uses a genetically engineered insect virus to express spike proteins, Adalja explained, which are then incorporated into the vaccine.

“The vaccine itself is coupled with an immune system booster, called an adjuvant, which strengthens its immunity,” he said, referring to a component also found in existing vaccines.

This year there are also slight differences between Novavax and Pfizer, as well as Moderna's updated vaccines. Both mRNA vaccines have been optimized to target the KP.2 strain of COVID-19, which is a slightly newer version of the virus than what Novavax is targeting, namely the “parent” strain JN.1 of KP.2 . Although the FDA ultimately decided that KP.2 was preferred among vaccines, all vaccines are expected to help protect against serious illness and death.

However, no COVID vaccines will be covered for free by the U.S. government this season. While most people assume that the costs will continue to be covered by their health insurance, adults without private or statutory health insurance have to cover the costs. The Bridge Access program was supposed to provide free COVID vaccines to people without health insurance this year, but it ended in early August due to a lack of funding.

According to GoodRx, which offers a coupon for Novavax, the retail price of the protein-based vaccine is about $191.

Who should get Novavax? Does Novavax have various side effects?

Novavax has been approved by the FDA for use in adults and children ages 12 and older, so younger children cannot receive this vaccine. However, for most adults, the choice of COVID vaccine depends on your preferences and your local pharmacy's supplies.

However, people may choose Novavax for different reasons. For people who don't want to take an mRNA vaccine, the availability of a protein-based vaccine like Novavax means they can still get vaccinated for the fall and winter seasons.

Other people may be interested in Novavax for its use in the “mix-and-match” approach to strengthening, which has been linked to a strong immune response in the past.

There is some early research that suggests Novavax may have fewer short-term side effects like muscle fatigue and nausea, but “we can't say that for sure,” Joshua Murdock, pharmacist and pharmacy editor of GoodRx, said in an email.

“This is not proven and side effects vary from person to person,” Murdock said. He added that the CDC does not recommend one vaccine over another, even in people with weakened immune systems.

In general, mRNA vaccines have been found to be quite “reactogenic” compared to other vaccines, Adalja said, noting that this also depends on the individual. But if someone has had a bad experience with the mRNA vaccine, Adalja said, “they may do better with the Novavax vaccine.”

Some flu-like side effects are to be expected after vaccination, no matter which vaccination you choose. These include symptoms such as headaches, fatigue, a sore arm and even chills. If you don't experience any symptoms, it doesn't mean that your immune system isn't working, but the appearance of some side effects can be a signal that your immune system is reacting to the shock.

In rare cases, myocarditis or heart inflammation problems have been linked to the COVID vaccination, particularly in younger men and adolescents within two weeks of vaccination. However, research so far shows that Novavax, like mRNA vaccines, may cause this rare side effect.

With high COVID cases this summer in the U.S., more information is needed to see how all vaccines and their newly developed formulas perform against the virus, which is expected to continue spreading this fall and winter.

“There is no clear evidence that one vaccine is preferable to another in certain individuals, but this will be an important research avenue for more precise vaccine recommendations,” Adalja said.

How to find a Novavax vaccine

Novavax announced on September 13 that doses of its vaccine would be available at the following pharmacies:

Novavax also has a vaccine finder on its website. To use it, enter your zip code in the small search box. Pharmacies nearby that have the vaccine in stock will then be displayed.