# How long would you wait to get Moderna/Pfizer vs J&J?

**My assessment:**

*   People who can easily continue to guard against significant COVID risks for several weeks without much downside other than quality of life should wait several weeks for Pfizer or Moderna.
*   (People who have to expose themselves to a non-trivial amount of COVID risk no matter what should take the J&J vaccine if they'd have to wait several more weeks for Pfizer / Moderna. I haven't run the numbers on this, but at some point I'd expect the additional risk exposure from being unvaccinated for several weeks to outweigh the difference in efficacy.)

**My rationale:**

1\. Moderna and Pfizer provide significantly better protection against non-severe infections.

*   J&J provides:
    *   *28 days after the injection:* 66% protection against moderate to severe COVID infections (72% "in the United States", but I don't know to what extent that is robust to further spread of foreign variants in the US) and 85% against severe disease \[1\]\[2\]
    *   *48 days after the injection:* 100% protection against severe COVID. (I don't know what 100% protection means, exactly - a commenter pointed out that there is no such thing as 100% protection - but for the sake of argument, let's say it's close to that.) \[3\]
*   Moderna and Pfizer provided 94.1% and 95% protection against any symptomatic infections generally after the 2nd dose \[1\]

2\. I'd expect that even non-severe infections increase your risk of long-term lingering effects (in addition to being fairly unpleasant in the meantime, but I'm less concerned about that). 

*   I don't have great evidence for #2 yet. While mild infections have a non-trivial risk of long COVID \[4\], it seems like even initially asymptomatic cases account for about a 3rd of long-COVID cases \[5\]. I would hypothesize that the risk of long COVID is significantly less for asymptomatic cases than for symptomatic cases, but haven't researched that much yet.

Zvi said in his [2/4 COVID post](https://www.lesswrong.com/posts/4HA3iRqv7twrjsRYB/covid-2-4-safe-and-effective-vaccines-aplenty), "I’d pay a substantial amount to get Pfizer or Moderna instead of J&J if I could get either one today, but given the choice between waiting and taking what’s available, I will happily accept the J&J vaccine now rather than hold out for Pfizer or Moderna."

What am I missing? Is this just a difference in the weight we place on resuming higher-risk activities sooner rather than later? Or am I overplaying the superior efficacy of the Pfizer and Moderna vaccines?

**Sources:**

\[1\] [https://www.statnews.com/2021/02/02/comparing-the-covid-19-vaccines-developed-by-pfizer-moderna-and-johnson-johnson/](https://www.statnews.com/2021/02/02/comparing-the-covid-19-vaccines-developed-by-pfizer-moderna-and-johnson-johnson/)

\[2\] [https://www.fda.gov/media/146265/download?fbclid=IwAR1eMK87XHF7ibOLoojaoH-ZFPNgTuOLqgkqur9D1SCtSGbrQj3A3VT5C5k](https://www.fda.gov/media/146265/download?fbclid=IwAR1eMK87XHF7ibOLoojaoH-ZFPNgTuOLqgkqur9D1SCtSGbrQj3A3VT5C5k) 

\[3\] [https://twitter.com/VirusesImmunity/status/1355149007220310019](https://twitter.com/VirusesImmunity/status/1355149007220310019) 

\[4\] [https://www.webmd.com/lung/news/20210111/even-mild-cases-of-covid-can-leave-long-haul-illness-study-shows#1](https://www.webmd.com/lung/news/20210111/even-mild-cases-of-covid-can-leave-long-haul-illness-study-shows#1)

\[5\] [https://www.pharmacytimes.com/view/study-many-long-haul-covid-19-patients-were-asymptomatic-during-initial-infection](https://www.pharmacytimes.com/view/study-many-long-haul-covid-19-patients-were-asymptomatic-during-initial-infection)