Vaccine brand “comparison shopping” presents a critical public health challenge

Not generic.
Not generic.
Image: Reuters/Dado Ruvic
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“Is Pfizer available today? If not, I’ll come back tomorrow.”

While on queue for the Covid-19 vaccine last week, I overheard a woman in front of me quibbling over the dose she was about to receive. To the nurse’s dismay, she refused to budge on the conviction that the mRNA vaccine manufactured by the American pharmaceutical giant was the far superior choice. It’s not a rare case. Tell people that you’ve received the jab, inevitably someone will ask: Which brand?

What may sound like idle small talk points to a bigger public health challenge. Despite the chorus of medical experts stressing that any of the approved vaccines is effective against SARS-CoV2, significant pockets of the population are holding out for their preferred brand. It’s a position shaped as much by their understanding of efficacy rates as well as cultural stereotypes, nationalism, and long-held notions about country of origin branding.

Being choosy among the approved vaccines is more than administrative nuisance for vaccination centers. Public health officials warn that it further delays achieving herd immunity which they contend, is the path to getting the world back to a semblance of normalcy. Experts estimate that at least 70% of a population need to have immunity from Covid-19, which can only be achieved through vaccinations or having anti-bodies from a previous infection.

A woman wearing a protective face mask stands by a sign reading "Pfizer first injection" in a vaccination center in Antibes as part of the coronavirus disease vaccination campaign in France
Image: Reuters/Eric Gaillard

Attitudes about vaccine brands around the world

Canadians prefer Pfizer and Moderna over AstraZeneca. A new study conducted by political scientist Peter Loewen, a professor at the Munk School of Global Affairs & Public Policy, suggests that about 10% of those willing to be vaccinated will refuse the dose if their preferred brand isn’t available. He anticipates that “convincing vaccine recipients that the best vaccine is the one that is on the table in front of them will be a major challenge.”

In the UK, some Brits are holding out for the “English one,” referring to the Oxford-AstraZeneca vaccine. Some ask for Pfizer or “the posh one,” as the Washington Post reports. However, there are reports of Germans and Italians shunning the AstraZeneca dose, mostly because of its messy clinical trial results.

A worker unloads a box of Sinovac Biotech's CoronaVac vaccines against the coronavirus disease (COVID-19) from a Chinese military aircraft at Villamor Air Base in Pasay, Metro Manila, Philippines,
Made in China
Image: Reuters/Eloisa Lopez

In the Philippines, a long-held belief that Chinese goods are inferior has tarnished the reputation of the SinoVac Biotech shot. It hasn’t helped that its latest clinical trials reflect an efficacy rate of just over 50%. Most Filipinos don’t really have a choice since the Duterte government has procured the China-made vaccine for the general public, in addition to AstraZeneca and Pfizer. To muffle the association with China, most Filipinos have begun referring to it by its brand name “CoronaVac“.

Vaccine choice is also influenced by religion. In a March 2 statement, the US Conference of Catholic Bishops urged Catholics to seek alternatives to the Johnson & Johnson vaccine because it was produced with cells harvested from abortions. Addressing the 51 million Catholics in the US, the influential body explained that though Pfizer and Moderna used fetus cells for testing, Johnson & Johnson poses the higher moral dilemma because it was developed, tested, and is produced with them. “If one has the ability to choose a vaccine, Pfizer or Moderna’s vaccines should be chosen over Johnson & Johnson’s,” the Conference advised. 

It was a bold stance that adds a problematic layer to Vatican’s blanket absolution for all options last December, which stressed that “all vaccines recognized as clinically safe and effective can be used in good conscience.” Pope Francis, who received the Pfizer vaccine in January, said getting vaccinated is an ethical obligation.

The preference for Pfizer

This stage of the pandemic is a major moment for manufacturers developing their own tozinameran, the generic name for mRNA vaccines. How they perform will have a ripple effect through their product lines, beyond the Covid-19 drug, explains Manuel Hermosilla, assistant professor of marketing at the Johns Hopkins Carey Business School.

According to marketing experts, Pfizer has emerged as the victor of the vaccine branding wars so far. “The brand Pfizer has been in the news for endless of hours, with the headline 95% efficacy. From the point of view of advertisers, that’s like a gift from heaven,” says Hermosilla, who specializes in the marketing of pharmaceuticals. “Pfizer is, in some way, now equated to the almost perfectly efficacious drug…I would expect that Pfizer is going to start making its brand a much bigger deal in promotions moving forward.”

Pfizer's new logo shown on top, old logo below.
Out with the lozenge: Pfizer’s 2021 logo reboot.
Image: Pfizer

To his point, Pfizer has seized their moment in the spotlight. In January, they even unveiled a new logo that emphasizes their link to hard sciences. It was the first major redesign in 70 years, and the timing couldn’t have been more symbolic. Discarding the lozenge for a helix graphic, CEO Albert Bourla says that it’s a marquee to its new mission. “After 171 years, we arrive at a new era. A time of extraordinary focus on science and dedication to patients. Pfizer is no longer in the business of just treating diseases—we’re curing and preventing them,” he declared.

In theory, one could see the Pfizer’s logo appearing more prominently in its drugs packaging and commercials. Prepare to hear more about Pfizer’s Prevnar or Pfizer’s Viagra.

"Comirnaty" aka the Pfizer vaccine
Call me “Comirnaty”
Image: Reuters/Eric Gaillard

It’s also notable that Pfizer chose to highlight its umbrella brand instead of the name they came up for their Covid-19 gambit. Last year, it worked with the Brand Institute to coin the name “Comirnaty,” (koe mir’ na tee), a mouthful of a mash-up of community, immunity, mRNA, and Covid.

Moderna’s vaccine is very similar to Pfizer’s in term of technology, dosage, and efficacy rates. The 10-year old Massachusetts-based company reported a 94.1% efficacy rate in clinical trials compared to Pfizer’s 95%, and consumers seem to be honing in on the slight percentage difference. When given the choice, they pick Pfizer over Moderna. A more recent survey of recipients suggests that both vaccines have an efficacy rate of 90%.

The purpose of branding

Brands, in essence, serve to simplify choices for the public. In a sea of options, a well developed brand will highlight differentiating attributes of a product.

“Brands address an information problem,” explains Hermosilla. “On a very high level, brands help in the search process and they do so by giving you some sort of quick summary of the functional and emotive value of a product.”

But Hermosilla says in the interest of getting through the pandemic, it’s crucial to subvert our consumerist instincts for comparison shopping and heed the advice of health experts.

“Rather than use this commentary to rationalize brand preferences and further a kind of vaccine elitism, we should try to understand the bigger crisis and postpone the dilemma of choice until the height of the pandemic is behind us,” he adds.

Hermosilla, who is scheduled to receive his second Pfizer dose this week, says he was glad to receive the favored brand, but he would have taken any drug available.

My parents who are in their 70s and my grandma who is 90 living in Chile received the Chinese vaccine. I was extremely happy that they had gotten it, even though the headline efficacy number isn’t as good as Pfizer’s,” he says.

Hermosilla echoes the opinion of the world’s top medical experts who stress that any of the approved vaccines is 100% effective against preventing severe complications that lead to hospitalizations or fatalities. “The most important thing to do is to get vaccinated and not to try and figure out which one may be or may not be better than the other.” explained Dr. Anthony Fauci in a recent White House briefing. Similarly,  Dr. John Wright, head of the Bradford Institute for Health Research, wrote a searing editorial explaining the futility of fussing over brands. “The concept of consumer choice when it comes to immunization, or even medications, is alien,” he argued. “Comparing vaccines is not as simple as comparing cola drinks or cars. The clinical trials that have reported very early results will continue for their full twelve-month duration and the results will become more reliable with time. We have yet to start vaccine trials that can make head-to-head comparisons between different vaccines, so it may be that early results reflect different populations, or dosing regimes.”