What is the difference between Spikevax and mNEXSPIKE?
Moderna has developed mNEXSPIKE, a next-generation COVID-19 vaccine that uses only one-fifth the dose of their current Spikevax vaccine. This lower dose is possible due to a more targeted design that creates a focused immune response.
Key Differences Between Spikevax and mNEXSPIKE
Vaccine Technology:
Spikevax:
- Codes for the whole spike protein of SARS-CoV-2
- Uses 50 mcg mRNA dose.
mNEXSPIKE:
- Codes only for the N-terminal domain and the receptor-binding domain of the spike protein
- Uses much smaller dose: 10 mcg vs 50 mcg with Spikevax
- The more targeted vaccine formulation allows for administration of a smaller mRNA dose (10 mcg/0.2 mL).
Eligibility:
Spikevax:
- 65 years of age and older
- 6 months through 64 years of age with at least one underlying condition that puts them at high risk for severe outcomes from COVID-19.
mNEXSPIKE:
- Adults ≥65 years old
- Adults and adolescents aged 12 through 64 years who have a condition that puts them at high risk for severe outcomes from COVID-19.
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Effectiveness:
Clinical trials showed:
- After a median follow-up of 8 months, the incidence of COVID-19 occurring ≥2 weeks after immunization was 9.9% with mNEXSPIKE and 10.8% with Spikevax
- Seroresponse rates and geometric mean neutralizing antibody titer levels were higher with mNEXSPIKE.
Practical Differences:
Storage:
- mNEXSPIKE can be refrigerated for up to 90 days vs. Spikevax's 60 days
- mNEXSPIKE stable at room temperature for 24 hours vs. Spikevax's 12 hours.
Dosing:
- mNEXSPIKE vaccine is supplied in 10 mcg/0.2 mL prefilled syringes
- Spikevax vaccine is supplied as 25 mcg/0.25 mL prefilled syringes (6 months through 11 years of age) and 50 mcg/0.5 mL prefilled syringes (12 years of age and older).
Bottom Line
mNEXSPIKE is a next-generation vaccine that targets specific parts of the spike protein, allowing for a much lower dose while potentially providing better immune responses.
References
- COVID-19 Update: mNEXSPIKE — A New Moderna mRNA Vaccine for COVID-19. The Medical letter. July 21, 2025. https://secure.medicalletter.org/TML-article-1733h
- mNEXSPIKE Prescribing Information. https://www.fda.gov/files/vaccines%2C%20blood%20%26%20biologics/published/Package-Insert-MNEXSPIKE.pdf
- Spikevax Prescribing Information. https://static.modernatx.com/pm/6cef78f8-8dad-4fc9-83d5-d2fbb7cff867/5efa7d9d-05e8-46b5-945a-637c2867bd00/5efa7d9d-05e8-46b5-945a-637c2867bd00_viewable_rendition__v.pdf
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