I want Johnson & Johnson’s COVID-19 vaccine

BY D. LARS DOLDER, News + Record Staff
Posted 3/2/21

Johnson & Johnson’s single-shot COVID-19 vaccine arrives in North Carolina this week, and some experts fear the public will reject it.

The problem is J&J’s efficacy rate. Compared to …

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I want Johnson & Johnson’s COVID-19 vaccine

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Johnson & Johnson’s single-shot COVID-19 vaccine arrives in North Carolina this week, and some experts fear the public will reject it.

The problem is J&J’s efficacy rate. Compared to Pfizer and Moderna shots — coming in at 95% and 94% efficacy, respectively — Johnson & Johnson achieved a pedestrian 72% in its U.S. trials (66% worldwide).

But Pfizer and Moderna’s vaccine efficacy rates were unprecedented. Before any clinical trials concluded, the FDA hinted it would authorize emergency use for safe vaccines that achieved at least 50% efficacy. As vaccines go, that wouldn’t have been so bad.

For example, the polio vaccine — a game changer when it came out in 1955 — prevented polio in 60-70% of recipients. In 80-90%, it staved off paralytic polio. More doses improved those figures, though, hence the reason for our four polio shots within the first four years we’re alive.

The chickenpox vaccine, too, isn’t full-proof. It has a one-shot efficacy rate of 82%.

In the greater context of vaccine development, then, Johnson & Johnson’s COVID-19 vaccine holds its own. But we’ve been spoiled. Pfizer and Moderna set ostensibly insurmountable benchmarks — why settle for anything else?

That reasoning has already provoked a movement in Europe where another “lesser” vaccine — Oxford-AstraZeneca’s 66-81% efficacy rate contender — rolled out early last month. The medical community in particular has decried government priority standards which reserve Pfizer and Moderna vaccines for other population groups.

“Medical staff need the most effective vaccine,” Jerome Marty, president of a French doctor’s union, said in an interview with The Wall Street Journal. And Forbes reported that 3,000 doctors in Italy wrote a letter to the Italian government demanding that “‘private doctors and dentists be inoculated with mRNA vaccines’ like those developed by Moderna and Pfizer and BioNTech, as opposed to AstraZeneca’s ‘since there is evidence they are more effective.’”

Some expect the same outcry to erupt in the U.S. when Johnson & Johnson’s vaccine hits distribution sites this week. And it makes sense, right? Who wants 72% when you can have 95%?

I do. Here’s why.

No fair comparison can be made between the Pfizer/Moderna vaccines and Johnson & Johnson’s. The latter arrives several months deeper into this protean pandemic and its clinical trials were conducted amid an especially severe strain of the virus.

Nirav Shah, director of the Maine Center for Disease Control and Prevention, warned in an interview with The Washington Post that vaccine efficacy rates are not an “apples to apples” comparison. The first two vaccines were tested under narrow circumstances. Johnson & Johnson’s clinical trial spanned several continents and included subjects exposed to especially deadly coronavirus variants which had not emerged when the FDA authorized Pfizer and Moderna for emergency use.

“The Johnson & Johnson vaccine was tested in South America and South Africa ...” Rachel Roper, a virologist at East Carolina University told The News & Observer earlier this week. “The Moderna and Pfizer (vaccines) weren’t, and they were tested at a time when those variants didn’t exist.”

Especially in South Africa, coronavirus variants have been more aggressive and life-threatening than previously known versions of the disease. Apparent efficacy rates, then, don’t completely reflect a vaccine’s ability to do its job.

“Don’t get caught up, necessarily, on the number game, because it’s a really good vaccine, and what we need is as many good vaccines as possible,” said Dr. Anthony S. Fauci, the U.S. government’s top infectious disease expert, in an interview with The New York Times. “Rather than parsing the difference between 94 and 72, accept the fact that now you have three highly effective vaccines. Period.”

Besides, 72% efficacy in preventing symptomatic infection does not mean that 28% might die of COVID-19. The Johnson & Johnson vaccine showed 85% efficacy against severe forms of COVID-19 and 100% efficacy — yes, 100% — against hospitalization and death from the virus.

Isn’t that all that really matters? Lest anyone has forgotten, we did live with sickness before the pandemic began. We didn’t shut down during cold and flu season, not because we expected to entirely avoid illness, but because the chances of severe and lasting damage were slim.

That must be the goal with COVID-19. The virus probably isn’t going anywhere. But with effective vaccines that can prevent the most adverse consequences, normalcy might resume.

Johnson & Johnson’s vaccine can get us there. It’s the only one-shot option available in this country so far. That means, every shipment goes twice as far as corresponding allotments from Pfizer and Moderna.

And J&J doesn’t require storage in frigid temperatures. Pfizer’s vaccine needs special and expensive coolers to preserve potency. Moderna needs at least a freezer. Johnson & Johnson does just fine in a fridge — making it the strongest candidate for rural distribution.

On all counts, the Johnson & Johnson vaccine presents a propitious path toward resumption of regular life. So, please, if the first vaccine you can get is from J&J, take it.

I will. In fact, it’s my preferred choice. One shot instead of two? A 100% record in preventing hospitalization and death? And the most robust clinical trials of any vaccine so far? Sign me up.

Reporter D. Lars Dolder can be reached at dldolder@chathamnr.com and on Twitter @dldolder.

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