Why Stigmatizing the Johnson & Johnson Vaccine Is a Bad Idea

The newest COVID-19 vaccine option will likely be just as valuable for ending the pandemic as the two-shot alternatives
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Studies indicate that the Johnson & Johnson vaccine is very effective, almost entirely prevents death or hospitalization from the virus, and works in just one dose rather than two, making it faster, easier, and cheaper to inoculate more people, thus bringing the pandemic under control faster.

So why are some people acting like it’s some bargain-basement alternative to Moderna and Pfizer?

This week, Detroit Mayor Mike Duggan fully turned down an allocation of the J&J when it was offered for distribution in his city.

“Johnson & Johnson is a very good vaccine. Moderna and Pfizer are the best. And I am going to do everything I can to make sure the residents of the City of Detroit get the best,” he said at a press conference.

Duggan asserted that he didn’t need the J&J because he is receiving enough Moderna and Pfizer doses to meet demand, and that the “very good” but not “best” shots should be passed along to other parts of Michigan.

According to that state’s most recently available data, the City of Detroit Health Department has administered a total of just 81,283 doses of all COVID-19 vaccines combined. The city’s population 674,841 as of 2019. A White House spokesperson later walked back Mayor Duggan’s comments on his behalf, saying they represented a “misunderstanding.”

There are significant differences between the J&J vaccine and the Moderna and Pfizer/BioNTech offerings. Most importantly, while the two earlier options are two-dose mRNA vaccines, the J&J is a single-dose, viral vector vaccine.

The J&J shot contains DNA of a common cold-type virus that has been modified to teach your immune system how to respond if it encounters COVID-19 in the future. This particular vaccine is similar to one that has been used safely and effectively to control outbreaks of Ebola. It can be shipped and stored at standard refrigerator temperatures and can be stored for up to three months, all of which helps ease distribution, particularly in areas with infrastructure limitations. It can also be given to people at risk of certain severe allergic reactions to the mRNA shots.

Delivering the full vaccine in a single shot is also a big selling point for the Johnson & Johnson version for vulnerable populations who may be hard to track to deliver the second dose–populations which remain radically under-vaccinated compared to more affluent communities–and for a lot of other people, too.

“If there are individuals who may not like needles, who may have concerns about returning for a second shot, who may not want the inconvenience of scheduling a second appointment, or who may be concerned that there isn’t enough supply of the vaccine at the moment for a second shot—for those individuals, that convenience of being done [after one dose], fully vaccinated, is really important,” Dr. Leana Wen, an emergency physician and George Washington University professor, told NPR.

Those assessing the J&J as less good than the mRNA options seem to be doing so based on information about efficacy. Some studies indicate that the Johnson & Johnson vaccine is less effective than the other versions at preventing mild cases of COVID-19, and may provide less coverage against more recently documented variants.

When they were being studied, both mRNA vaccines showed nearly 95 percent effectiveness at preventing any symptomatic case of COVID-19. In the Johnson & Johnson studies–which were conducted later, as the pandemic worsened, and under conditions that included more exposure to the South African and Brazilian variants–its vaccine was found to be closer to just 72 percent effective in the U.S. and 66 percent effective in other parts of the world, where other strains are common.

However, experts say, those numbers look at a case of COVID-19 that might feel like anything from light symptoms to a moderate case of flu; cases that are unlikely to be life-threatening for most people. When it comes to severe cases, studies suggest all three reach similar levels of protection.

“When we look at the thing we probably care about most—making sure that we don’t end up in the ICU or dying—the efficacy of the three vaccines is virtually identical,” Dr. Kirsten Bibbins-Domingo, chair of the department of epidemiology and biostatistics at the University of California-San Francisco, told NPR.

As yet, scientists still aren’t entirely sure that being vaccinated prevents people from becoming infected, carrying, and spreading the virus, so masks are still being recommended for people who’ve gotten their shots.

California is expected to get around 320,000 doses of the Johnson & Johnson vaccine this week as part of a push to get as many people inoculated as possible, though it is not yet clear how those doses will be integrated into the current vaccine distribution pipeline.

People love to invent status symbols and brand loyalties–but the middle of a race to deliver life-saving vaccine really isn’t the time for snobbery. At the moment, officials raising doubts about the J&J shot could compromise efforts to deliver vaccinations to people in high-risk situations and increase health care equity.

“All three of them are really quite good, and people should take the one that’s most available to them,” Dr. Anthony Fauci said recently on Meet the Press. “If you go to a place and you have J&J and that’s the one that’s available now, I would take it. I personally would do the same thing. I think people need to get vaccinated as quickly and as expeditiously as possible.”

For those who remain concerned, the option remains open to accept a J&J now, and, in a few months, once everyone has had the ability to access some form of vaccine, experts say you can safely go get an mRNA vaccine in addition.


RELATED: California to Set Aside 40% of Vaccine Doses for Residents of Highest-Risk Communities


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