‘They’re All Remarkable’: An Expert Answers Our Questions About the COVID-19 Vaccines

With Johnson & Johnson’s one-dose option poised to hit the market, Dr. David Agus of USC’s Keck School of Medicine weighs in on the latest

Johnson & Johnson’s COVID-19 vaccine just got a big shot in the arm. On Wednesday, the U.S. Food and Drug Administration announced that it’s deemed the one-dose shot safe and effective, which means it could be approved for emergency use as soon as Friday, giving Americans a third option, along with the two-dose vaccines from Moderna and Pfizer-BioNTech.

With a third COVID-19 vaccine nearing approval, many are wondering what the difference in efficacy is and whether they should vie for one over the others. Author and professor of medicine Dr. David Agus of USC’s Keck School of Medicine and the Ellison Institute for Transformative Medicine, who regularly confers with the Biden administration on the COVID crisis and other health matters, spoke with Los Angeles about the latest on the vaccine front.

The Johnson & Johnson vaccine could be approved for emergency use by this weekend. It’s just one dose where the others are two. But there are also questions about which gives better protection. Which vaccine would you say is best?

They are all remarkable vaccines that are blocking hospitalization and death of the virus 100 percent. Those are dramatic numbers, and they’re all remarkably safe. I would get whichever one that you can get first.

Johnson & Johnson’s entry into the market could dramatically help the supply chain. If AstraZeneca gets emergency use next, that’s a real game changer. 

The hope is certainly that it gets better now as we will get the Johnson & Johnson vaccine. Hopefully, shortly thereafter, the AstraZeneca vaccine. Those are much easier. They’re refrigerated. They’re not stored at super-cold temperatures like the RNA vaccines, and there isn’t a chance of an allergic reaction, so people don’t need to wait after the shot before they leave. With the RNA vaccines [Moderna and Pfizer], we have to follow you for 15 or 30 minutes afterwards to make sure there’s no allergic reaction.

Right now we have Moderna and Pfizer available. These are two-dose vaccines. Anecdotally, people have reported that the second shot is producing some mild side effects. What can people expect? 

The reason you have side effects is that you prime your immune system. Those side effects don’t reflect the vaccine, they reflect your immune response to the vaccine, which is good. In general, there have been slightly more side effects on the second shot. They haven’t been dramatic. People get muscle aches, chills, fever, fatigue, and pain at injection site. After my vaccine, I had a little bit of a fever. I knew that this wasn’t something bad, it was something good. I know it sounds strange, but I was happy to feel a bit off, as it meant my immune system was working well. I took Tylenol and I was fine.

Is it true that people over 65 seem to be having fewer, less intense side effects?

We’re not quite sure all of the reasons, but it’s a really interesting observation that the older you are, the more you’ll tolerate the vaccine without significant side effects.

What about people who wonder how it could affect fertility?

There has really been a lot of chatter on the internet about how the vaccine can affect fertility. It is incorrect and it’s not true. There have been over 40,000 pregnant women who got the vaccine, there’s been no detrimental effect on the women, nor the fetuses, nor the delivery of the child. Also, the vaccine has no cross reactivity with anything related to fertility. So, it is really internet chattering meant to scare. Again, the COVID-19 vaccine have no effect on fertility.

Was the vaccine rushed out too quickly?

There is a notion that these vaccines were rushed. But scientists really worked for decades on the vaccine platforms to get to where we are today. Had the pandemic happened a decade ago, we wouldn’t have a vaccine, because we weren’t ready for it, but we are now. The current vaccine trials were very similar to every other clinical trial we’ve done with vaccines. The manufacturing, especially starting before the clinical trials had been completed, is a new thing, and helped push the timeline forward dramatically for the vaccines.

I think you’re going to see a new awareness of developing both treatments and vaccines even quicker in the future, hopefully not just for viruses but for diseases like cancer also.

If you’ve had COVID, how long should you wait to get the vaccine?

We normally say you should wait three months. And the main reason for that is because you have probably immunity for those three months, to enable somebody else to get the vaccine because there is a limited supply.

Will the vaccines protect people against the new variants?

The vaccines will help obviously. The data shows that it can prevent you from being hospitalized and dying from the different variants, which is what we’re going for.

We’re worried with these new variants that they’re twice as infectious. Before, if it took five minutes of talking to somebody in a close distance to get the virus, maybe now it takes two. So when something’s more infectious, it can spread very, very quickly. I just don’t want people to let their guard down. And I think we’re seeing some of that now. And that always worries me.

RELATED: Here’s What You Need to Know About When and How to Get a COVID Vaccination in L.A.

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