J&J vaccine raises hopes, concerns
1-dose drug strong, but less so against S. African variant
One-dose drug strong but less so against South African COVID-19 variant.
Johnson & Johnson, the only major drugmaker developing a singledose vaccine for COVID, announced Friday that its shot provided strong protection against COVID-19, potentially offering another powerful tool in a desperate race against a worldwide rise in virus mutations.
But the results came with a significant cautionary note: The vaccine’s efficacy rate dropped from 72% in the United States to 57% in South Africa, where a highly contagious variant is driving most cases.
Studies suggest that this variant also blunts the effectiveness of COVID vaccines made by Pfizer-BioNTech, Moderna and Novavax. The variant has spread to at least 31 countries, including the United States, where two cases were documented this week.
With these results, Johnson & Johnson became the fifth company supported by the U.S. government to develop an effective COVID vaccine in less than a year, and the only one that doesn’t need two doses — a big advantage when most countries are struggling to get shots in arms more quickly.
The Johnson & Johnson vaccine was extremely effective in preventing severe cases of COVID — including serious illness caused by the variant, the company said. Though less effective than the Moderna and Pfizer vaccines now authorized in the United States, Johnson & Johnson’s is still considered a strong vaccine by scientists. Annual flu vaccines, for example, are typically 40% to 60% effective.
“This is a really great result,” said Akiko Iwasaki, immunologist at Yale University. “I hope this vaccine gets approved as soon as possible to reduce disease burden around the world.”
Johnson & Johnson said that it planned to apply for emergency authorization of the vaccine from the Food and Drug Administration as soon as next week, putting it on track to receive clearance later in February.
“This is the pandemic vaccine that can make a difference with a single dose,” said Dr. Paul Stoffels, the chief scientific officer of Johnson & Johnson.
The company’s announcement comes as the Biden administration is pushing to immunize Americans faster even with a tight vaccine supply. White House officials have been counting on Johnson & Johnson’s vaccine to ease the shortfall. But the company may only have about 7 million doses ready when the FDA decides whether to authorize it, according to federal health officials familiar with its production, and about 30 million doses by early April.
The variant from South Africa, known as B.1.351, could make things even worse for the vaccine push. Given the speed at which the variant swept through that country, it is conceivable that by April it could make up a large fraction of infections in the United States.
The fact that at least four vaccines backed by the federal government seem to be less effective against the B.1.351 variant has unsettled federal officials and vaccine experts alike. Facing this uncertainty, many researchers said it was imperative to get as many people vaccinated as possible — quickly. Lowering the rate of infection could thwart the contagious variants while they are still rare, and prevent other viruses from gaining new mutations that could cause more trouble.
“If ever there was reason to vaccinate as many people as expeditiously as we possibly can with the vaccine that we have right now, now is the time,” Dr. Anthony Fauci, the government’s top infectious disease expert, said in an interview. “Because the less people that get infected, the less chance you’re going to give this particular mutant a chance to become dominant.”
As the United States scrambles to get enough vaccines, the country is turning into something of an evolutionary experiment. The B.1.351 variant is one of several that have arrived in the country or originated here, all with the ability to spread faster than other variants.
Vaughan Cooper, an evolutionary biologist at the University of Pittsburgh, said that all the new variants were likely evolving quietly for months before bursting on the scene.
“I think we’re going to see many stories like this,” he said.
Federal regulators are also still waiting on data from Johnson & Johnson’s new manufacturing facility in Baltimore that prove it can mass-produce the vaccine. The company is counting on that factory to help reach its contractual pledge to the federal government of 100 million doses by the end of June.
If Johnson & Johnson can deliver vaccines quickly enough to the United States, it might be able to help drive down cases before variants make things worse. Since the vaccine requires only a single shot — unlike the Moderna and Pfizer-BioNTech vaccines, which require two — that delivery would translate into full coverage for 100 million people.
Johnson & Johnson’s vaccine has another advantage that might help speed up the rollout. It can stay viable in a refrigerator for three months, while the two authorized vaccines have to be kept frozen. That also gives the company an edge in getting the vaccine to remote areas of the world.