The Atlanta Journal-Constitution
» The best vaccine is the one you can get,
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The anticipated authorization of a third coronavirus vaccine has raised a new question for many Americans: Which shot should I get?
The answer, experts say, is whichever one you can.
If authorized, the new Johnson & Johnson vaccine would join the Pfizer-biontech and Moderna vaccines, which are already being distributed nationwide. Food and Drug Administration reviews have found all three vaccines to be highly effective at preventing hospitalizations and deaths from COVID-19. One of the main differences between them is the Pfizer-biontech and Moderna vaccines require two shots given several weeks apart, while the Johnson & Johnson vaccine is a single shot.
The one-shot vaccine
The FDA’S recently released review of Johnson & Johnson’s single-shot vaccine, which is expected to be authorized as early as this weekend, found it was more than 80% effective at preventing severe illness in a large international clinical trial.
But the review noted the vaccine had lower efficacy among higher-risk older adults in the trial, a finding experts hope will not discourage people from taking it.
At this point in the vaccine rollout, it’s difficult to get any vaccine, much less a particular brand. And even if it were now possible to pick and choose, experts say, that would likely hinder the goal of mass vaccination – which is to protect lives.
“What we really are hoping for and what we want out of these vaccines is that we keep people out of the hospital, and we keep people from dying,” said Joshua Barocas, an infectious-disease physician at Boston Medical Center. And, he added, of the Johnson & Johnson trial, “when we look at that data, that data is still robust.”
Lower efficacy in a subgroup
While the Johnson & Johnson vaccine was 42% effective at preventing moderate to severe illness among the group of older adults with comorbidities, the FDA emphasized the statistical significance was uncertain and none of those older adults died or needed to be hospitalized in the month after they were vaccinated. In fact, the vaccine completely
prevented hospitalization and deaths among all trial participants who received the shot, providing a level of protection against serious illness experts say is comparable to the Pfizer-biontech and Moderna vaccines, which were shown to be more than 90% effective in trials.
The lower efficacy rate of the Johnson & Johnson vaccine in the older subgroup “requires further evaluation going forward,” said William Moss, executive director of the International Vaccine Access Center at the Johns Hopkins Bloomberg School of Public Health. But he, too, urged people to get whichever vaccine is available to them.
“Although cases, hospitalizations and deaths are coming down, there’s still a lot of community transmission in this country,” Moss said. “Until we really get that down, it’s really important that people get protected as early as possible.”
Argument against waiting
If many Americans opted to wait for a preferred vaccine, it would not only leave more people at risk of developing a serious case of COVID-19, but would also likely slow down the country’s vaccination program, which only recently started gaining steam after a tepid start.
“Most vaccine sites administer one [type of ] vaccine on a given day,” Manisha Juthani, an infectious-disease specialist at Yale Medicine, wrote in an email. “If you go to a site and they are not administering a vaccine that you want, you will miss your opportunity and have to reschedule while the same thing could happen on another day.” Furthermore, you could be denying another person the opportunity to be vaccinated.
Given the current rates of vaccine development and production, experts estimate that most adults who want to be vaccinated should be able to do so by the summer, said Marc Siegel, an associate professor of medicine in the Division of Infectious Diseases at George Washington University.