The Atlanta Journal-Constitution

Third vaccine could reach state soon

‘This is a game-changer’: Expected FDA approval would boost supply.

- By Helena Oliviero helena.oliviero@ajc.com

A third coronaviru­s vaccine could be heading to Georgia as early as next week, a move that could ease supply constraint­s and bring the state one step closer to bringing the COVID-19 pandemic under control.

After a daylong meeting Friday, an advisory committee for the U.S. Food and Drug Administra­tion, in a unanimous vote, recommende­d emergency use authorizat­ion be granted for Johnson & Johnson’s single-dose COVID-19 vaccine for adults. Though advisory committees’ recommenda­tions are not binding, the FDA typically follows their endorsemen­ts. FDA authorizat­ion could

come as early as this weekend.

“This is a game-changer,” said

Jimmy Lewis, chief executive officer of Hometown Health, an advocacy group for rural hospitals in Georgia. “To go from two vaccines to three is a tremendous boon for capacity. This is huge, for rural hospitals but also any hospital system, and this will make it easier to reach more people throughout the state in pharmacies and other providers.”

Because the J&J vaccine can be stored in a refrigerat­or for at least three months, it will be less challengin­g to distribute in areas without access to specialize­d, subzero freezers required for the two vaccines authorized late last year. It also hasthe advantage of being given in a single shot instead of two.

How many doses will come to Georgia isn’t yet clear, but Johnson & Johnson says it will have 4 million doses available to ship as soon as the vaccine is authorized. Though that will barely make a

dent in the vaccine shortage, supply is expected to ramp up quickly. Company officials say they can have 20 million doses available to the U.S. government by the end of March. The U.S. has agreed to buy 100 million doses of the vaccine by June.

It’s also not immediatel­y clear where it would be distribute­d in Georgia, but Department of Public Health spokeswoma­n Nancy Nydam said the availabili­ty of a third COVID-19 vaccine will help allow expansion of vaccinatio­n to those eligible throughout the state. She said DPH will place orders based on the allocation from the federal government once Johnson & Johnson vaccine receives the anticipate­d authorizat­ion.

Georgia desperatel­y needs more vaccine supply, especially with a new plan taking effect March 8 that expands eligibilit­y to teachers and school employees, along with a group of “medically fragile” residents. Officials said this will add an estimated 1 million more people to the vaccine pool.

The state already allows those who are 65 and older and their caregivers, first responders, health care workers, and staffers and residents of long-term care facilities to receive the vaccine. About 57% of older Georgians have received at least one dose of the twodose regimen of the vaccines authorized so far, Gov. Brian Kemp has said.

The success of the plan to expand eligibilit­y also hinges on hopes that the state’s vaccine allotment will continue to rise. Georgia now receives about 215,000 first doses of vaccine a week, up from about 150,000 earlier this month. The White House said this week that weekly shipments of coronaviru­s vaccines nationwide will rise to 14.5 million, as vaccine manufactur­ers continue to ramp up production. That’s up from 8.6 million when President Joe Biden took office.

At first glance, the Johnson & Johnson vaccine doesn’t appear to be as stellar as FDA authorized vaccines from Pfizer-biontech and Moderna, which have an overall efficacy rate of 95%.

In clinical trials, the Johnson & Johnson vaccine had a 72% overall efficacy rate in the United States and 64% in South Africa, where a highly contagious variant emerged. The vaccine showed 86% efficacy against severe forms of COVID-19 in the U.S. and 82% against severe disease in South Africa.

But Kaiser Permanente of Georgia epidemiolo­gist Dr. Felipe Lobelo, a former officer at the Centers for Disease Control and Prevention, noted that results from Johnson & Johnson’s clinical trials have shown the vaccine to be 100% effective at preventing hospitaliz­ations and deaths.

“I think the message we need to focus on is we are in survival mode, and these vaccines will help us stay alive,” he said.

The Johnson & Johnson vaccine also appears to have milder side effects.

Like other vaccines, questions remain about how long immunity would last.

Though Johnson & Johnson is confident that its onedose vaccine can protect against COVID-19, the company started a trial last year to test a two-dose schedule to see whether that would provide even greater or longer protection.

Though some committee members expressed concern about adding another vaccine dose down the road causing logistical challenges as well as confusion in the public, others said the situation is fluid, and there may be needs for booster vaccines for all of the vaccines down the road.

Committee members also raised questions about the vaccine’s effectiven­ess among older adults with comorbidit­ies. The company’s limited data on how well the vaccine protects people over 60 years old with risk factors — conditions such as heart problems and diabetes — suggests the vaccine may be only about 42% effective. Both FDA and the manufactur­er noted that the statistica­l significan­ce of that finding was uncertain, and no deaths or cases requiring medical interventi­on were reported a month after those older adults were vaccinated.

Professor Baozhong Wang at Georgia State’s Institute for Biomedical Sciences said we are in a race against time to vaccinate as many people as possible before new COVID19 variants take hold. He said he doesn’t see the vaccine as inferior but, rather, different, with the J&J vaccine offering important benefits as a single-dose vaccine with more lax storage requiremen­ts.

Over time, he said, there will be a better understand­ing of the difference­s among the vaccines. But for now, he and others stressed, even if a vaccine is not 100% effective, it can still be an important tool in the fight against the virus. He and others also pointed to the flu vaccine, which is generally only 40% to 60% effective but is recommende­d every year as a way to reduce severe flu illness and deaths.

Dr. Colleen Kraft, an infectious disease physician and associate chief medical officer at Emory University Hospital, said as someone who spends “an inordinate amount of time” taking care of people with severe COVID19 disease, the vaccine is a welcome developmen­t. “I think we are past the point of being overly academic about whether one is better or not,” she said. Lobelo agreed.

“We need all of the vaccines because otherwise, this could take years to end, and there is a role for all of the vaccines to help us fight our way out of the pandemic,” he said.

 ?? JOHNSON ?? The J&J vaccine can be stored in a fridge for at least three months, an easier option in areas without the subzero freezers two other vaccines need. JOHNSON &
JOHNSON The J&J vaccine can be stored in a fridge for at least three months, an easier option in areas without the subzero freezers two other vaccines need. JOHNSON &
 ?? JOHNSON & JOHNSON ?? A scientist toils in a Janssen Pharmaceut­icals lab in September in Leiden, The Netherland­s. Janssen created parent company Johnson & Johnson’s vaccine.
JOHNSON & JOHNSON A scientist toils in a Janssen Pharmaceut­icals lab in September in Leiden, The Netherland­s. Janssen created parent company Johnson & Johnson’s vaccine.

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