Baltimore Sun Sunday

What to know about one-dose J&J vaccine

21, STUDENT, MORGAN STATE UNIVERSITY, EDITOR, MSU SPOKESMAN, COLLEGE NEWSPAPER

- By Hallie Miller and Meredith Cohn

The U.S. Food and Drug Administra­tion granted emergency use authorizat­ion to Johnson & Johnson’s single-dose COVID-19 vaccine on Saturday, a move that would add a third vaccine against the coronaviru­s, ease the nationwide supply constraint­s and bring America one step closer to combating the coronaviru­s pandemic.

Data suggests the vaccine, made by Johnson & Johnson’s Janssen Pharmaceut­ical Companies, is safe and effective, especially at preventing severe disease, scientists and medical experts say.

The company reports an overall efficacy rate of 66% in preventing moderate to severe cases of the disease caused by the virus. It also reported being 85% effective overall in preventing severe disease and 100% effective in preventing COVID-19related hospitaliz­ation and death.

Shipments to be divided among states could begin as early as Monday. Johnson & Johnson has said that it expects to deliver 20 million doses to the U.S. by the end of March, and 100 million by summer. On Sunday, a U.S. advisory committee will meet to recommend how to prioritize use of the vaccine.

Here’s a roundup of frequently asked questions, and answers, as Johnson & Johnson’s vaccine reaches Marylander­s.

If I’m offered a Johnson & Johnson vaccine, should I take it, or wait for a more effective one?

There is wide agreement among public health and medical profession­als that people should not hesitate to take Johnson & Johnson’s vaccine in favor of other COVID-19 immunizati­ons.

“It’s terrific to have a third vaccine with clear evidence that benefits exceed the risks,” said Dr. Joshua M. Sharfstein, a vice dean in the Johns Hopkins Bloomberg School of Public Health and a former FDA deputy commission­er. “The use of this vaccine should accelerate the progress against COVID-19.”

The latest vaccine offers a high level of protection after just one dose, while Pfizer/ BioNTech’s and Moderna’s products call for two doses. Johnson & Johnson’s vaccine can also last up to three months in the refrigerat­or, whereas the other vaccines must be stored at very cold temperatur­es. That could potentiall­y make it easier to access and administer, especially in rural areas without freezer capacity.

Dr. Anna P. Durbin, a professor of internatio­nal health at the Johns Hopkins Bloomberg School of Public Health, said people should not dwell on which vaccine to get, and that it’s difficult to compare the vaccines, which were tested in different places and reported their data differentl­y.

Johnson & Johnson, for example, factored in some of the new, more contagious virus variants into its study, including the one first discovered in South Africa, which the Pfizer and Moderna trials did not originally include. It also studied more non-U.S. citizens than the other two candidates, and measured efficacy at different points in the study.

“It’s like comparing apples and oranges,” Durbin said. “What I would recommend is: Take whatever vaccine you can get. Don’t quibble over which one it is. Take whichever is available. Efficacy numbers ... are not the whole story. We’re really looking for prevention of severe disease, hospitaliz­ation and death. All of these vaccines are excellent at that.”

Should anyone in particular get Johnson & Johnson’s vaccine over the other vaccines?

The three vaccines could each be used for those who are eligible, but some have advantages for certain groups over others.

For example, Johnson & Johnson’s single-dose vaccine could be especially beneficial for people who have difficulty taking time off work, and may offer more

protection faster than the other two candidates, which require two shots three and four weeks apart.

Johnson & Johnson’s vaccine also might have less severe side effects, Durbin said, potentiall­y making it more desirable for people who can’t take time off or prefer not to experience flu-like symptoms or prolonged muscle soreness.

Ed Singer, president of the Maryland Associatio­n of County Health Officers and Carroll County’s health officer, said a single-dose vaccine will make a difference for people who are more “medically fragile,” since it requires only a day’s trip. It may also help increase vaccinatio­n rates in rural communitie­s, which have less access to pharmacies, drug stores and medical providers, he said.

Smaller, private medical practices might also benefit more from Johnson & Johnson, he said.

“This is much easier to handle, and not nearly as complicate­d,” Singer said. “We hope the state will push this out to private providers, people who have relationsh­ips with people in their community, and for private pharmacies. If we get Johnson & Johnson, maybe local health department­s could get more Pfizer and Moderna, which are more suitable for a mass vaccinatio­n effort.”

Durbin said people might feel more comfortabl­e with Johnson & Johnson’s vaccine, which sends a piece of the virus’ genetic code into people’s cells on an adenovirus, a cause of the common cold. The code tells cells to make virus proteins

that in turn spark an immune response to fight the virus.

Pfizer’s and Moderna’s vaccine, meanwhile, uses messenger RNA technology, which involves a process that was studied for a long time for other infectious diseases and cancer but not approved.

What if I have an underlying health condition or am statistica­lly more vulnerable to contractin­g severe COVID-19?

The Johnson & Johnson trials reported that the vaccine candidate was 85% effective in preventing severe disease across all regions studied, 28 days after vaccinatio­n in all adults 18 years and older. Efficacy against severe disease increased over time, with no cases in vaccinated participan­ts reported after day 49, according to the company.

Durbin said that means the vaccine works across ages and medical conditions. In fact, the trials found participan­ts with underlying health conditions and those over age 65 fared exceptiona­lly well, she said.

Perhaps most importantl­y, the vaccine demonstrat­ed efficacy against the new variants, making it a viable option for all interested adults, she added.

“This is going to be highly effective at preventing severe COVID-19, even caused by the South African variant,” she said. “If one were significan­tly less efficaciou­s, that would be a concern. But when we look at these, they’re all highly

efficaciou­s.

“If you can prevent hospitaliz­ation and death, you can have a huge public health impact.”

How long will protection last?

Much like with the Pfizer and Moderna vaccines, it is not clear how long immunity from Johnson & Johnson’s product will last.

Scientists are trying to answer that question now and say it’s possible people might need annual shots, just like with the flu vaccine, especially as more variants emerge and become dominant.

The vaccine makers also say they are prepared to adapt their vaccines for the variants if needed, and the U.S. Food and Drug Administra­tion said recently that they would not need to do more expansive human trials.

When will it become available to Marylander­s, and where?

Johnson & Johnson said it could provide the nation with 20 million doses by the end of March and 100 million doses by the end of June, though vaccine making is complicate­d and production issues could hinder the totals.

That would add significan­tly to the 600 million doses that President Biden recently said would be available of Pfizer and Moderna vaccines by the end of summer, enough to cover most Americans, considerin­g those vaccines require two doses and the Johnson and Johnson vaccine requires one.

How many doses will come to Maryland isn’t yet clear. But Maryland Department of Health spokesman Charles Gischlar said Johnson & Johnson’s vaccine could arrive in Maryland as early as next week.

It was not immediatel­y clear where it would be allocated; Gischlar said in an email that state health officials “are ready to integrate it into our overall distributi­on plan.”

Bob Atlas, president and CEO of the Maryland Hospital Associatio­n, also did not give specifics, but said hospital-based vaccinator­s would make use of any immunizati­on distribute­d to them.

“This shot can be given to hospital inpatients before discharge and to rehabilita­tion or nursing facilities without their needing to return for second doses,” Atlas said in a statement. “Many hospitals will send vaccinator­s into their communitie­s to take care of people who are home-bound or who face other obstacles to traveling to retail pharmacies or mass vaccinatio­n sites.”

Singer, Maryland Associatio­n of County Health Officers’ president, said the local health department­s would also be poised to administer Johnson & Johnson should it become available to them.

“We as health department­s wouldn’t say no if they decided they wanted to give us Johnson & Johnson,” Singer said. “But it’s probably easier for medical practices and pharmacies than Pfizer and Moderna, which we are already accustomed to handling.”

Spokespeop­le from CVS Pharmacy and Giant Foods also said they did not have any informatio­n to share at this time.

Will Baltimore get extra doses since the vaccine is being produced in the city?

Johnson & Johnson said in April it had contracted with Emergent BioSolutio­ns to produce tens of millions of doses of the vaccine in its East Baltimore plant.

Baltimore Mayor Brandon Scott asked Johnson & Johnson in a letter in early February to tap that stock and directly sell the city 300,000 doses, enough to cover half the population. Scott has been concerned city residents haven’t gotten their fair share despite state mass vaccinatio­n sites operating in the city.

Such a sale would bypass the normal process where vaccine is bought by the federal government and allocated to states, which determine where doses go. The company did not comment, but Maryland Gov. Larry Hogan said the city cannot jump the line.

When I saw 22-year-old Amanda Gorman speak at President Biden’s inaugurati­on, I saw myself in a way that I believe many young Black “Gen Zers” see themselves.

Her performanc­e, solidified what the Black Lives Matter protests of 2020 showed us: that there is hope, there is resilience. And while last year’s protests reignited a spark for change, the fire needs to be tended daily to maintain the glow of change.

We can keep making changes by investing in Black youth, by providing more culture centers, good public education and health systems.

The disparity of access to adequate health care and education in Baltimore’s Black communitie­s is the focus of Black Health Matters, a project I launched through Morgan State University’s student newspaper. The reporting project, in partnershi­p with The Poynter Institute, a national journalism program, is illuminati­ng health disparitie­s.

Everyone has a role in the fight to remove these disparitie­s. As a journalist, I see my role as a public servant, a conduit through which stories about the disparitie­s and how to remove them can travel.

 ?? KENNETH K. LAM/BALTIMORE SUN ?? A Rite Aid health care worker prepares a dose of COVID-19 vaccine at the Emergent BioSolutio­ns facility on Feb. 8, where the vaccine is being manufactur­ed in Baltimore.
KENNETH K. LAM/BALTIMORE SUN A Rite Aid health care worker prepares a dose of COVID-19 vaccine at the Emergent BioSolutio­ns facility on Feb. 8, where the vaccine is being manufactur­ed in Baltimore.
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