• Concerns raised about inequity in vaccine distribution,
The nation has a third weapon to wield against the coronavirus, and this one doesn’t need to be kept frozen or followed by a booster shot.
Those attributes of Johnson & Johnson’s COVID-19 vaccine — which gained regulatory clearance Saturday and began shipping Sunday night into Monday — promise to help state and local officials quell the pandemic punishing their communities. First, however, they will need to determine its place in an expanding anti-virus arsenal, where it joins vaccines with sky-high efficacy rates that are still in short supply.
Decisions to send the shots to harder-to-reach communities make practical sense, because Johnson & Johnson’s single-shot vaccine is easier to store and use. But they could drive perceptions of a twotiered vaccine system, split along racial or class lines — with marginalized communities getting what they think is an inferior product.
The issue came up on a recent call between governors and Biden administration officials coordinating the country’s coronavirus response. Massachusetts Gov. Charlie Baker, a Republican former health insurance executive, stressed the need for prominent health officials to communicate clearly about the benefits of the one-shot vaccine, according to three people who heard his remarks and spoke on the condition of anonymity to discuss a private conversation.
The J&J vaccine proved safe and effective in a clinical trial, completely preventing hospitalization and death from COVID-19, including in South Africa against a more transmissible variant of the virus.
When moderate cases were included, however, it was 66% protective, compared to efficacy of more than 90% reported for a vaccine jointly developed by U.S. pharmaceutical giant Pfizer and German biotech firm BioNTech and another from U.S. biotech company Moderna.
But those trials were conducted at different points during the pandemic in different countries with different transmission rates, which makes head-to-head comparisons pointless and impossible.
A spokeswoman for Mr. Baker declined to make him availablefor an interview. But the apprehension he articulated is shared by state and local health officials throughout the country, even as they celebrate the third vaccine and acknowledge that the U.S. faces an embarrassment of riches compared with many countries.
To complicate matters further, these dilemmas are inseparable from characteristics of the new vaccine that make it a logistical gift. The easier storage and scheduling requirements position the J&J product to penetrate hard-to-reach populations, such as those without housing, as well as transient groups, including people moving through the criminal justice system.
Because people of color are overrepresented in both populations, however, the racial undertones of a targeted approach to distribution could become pronounced.
“There is a risk of that,” acknowledged Dr. Mouhanad Hammami, director of the Wayne County Health Department, which serves Detroit as well as suburbs that include some of the richest ZIP codes in Michigan.
The risk, too, is that residents may try to be selective about which vaccine they’re getting. .
“We hold our clinics based on the vaccine made available to us, so we have a Pfizer clinic or a Moderna clinic,” Dr. Hammami said. “And probably people will come — or choose not to come — based on the product being offered.”
That is unwise, specialists say.
“The vaccine that’s available to you, get that vaccine,” said Dr. Anthony Fauci, the nation’s leading infectious-disease expert, during a briefing on the eve of Johnson & Johnson’s authorization.