Variant’s rise worries J&J vaccine patients
The rise of the more contagious delta variant of the coronavirus is prompting many to ask how well the Johnson & Johnson vaccine works against it and whether those who got the shot should get a booster.
Scientists don’t yet know the answer to either question, and many urge people to wait until data comes out, likely in the next few months, that could provide clarity. The federal Centers for Disease Control and Prevention has not recommended booster shots for J&J recipients, who include Gov. Gavin Newsom and San Francisco Mayor London Breed — both of whom got the oneshot vaccine in April when officials were trying to build public confidence in it.
The Pfizer and Moderna
vaccines are highly effective at preventing COVID symptoms brought on by the delta variant, according to studies and the companies. But less is known about the J&J vaccine’s effectiveness against the delta variant, which was first identified in India and now accounts for nearly a quarter of new coronavirus infections in California. It is far more transmissible than other variants — but whether it is more likely to lead to a more severe case of COVID19 is still being studied.
J&J has not released data on the onedose shot’s efficacy against the delta variant, but said Wednesday it is studying the matter and will share data “in the near future.” The company is also testing a twodose regimen on the most commonly circulating variants, including the delta, and expects to have interim results this summer.
“We believe that the singleshot Johnson & Johnson COVID19 vaccine will continue to offer durable protection, and at present there is no evidence to suggest a need for a booster dose to be administered,” J&J said in a statement.
The J&J vaccine has been shown to work well at preventing hospitalization and death against variants that were first identified in South Africa and Brazil, as have the Moderna and Pfizer vaccines.
In countries where delta is spreading, few people have gotten the J&J, so there’s not much evidence yet to show how well it’s working against the variant. The United Kingdom and
India, for instance, where delta is circulating widely, are mostly using the AstraZeneca vaccine.
Similarly, in the U.S., where the delta variant is expected to become dominant by the fall, the vast majority of people have gotten Pfizer or Moderna. In California and the rest of the nation, the J&J vaccine makes up less than 4% of all doses administered. Still, that translates into 1.5 million Californians relying on the vaccine to keep them safe from COVID.
Former Food and Drug Administration Commissioner Scott Gottlieb recently said the J&J vaccine appears to be about 60% effective against delta — slightly lower than the 66% level at which it was tested in clinical trials against the original coronavirus strain. But Gottlieb’s figure is an estimate that has yet to be backed up by studies, infectious disease experts said.
Experts say there’s simply not enough information about the J&J
vaccine and the delta variant to recommend people who got it to seek a booster. Their best advice is to wait and see. But if someone is worried they’re not protected enough with one J&J shot, seeking an additional shot would probably not harm them.
The CDC has not recommended that J&J recipients get boosters, but its permission may not be necessary. Even so, it’s not clear if vaccine providers would administer a booster to a person who has already
received a J&J shot — although providers don’t always ask if someone has already been vaccinated.
Dr. Phil Grant, who led the J&J vaccine clinical trial at Stanford, said he knows of some participants who later got a second J&J shot, or a Pfizer or Moderna vaccination.
Mixing and matching vaccines is “safe, with little downside,” he said.
“If people are concerned and want to do something before data is available, I don’t think it’s unreasonable,” Grant said. “But I think from a public health standpoint, it’s not something that’s recommended because the data’s not there.”
Some countries are already allowing the mixing and matching of vaccines. Canada recently recommended that people who got their first dose of AstraZeneca get Pfizer or Moderna for their second dose. This was mostly meant for people concerned about the rare risk of blood clots with AstraZeneca, a vaccine that is not being used in the U.S.
Even if the J&J shot turns out to be less effective against the delta variant, the difference may not be significant if it still reduces severe disease and death. The vast majority of people who have recently died or been hospitalized with COVID19 have been unvaccinated, indicating that all the vaccines, including J&J’s, work very well at preventing the worst outcomes.
“If what the FDA says is accurate, 60% is really not bad,” said Dr. Lee Riley, chair of the division of infectious disease and vaccinology at UC Berkeley’s School of Public Health. “In fact, that might be sufficient to prevent severe disease outcomes.”