Single-shot Johnson & Johnson vaccine 66 percent effective against moderate and severe illness

[BumRushDaShow]

Source: Washington Post

A single-shot coronavirus vaccine from pharmaceutical giant Johnson & Johnson was 66 percent effective at preventing moderate and severe illness in a massive global trial, findings released Friday show. But its performance was stronger in the United States and weaker in South Africa, where a worrisome coronavirus variant now dominates — a complicated result that reflects the evolution of the pandemic.

The results, reported in a news release, put a third vaccine on the horizon in the United States — one with logistical advantages that could simplify distribution and expand access to shots in the United States and worldwide. Johnson & Johnson is expected to apply for emergency use authorization from the Food and Drug Administration next week. If the review follows the path of two earlier vaccine candidates, the shot could be authorized and available to the public by late February or early March.

The company has a $1.5 billion agreement with the federal government to support vaccine development and deliver 100 million doses to the United States by the end of June. But manufacturing lagged projected milestones earlier this month, and company officials declined to provide additional information on the pace of doses likely to be available month by month.

A communication challenge lies ahead for Johnson & Johnson and public health officials. Though less effective in its 44,000-person trial than 90-percent-plus effective vaccines made by Pfizer-BioNTech and Moderna, the Johnson & Johnson shot was tested at the height of the pandemic, in areas of the world where the virus had changed in ways that can elude parts of the immune response.



Read more: https://www.washingtonpost.com/health/2021/01/29/covid-vaccine-johnson-and-johnson/

[Ferrets are Cool]

1. Am I wrong in thinking that 66% may as well be 0 %?

Seems to me as though it would be like playing Covid roulette.

[LisaL]

5. Yes, you are wrong.

Flu vaccine effectiveness is hovering below 50% most years, yet we are still encouraged to get it.

[genxlib]

7. It may not be as obvious as it seems

In the near term and in the long term, that is certainly less effective. But it isn't nothing if it is the only shot you have access to. If it is like playing Russian roulette, it is like playing with a third as many bullets. Still, that is worse than playing with the other vaccine which is like 10% of the bullets. Either way, you have to stay careful.

However, there is an argument to be made that there is a benefit to it IN AGGREGATE if we vaccinate faster because of it.

The third vaccine could allow us to double our vaccination rate since it only needs one shot.

Vaccine penetration is a linear function since it grows at the same rate as it is applied. However, vaccine effect is an exponential function since every vaccinated person can prevent multiple future infections (ie they aren't going on to infect other people.)

Fast forward a few months. If we are at 100 million people vaccinated versus 50 million people vaccinated, the number of active infectious cases in the US could be a fraction as many. During that time, your chances of getting sick might actually be lower since you would be interacting with a lot fewer sick people. in other words; 66% of a low interaction number could be better than 95% against having lots of sick people around.

I am sure the public health people are crunching these numbers. But it won't be easy because the aggregate benefit is hard to argue to a bunch of individuals who want the better protection for themselves. I don't envy them. I was hoping this would not be an issue but it is going to be controversial.

[HUAJIAO]

24. Correct me if I am wrong,

but I was under the impression that Pfizer and Moderna protect against getting symptoms from but not against actually contracting or passing on Covid-19

[genxlib]

26. I don't think that has been determined yet

One way or another.

Still, my gut tells me that a protected person would be less contagious over a shorter duration of time if they are contagious at all. I figure it is a combination of viral load being reduced (since your body is actively defeating it) and fewer transmitting vectors (ie sneezes and coughs)

In the end, a lot will depend on continued practicing of good protective behaviors like masks and handwashing.

[AllyCat]

30. No one really knows right now.

Part of the trouble with the flu vaccine and its low effectiveness is that we cannot get people out to get the blasted shot. We are no where near herd immunity with that. If we could get more people to get the flu shot, we would have less flu in an exponential fashion.

I work in a hospital where flu vax is required for employment. We still have staff that get the flu, but NONE of them have been so sick that they died or ended up hospitalized. It DOES seem to make the severity of the disease less than not getting vaccinated.

This year, flu numbers are WAY down because of the masks, hand washing, and social distancing and at least in my region, more people got the flu vax this year. We test flu off the same swab as the coronavirus so we know we are getting many fewer cases than in years past.

Long story short, we still need safe behaviors until more people are vaccinated against this horrible disease.

[HUAJIAO]

49. So even if the covid vaccines do not prevent infection,

if they at least greatly reduce the symptoms, that is still a huge boon, is it not? And as I have read elsewhere, covid may be with us a long time and could with good vaccines, or even without them, turn into nothing more than the virus known as the common cold.... which I actually had Tue all day...

[RobinA]

37. I Hope You Are Wrong

because that makes it pretty useless in stopping the pandemic. Makes it essentially a pre-treatment of symptoms. I do hear comments to this effect, but that raises the question as to what exactly "95% effective" means. Vaccination effectiveness of 95% in my book means 95% (give or take) of people exposed to the pathogen do not get infected by it. I'm old though, 63, so maybe the meaning of English words has changed since my day.

And sorry, I'm not attacking you, this is a peeve of mine since I read somewhere exactly what you are saying. I got the vaccine so I didn't have to worry about getting somebody sick and now there seems to be talk that I can still get somebody sick. And get sick myself. What a cluster.

[HUAJIAO]

48. I hope I am wrong, also.

I think it is just poor statements from the vaccine manufacturers and other knowledgeable spokespeople, like Fauci!

It seems a pretty simple thing to do. when the trials were being run, just test people for Covid before and after the vaccine, at various times... If someone GETS covid but doesn't 'get sick,' you know the answer, percentages no, but,...


Don't worry, we're on the same page... I'm acting as if I never got the vaccine......

[Rebl2]

38. That's what

I have heard, but maybe it’s not known for sure since this is so new.

[maddogesq]

25. Yup, JNJ is still a game changer...

In terms of initial distribution of all vaccines.

I have been saying all along that it’s about biding time and lowing the hospitalization and death rates.

At 66%, JNJ’s gizmo is still better than flu shot de hour and can be distributed to more remote areas quicker. As time goes on, they can adjust the mRNA vaccines to deal with variants.

Here’s an idea:

Contract with non-vaccine drug makers to produce more vials of Pfizer or Moderna. Meantime, get the one and done shot out to Moose Jaw and other locations, and everyone keep wearing their masks for a few more months. For the first time, I think we have a chance to get out ahead of this mess.

[Towlie]

23. It doesn't appear to be much better than a single shot of Pfizer or Moderna.

 
?

... and it's much worse than two shots of Pfizer or Moderna, so I don't see any point in distributing it at all. What would be the point when we already have something better?

[FBaggins]

28. But we don't have something better

That is... hundreds of millions of people currently don't have something better (billions worldwide).

Adding a 60% effective single-dose for tens of millions for a few months likely makes a significant dent in the virus' potential to continue spreading.

It's unlikely that switching to the more effective option a few months later adds much (if any) risk.

[maddogesq]

34. A sports analogy:

It’s not about winning a championship—in this case eliminating the virus—it’s about getting into the playoffs. At 66%, JNJ has earned it’s way in. And it they can come up with a booster, well...

We all want that one magic bullet but guess what, that isn’t here yet so let’s distribute all 3 vaccines as long as they are safe and effective. We now have a real chance of fighting our way off the ropes.

[FBaggins]

36. I think that's apt

It's also worth noting that 66% is pretty close to what we were hoping for in a vaccine. It's just that the first couple of candidates came in much higher.

But if all we had was this option, it would significantly improve public health outcomes as they relate to COVID once much of the population had been vaccinated.

[Towlie]

43. How about a Soylent Green analogy?

 
?

They can't produce enough decent food for everyone so they give them Soylent Green instead. To the government that may look like a solution, but if you can get decent food then you'll definitely eat that instead.

[thesquanderer]

35. I think it is better than a single shot of those other two...

...because it is said that the one dose of J&J is 85% successful at preventing serious symptoms, and 100% effective at preventing death. I don't know that that could be said of a single shot of the others.

So yes, maybe it is only 66% successul at preventing "moderate" symptoms, but I think people are not so worried about "moderate" symptoms. I think most people would be okay with feeling only about as sick as you do if you catch the common cold. That's not what most people are afraid of.

There is also a real issue of compliance with the two-shot approach. Some percentage of people will end up not getting the second shot, or not getting it when they ideally should have, because people are like that. Plus it's not impossible that there could be an availability issue which ends up interfering with the ability to get that second shot at the ideal time. It's not a foolproof system. See for example https://www.democraticunderground.com/10142683356

We really need all the vaccine we can get, as fast as we can get it. If I could get a vaccine today, and it was the J&J, I'd say yes,

[flying_wahini]

51. Because 66% effectiveness is better than 0%.

Moderna version is more expensive because of refrigeration factors. It must be kept cold until
It actually gets to the clinic. $$$$$ It takes 4-6 hours to ‘defrost’.
The J&J may be better suited for lower risk patients or patients that have more difficulty accessing clinics. One shot and will get you thru till the next round.
As a home health nurse it would be great to have it to give those that are actually lower risk

[AllyCat]

29. For some people, one jab is the draw to this vaccine

I know quite a few needle-phobic folks that won't get the two shot versions, but would get this one. Additionally, we are going nowhere with this pandemic if we don't vaccinate the whole world. In areas of the country and globe with no access to the ultra-cold storage needed for the mRNA vaccines, this would make a HUGE difference in stemming the spread of this vaccine.

There is some speculation that a second dose of J&J might make it more effective although that has not been studied. If, after the first one, we could convince those recipients that just one more poke would be more effective, so much the better.

This is a gamechanger. We need as many safe tools as we can get to fight this Plague.

[raccoon]

33. That struck me too. Nt

[genxlib]

2. Well that's going to turn into a pissing match

I have been wondering about what would happen if this turned out to be the case.

From a public health perspective, the benefits of this third vaccine would be advantageous simply to get faster and greater vaccine penetration. The one shot solution could capture as many people as the two approved vaccines combined. In aggregate, this could drive the numbers down faster and save lives.

However, at the personal level, very few people are going to want that one instead of the 95% effective. Some perhaps out of convenience. But most are going to want the better protection.

What I see brewing is a gigantic fight over structural and economic inequality. In an emotion free world, a strategy of sending the convenient version to remote places as being much more effective and using the logistically complicated vaccines in urban areas that have the density and infrastructure to support it. That is going to be a huge pissing match.

[LisaL]

6. I would get it if offered now.

I am tired of waiting for Pfizer's or Moderna's. Who knows when that will be available.

[AllyCat]

31. Right? Better than nothing and still quite effective against some of the new variants

I know many who won't get the two shot vaccines and are waiting for a single shot vaccine. This would really help globally too which, in turn, protects everyone.

[Politicub]

46. I doubt we will have a choice of vaccine brand.

Even though I want the more effective vaccine, J&J will probably win out in the long term because of cost and convenience. More deaths than the RNA vaccines will be chalked up to collateral damage.

[gab13by13]

3. It raises the question with me,

and I am certainly no expert, but it makes me wonder if Pfizer and Moderna are 90-95% effective against the new mutations, I doubt they are. With that said 66% is better than 0%.

I mean when the experts guess the wrong flu strain it makes a difference.

[LovingA2andMI]

39. The Lower Efficiency

Of J & J is LIKELY the right number. There is an incredible HYPE on the "95%" for Moderna and Pfizer in the Law of Large Numbers. There is much reason to believe, it is just that -- hype that individuals have been caught into.

There's a famous song that says "Don't Believe the Hype".

With that, J & J is looking optimal based on what it turns out the adverse effects are in the 90-120 day term.

[groundloop]

4. 85% effective at preventing severe disease, 100% effective at preventing hospitalization.

From an article at CNN.com

"We're 85% effective at preventing severe disease, which we define as disease that makes you feel particularly sick at home, or may go to the hospital, or worse," Dr. Mathai Mammen, global head of research and development at Johnson & Johnson, told CNN.

"And we are right now completely protective, it would appear 100% protective, against disease that actually does make you go to the hospital, we're 100% protective against death."

So while this one may not be quite as good as the two shot vaccines, it's still a hell of a lot better than not getting vaccinated.

[LisaL]

8. It's also better for a virus strain most prevalent in the US at the moment.

When Pfizer and Moderna got tested, the South African and Brazilian variants were likely non-existent or barely existent, and now they are most prevalent in South Africa and Brazil.

[IronLionZion]

17. That sounds promising

The real game changer is in getting everyone vaccinated to achieve some level of herd immunity faster.

[HUAJIAO]

50. And unfortunately millions and millions of people will refuse to get vaccinated...

[subterranean]

44. If true, that is excellent news.

The reason we've had to shut down portions of the economy is to prevent the virus from stretching the healthcare system beyond its limits. If this shot can guarantee that if you do get the virus, it would be no worse than a bad case of the flu for a few days, with no lingering long-term damage, it would allow life to go back to the pre-Covid "normal," although mask-wearing in public indoor places might still be recommended for a while.

[genxlib]

9. One major question for me

Is there any harm in having both versions of the vaccine?

If people are encouraged to get the 65% version now, could they get the 95% version later when it is more available?

Of course there are cost implications but for people with money to spare, that would be the best case scenario.

[LisaL]

10. My concern would be a bad immune response if getting

different vaccines close together. But vaccine combinations haven't been tested yet, so who knows.

[BumRushDaShow]

12. The J&J one uses a different mechanism from the Pfizer/Moderna ones

Both types are sortof fascinating though.

The J&J one takes a "harmless" version of a virus (adenovirus) that is shaped like the cornaviruses with a few protein "spikes" and then "modifies" it to create "spikes" that actually "mimic" this coronavirus. The Pfizer/Moderna ones use mRNA to enter cells in your body to cause those cells to create similar "spikes" on them that "mimic" this coronavirus. The presence of those "spikes" triggers the body to produce T-cells and then antibodies to thwart anything "looking similar".

It seems the companies that actually used weakened viruses/viral fragments, which is more "standard" for developing vaccines (e.g., GSK-Sanofi and possibly Merck) were less successful in getting an "acceptable" immune response when going that route.

[LisaL]

13. I don't know if J&J is less effective in getting immune response.

These results were achieved with one dose. Pfizer and Moderna has to give two doses to achieve the 95%.

[BumRushDaShow]

18. J&J is trialing various 2-shot treatments via their Janssen Pharmaceutical division

which if successful, might end up matching the other 2-shot vaccines.

https://www.jnj.com/johnson-johnson-covid-19-vaccine-candidate-interim-phase-1-2a-data-published-in-new-england-journal-of-medicine

[groundloop]

21. No harm at all, according to Dr. Fauci

He was asked about that in the CNN article I'd quoted. He said that one scenario was for someone to get the J&J vaccine (because that's likely going to be easier to get in areas where the refrigeration isn't available) and later on get the Pfizer or Moderna vaccine, and that he saw no problem with that.

[genxlib]

27. Thanks

That will reduce the stress on getting people to use it. Especially if the government commits to paying for the follow up

In the end, it may turn out that a second shot of the J&J would provide the same benefit. They are testing a two dose regimen now.

[AllyCat]

32. There is speculation (but no study) that maybe a second dose of J&J

would actually improve the efficacy.

[Politicub]

47. It hasn't been studied. And no one knows if we will need booster

shots each year.

[still_one]

11. My understanding is JNJ is currently testing a booster to see if it increases the efficacy

[BumRushDaShow]

14. They are running a trial with a 2-shot regime

which might close that gap.

[still_one]

15. Yes, that is what I was referring to, but it will take a little longer for those results

Because of the shortages of the Moderna and Pfizer vaccines people may not have a choice

[BumRushDaShow]

19. Unfortunately, J&J is behind in their OWN manufacturing

Jan 14, 2021 - Health
Delays overshadow Johnson & Johnson vaccine's long-lasting potential

Shawna Chen


Participants who received Johnson & Johnson’s one-shot vaccine in an early study developed coronavirus immunity for at least 71 days, but a production lag could mean a rollout of fewer-than-promised doses, the New York Times reported Wednesday.

Why it matters: If approved, J&J’s vaccine would be the first available to protect from COVID with a single dose, streamlining vaccine administration and distribution.

The big picture: The U.S. government signed a $1 billion contract with J&J last August. The drug company promised that 12 million doses of its vaccine would be ready for deployment by the end of this February and a total of 100 million doses by the end of June.

J&J has fallen behind schedule by as much as two months and likely won’t catch up until the end of April, the Times reports.

This could lead to a shortage in doses once spring comes around; the federal government has only secured enough to vaccinate 200 million of the roughly 260 million eligible adults in the first half of 2021.

https://www.axios.com/delay-johnson-johnson-vaccine-study-b8d9b52a-1b10-4dbd-841d-80c83e20f13d.html

[My Pet Orangutan]

16. The Pfizer vaccine is 53% effective after one shot

Q: Can you just get one dose if supplies run out?

A: In order for the vaccine to be about 95% effective, patients need to take two doses.

For Pfizer, according to documents published by the FDA, the vaccine does offer strong protection (about 53% efficacy) against COVID-19 within about 10 days after the first dose.

https://www.kgw.com/article/news/verify-covid-19-vaccine-qa/283-bee4d404-2d89-4843-860b-40b5b5c6b329

[BumRushDaShow]

22. Yes

If J&J can get their Janssen vaccine to enhance/extend protection (as a "booster" -meaning done as 2 doses), then that will help close the apparent gap.

https://learnaboutcovid19.org/questions/why-is-janssen-starting-a-clinical-trial-with-two-doses/

[JT45242]

20. Effective "not sick enough to go to hospital, unable to leave home..."

That doesn't mean that you may not be an asymptomatic carrier after the vaccine.

This is one of my concerns. That people will get vaccinated and feel OK (even if they are carrying one of the strains) -- so they get complacent about going to restaurants, not wearing masks, seeing people outside the household. Then those later in the vaccine chain of delivery get sick because people are more willing to do risky stuff because they feel fine and they had the vaccine.

The other concern is that the new variants (South Africa, UK, South American and the two versions found in Ohio) will not be affected by the vaccine. The next wave of mutations will probably be more effective at transmission given evolutionary pressures or mutate so that they are able to reinfect people who had an earlier strain.

[RobinA]

41. I'm Not Sure

I would call that behavior "complacent." The assumption is that when you have been vaccinated against a disease you then don't have to worry much about getting that disease under normal conditions. I'm vaccinated against measles therefore I don't worry about getting measles. If I get vaccinated against a disease and then still have to worry about getting and passing the disease, well...then I'm wondering why I bothered.

[subterranean]

45. You can still catch the flu even if you get the flu vaccine.

It sounds like the J&J vaccine won't stop you from getting infected, it just reduces the severity of illness if you do. That probably means it would be necessary to get the shot annually, like the flu vaccine, unless/until someone develops another vaccine that actually prevents infection.

To me, if getting the Covid vaccine guarantees that, at worst, I might have flu-like symptoms for a few days, I think it's worth it.

I do worry about the inevitable mutations, though.

[extvbroadcaster]

40. I'll take anything

I'll take anything, 66% sounds better than zero, which is what I have now. I am afraid to go to the store, I can't see friends, it is a lonely isolated life. And the longer the pandemic goes on, the more variants show up. Get as much vaccine out there as possible, and let's hope we can get a handle on this.

[BobTheSubgenius]

42. I agree completely.

If that's all there is available, it is one HELL of a lot better than the vaccine I have now, which looks suspiciously like an isolated mask.