Why The Johnson & Johnson Vaccine Has Gotten A Bad Rap — And Why That's Not Fair

7 hours ago
Originally published on February 22, 2021 8:24 pm

Two COVID-19 vaccines are being distributed in the U.S. right now, and this week an FDA advisory committee will vote on whether a third should join them.

If granted emergency use authorization, Johnson & Johnson's one-dose vaccine would become available in the U.S., along with those from Pfizer and Moderna.

In clinical trials, the Johnson & Johnson vaccine appears to be 66% effective at preventing moderate to severe cases of COVID-19 — compared to about 95% for Moderna and Pfizer. That has some people wondering if they should avoid the Johnson & Johnson vaccine.

Absolutely not, says Dr. Ashish Jha, dean of the Brown University School of Public Health.

"What I've been saying to my family is, as soon as the J&J vaccine is authorized, if that's what you can get, you should get it as soon as it's your turn in line," says Jha.

He points out that the 66% vs. 95% effectiveness isn't the right comparison for several reasons. He notes that the Johnson & Johnson vaccine was tested in different settings — the U.S., several Latin American countries and South Africa, where some worrisome variants of the virus were first seen.

"So that 66% number really represents an amalgamation of a variety of different clinical trials. Moderna and Pfizer were not tested in those circumstances," Jha tells All Things Considered. "And even if you just look at the U.S. data, the Johnson & Johnson number then starts getting much closer to the Moderna and Pfizer numbers."

But all of that misses what Jha says is the most important point.

"What you care about is hospitalizations and deaths," he says. "And Johnson & Johnson appears to be just as good as Moderna and Pfizer at preventing those."

Jha notes that among the vaccines that have reported results, almost all of them — including the Johnson & Johnson vaccine — have shown to be close to 100% effective at preventing hospitalizations and deaths.

In excerpts from his interview, Jha discusses the advantages of the Johnson & Johnson vaccine and how that might affect distribution.

Are there other significant differences among the vaccines?

Johnson & Johnson has the huge advantage of being one shot. So that's, of course, really helpful. There are a lot of differences in storage. The Johnson & Johnson vaccine can be stored basically in any refrigerator. [The Pfizer vaccine is shipped and stored at ultracold temperatures.] So transportation, widespread availability, much easier. But I certainly think for most people, the idea of a single-shot vaccine should be attractive for a lot of folks. And that also makes it easier for people to get.

As people organizing this vaccination effort look at which vaccine should go where, does the ease of administering a one-shot vaccine that can be kept in a refrigerator determine where the Johnson & Johnson vaccine is going to go?

I think you're going to see that play out. The two-shot Pfizer vaccine is particularly hard to manage in, let's say, rural settings, hard-to-reach places. Doable, but harder. J&J vaccine — much, much easier on that front. There are also certain people who may just decide they'd rather get a single shot than two shots. And, you know, and that may also influence who ends up getting what.

Some people are expressing concern that the vaccines that appear to be more effective — Moderna, Pfizer — are going to go to constituencies that have more political power, more clout, a louder voice, and that the so-called less effective vaccine, Johnson and Johnson, is going to go to more disenfranchised groups. What's your response to that?

First of all, I want to make the case that the J&J vaccine is not a lesser vaccine. And second is we absolutely should not be distributing these things based on socioeconomic status or any of those things. We should really be getting all these vaccines out everywhere, we should be focused on disenfranchised groups, actually, for priority because they've been hit so hard.

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MARY LOUISE KELLY, HOST:

The United States hit a devastating milestone today - 500,000 people now dead from COVID-19. That's according to the tally kept by researchers at Johns Hopkins University. Well, while infections have been falling and vaccinations have been ramping up, about 2,000 people are still dying from the virus in this country each day. President Biden led the nation in remembering and mourning those deaths this evening at the White House.

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PRESIDENT JOE BIDEN: I know it's hard. I promise you I know it's hard. I remember. But that's how you heal. You have to remember. And it's also important to do that as a nation.

KELLY: NPR White House correspondent Tamara Keith is here now. And, Tam, what else did we hear from the president tonight as he marked this moment?

TAMARA KEITH, BYLINE: Well, it was certainly very somber and heavy. Five hundred thousand is a huge number, and each one of those numbers is a person. It's a loss. And Biden said that Americans need to resist viewing these deaths just as a statistic but instead to focus on the individuals who died.

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BIDEN: And I know that when you stare at that empty chair around the kitchen table, it brings it all back, no matter how long ago it happened, as if it just happened that moment when you look at that empty chair - the birthdays, the anniversaries, the holidays without them and the everyday things, the small things, the tiny things that you miss the most.

KEITH: At one point in his remarks, Biden was almost whispering, saying, you're going to be OK; you're going to be OK, which was a message not just to those who have had a loss but, I think, more broadly to the nation as a whole. After these remarks, he went outside, and the Marine Band played "Amazing Grace" as he and the first lady and the vice president and the second gentleman held a moment of silence. There were 500 candles on the South Portico of the White House, and the White House says that those represent those 500,000 lives that have been lost.

KELLY: It's such a marked contrast to his predecessor. Talk, Tam, about how Biden has approached this part of his job, leading the nation through what was previously unimaginable; leading the nation through such grief.

KEITH: Biden is someone who, as part of his political story, has very personally and publicly grieved and experienced loss. And he is bringing that to this job. And in a way, a president is always supposed to be the consoler-in-chief, but Biden does this more personally and more intensely. And, you know, before he took office even, the night before his inauguration, he held another ceremony - that was just a month ago - to mark 400,000 deaths. And now it's 100,000 more. And obviously, this is a big contrast with President Trump, who - although he would say, we mourn the lives lost, it was sort of a throwaway line. He didn't want to linger on it. Biden is lingering on the loss.

KELLY: He is also ordering flags lowered to half-staff at federal properties for five days. What's the significance of this?

KEITH: Well, one day for each 100,000 deaths. And if states and private businesses follow up on this - and cities - then that will be a lot of flags at half-staff to remind the public of the seriousness of the threat of this virus. And President Biden is certainly encouraging people to do all the things - to wear masks, to socially distance and to get vaccines when possible.

KELLY: Thank you, Tam.

KEITH: You're welcome.

KELLY: NPR's Tamara Keith reporting on a solemn ceremony tonight at the White House to mark a horrific milestone. Transcript provided by NPR, Copyright NPR.