IIt’s always good for consumers to have options, right? And indeed, the United States will soon have to inject three Covid-19 vaccines into people’s arms, which are more likely to come in the coming months, which will speed up the race to vaccinate hundreds of millions of people as quickly as possible.
But not all vaccines are the same, and increasingly, health authorities and suppliers will be dealing with shots with different characteristics: different storage requirements, efficacy, dosing regimens, and manufacturing platforms. This, plus the possibility of a more picky audience that might want a certain chance at another, could complicate an already messy implementation. But the different features also open the door to greater access than just more supply – a more convenient one-shot vaccine is likely to be available soon.
The key point, according to experts, is how remarkable it is that the US has several Covid-19 vaccines in the pandemic. All the vaccinations approved by regulators have been shown to be safe and effective, so you should get any one you have the opportunity to get, they say.
advertisement
“In case you have the choice to be vaccinated, I would encourage you to take the vaccine you are getting,” said John Brooks, chief medical officer of the Covid-19 Response Center of the Centers for Disease Control and Prevention, said Friday at a briefing.
Johnson & Johnson, which reported Friday that the vaccine was 66% effective in preventing moderate to severe disease and 85% effective in preventing serious Covid-19 in clinical trials, plans to report to the Food and Drug Administration in early February apply for emergency permission. . Assuming regulators move fast, health authorities will have the advantage of being able to distribute a third shot with millions more supplies.
advertisement
Unlike the two-dose mRNA vaccines already approved by Moderna and Pfizer-BioNTech, the J&J vaccine requires only one dose. It is also inexpensive and can be stored in normal refrigerators. This makes it easier to store and transport them than the mRNA vaccines, which have to be kept below zero, sometimes in special freezers that smaller clinics may not have.
“It’s going to be big for rural populations,” Alan Morgan, chief executive of the National Rural Health Association, said of J & J’s lap.
Similarly, it may now be easier for vaccine campaigns to go out in communities instead of having to come to hospitals to be vaccinated, which can reach people who do not have access to health care, or who are distrustful of health care institutions, but perhaps listen to community leaders. Mood data, for example, showed that people of color who are struggling with historical and ongoing abuse by medical providers are less likely to get Covid-19 vaccines as quickly as other people. In addition, early distribution data on vaccines show an excessively low number of black adults and Latino adults.
“It’s easier to bring the vaccine to hard-to-reach areas,” said Mitchel Rothholz, chief of staff of the American Pharmacists Association, about the vaccination of J&J.
However, some people want to choose their vaccine as if it is a piece of product they can choose to find the best choice. Results of clinical trials or reports of side effects can lead to what people want.
It is difficult to compare clinical trials of different products. The pandemic has also changed: J & J’s trial took place because at least one variant that appears to have the effect on vaccine efficacy was in circulation, while the Moderna and Pfizer BioNTech trials were completed before variants of concern began to spread widely. Without clinical data to evaluate each vaccine against the newer strains, it is difficult to determine whether the existing Covid-19 vaccines may be less effective against variants of the virus.
Some people still remember the headlines of the Moderna and Pfizer product offerings with more than 90% compared to Covid-19 and question the J&J announcement of 66%.
Public health officials were quick to point to J & J’s data as a strong result, especially since regulators initially said a vaccine only needed to be 50% effective to be approved. A vaccine that is 66% effective is an incredibly powerful tool to fight respiratory viruses, they stressed. “We are celebrating a seasonal flu vaccine with an effectiveness of 60%,” Jay Butler, the CDC’s deputy director for infectious diseases, told reporters.
In the US part of the clinical trial, J & J’s vaccine was 72% effective, which, in the absence of the mRNA data, ‘one would have said it was an absolutely spectacular result’, ‘Anthony Fauci, head of the National Institute of Allergy. and infectious diseases, said at a separate White House briefing. What’s more, the vaccine was 85% effective in preventing serious illnesses, and at trial, all hospitalizations and deaths occurred among people who received the placebo. None of the vaccines diagnosed with Covid-19 became ill enough to require hospital care.
“When it comes to vaccinating my family members, and all that’s available is J&J or Novavax, I would tell them to take it,” said Robert Hancock, president of the Texas College of Emergency Physicians.
Novavax is another vaccine manufacturer that reported on Thursday that the vaccine was 90% effective in one trial in the UK, but 49% in another trial in South Africa, probably due to the B.1.351 variant used in that country is spread, which seems to evade some aspects of the immune response. The company did not say when it could apply to the FDA for authorization.
The different levels of efficacy among vaccines may also complicate the logistical benefits of J & J’s uptake. If states only award J & J’s shots to rural areas, there may be concerns that they are unfair, ”said Marcus Plescia, medical director of the Association of Civil Servants and Territorial Health Officers. “People in the countryside can feel short-sighted.”
Julie Swann, head of the Department of Industrial and Systems Engineering at North Carolina State University, who advises the CDC during the H1N1 pandemic, agrees. She said providers should start researching their communities to see if people have a preference for what vaccines they receive. “It would be a real mistake to distribute J&J only on infrastructure,” she said.
Finally, as more vaccines are authorized, health officials may recommend that certain people, based on age or other risk factors for worse Covid-19, prefer certain shots. Perhaps the mRNA vaccines can be reserved for people who are most vulnerable to the coronavirus, Swann suggested, while the J&J vaccine could be used to more common populations.
So far, federal health officials have not issued guidelines for who should get which vaccines.
Another question awaits vaccination: the variants. It appears that B.1.351 has some effect on at least some of the vaccines, although experts note that vaccinations do not work like light switches that are on or off. On the contrary, vaccinated people may be less protected against B.1.351 than other forms of the coronavirus, but the vaccines may still protect them against severe Covid-19.
The health authorities and companies are tentatively saying that the emergence of B.1.351 and other variants serves as a sign that they must be ready to adapt the vaccine design if and when a form of the virus emerges affecting the immune protection provided by vaccines . Some vaccine manufacturers have begun studying booster shots designed specifically against B.1.351, and federal health authorities said Friday that they are reviewing emergency plans to adjust the vaccines if necessary.
“We will continue to see the evolution of mutants,” Fauci said. “We, as the government, the companies, all of us who are participating in this together, will have to be vigilant to adapt easily to make versions of the vaccine … specifically targeting the mutation that is actually occurring at any given time.”
The variants put pressure on the vaccine campaigns in other ways. B.1.351 and other variants confirmed in the United States appear to be more contagious than earlier forms of the virus, meaning that a higher percentage of the population must be vaccinated to destroy the American epidemic. If more people are vaccinated and cases decrease, this reduces the chance of even more rogue variants popping up.
“The sooner we can get people immunized, the better the chance that it will not continue to happen with more and more variants, because there are such a large number of viruses,” said Francis Collins, director of the National Institutes of Health , told reporters. Friday.
Rachel Cohrs and Matthew Herper reported.