A homeless person wearing gloves and a protective mask sits with a sign that reads: ‘In Search of Human Kindness’ amid the coronavirus pandemic on April 19, 2020 in New York, United States.
Alexi Rosenfeld | Getty Images Entertainment | Getty Images
Johnson & Johnson Covid vaccine suspended may not significantly slow the overall rate of vaccination of U.S. vaccines, but make it harder for hard-to-reach populations to get a chance.
Following the request of the Food and Drug Administration on Tuesday that states temporarily suspend the use of the J&J vaccine “out of caution” after six women contracted a blood clotting disorder, White House Minister Jeff Zients said that the announcement did not have a significant impact on the U.S. vaccination program.
“We have more than enough Pfizer and Moderna vaccines to continue the current rate of about 3 million shots per day,” Zients told press releases.
So far this is true. The country averages 3.3 million daily vaccine doses administered in the past week, and 3 million if only Pfizer and Moderna are counted. Only 7.8 million of the 202 million total shots fired in the U.S. are from J&J, according to Centers for Disease Control and Prevention data.
But the Johnson & Johnson vaccine represents about 10% of all people who are fully vaccinated in the US, a percentage that has been rising for weeks, and it is valuable for certain situations and communities.
“Because of the characteristics of the J&J vaccine, it is used in many cases for specific conditions and populations for which it was more difficult to obtain vaccines,” said Josh Michaud, co-director of global health policy at the Kaiser Family Foundation.
Mass vaccination sites and mobile pickups that manage doses to administer on the go probably have an easier time with the Johnson & Johnson storage requirements, Michaud said. The vaccine only needs to be kept in a standard refrigerator, while the needs for Pfizer and Moderna are stricter.
And for certain populations, such as prisoners changing facilities or homeless people who do not have a permanent residence, administering a two-dose regimen can be a challenge. According to Michaud, many states have used the J&J vaccine with these groups because it is difficult to find people to administer a second dose.
The one-shot option may also be more appealing to those who are more reluctant to get a vaccine. A March Kaiser Family Foundation survey showed that among those who say they want to wait and see how the vaccines work before being vaccinated, a greater proportion will get the J&J vaccine compared to one of the two doses.
One in six people in the “wait and see” group said they would “definitely get” the J&J vaccine, while about one in ten said the same about the Pfizer or Moderna vaccines.
“We know there’s a significant portion of the people on the fence about vaccines in general,” Michaud said, “and I think the J&J vaccine is actually a plus for the group. It’s a big selling point for people on the fence. “
“Add all these factors together, and the J&J disruption could have a significant negative impact on the U.S. vaccination rate,” he said.
It is not yet clear how long the use of the Johnson & Johnson vaccine will take. White House medical adviser Anthony Fauci said the interruption could take days to several weeks.
Vaccination of the homeless
Shelly Nortz, deputy executive director for policy at the New York City-based advocacy group Coalition for the Homeless, said the Johnson & Johnson vaccine break would make it harder to get shots for the people she works with.
The coronavirus has hit New Yorkers hard, especially those in shared housing. A Coalition for the Homeless and the University of New York showed that the age-adjusted mortality rate for sheltered homeless New Yorkers from February was 49% higher than the nationwide rate.
And while the vaccination campaign among homeless people in New York is off to a good start – Nortz said the city’s most recent announcement showed that about 4,500 individual homeless adults vaccinated total about 21,000, a rate that is not far behind the nationwide rate. not – the J&J stop is going to be an obstacle.
“Everyone was really eager to have the one-on-one situation with J&J,” she said, “especially for people who are unprotected and therefore not predictable in the same place.”
The coalition for the homeless recently partnered with the Center for Urban Community Services, which offers mobile medical care across New York, to supply the Johnson & Johnson vaccine at one of its emergency food stores. The program is now being discontinued, as well as discussions on the presentation of the J&J vaccine at the group’s head office where many customers are coming to pick up their mail.
Dr Van Yu, chief medical officer of CUCS, agrees that a two-dose Pfizer or Moderna vaccine regimen makes things much more complicated.
“If you live outside, how am I going to find you in four weeks?” he said.
Yu said the shelter system could make it easier to keep track of people, but there are still a bunch of people coming and going or being reassigned to one of the hundreds of shelters in New York.
The ease of storing the J&J shots, according to Nortz, is another benefit when vaccinating homeless people.
“The fact that the other two approved vaccines, in one case, require deep cold storage makes it very challenging to do something mobile or pop-up, or with an unknown number of people showing up,” she said.
Zients said Tuesday that all vaccine delivery channels, including mobile delivery units, are equipped to deliver all three of the vaccines. Yu said the Moderna vaccine is easy enough to handle on his group’s mobile sites, but that the Pfizer vaccine’s ultra-cold cooling need means it’s not an option.
He is currently on 185 unused J&J doses and has no access to any Moderna vaccines.
Some homeless people in the South Bronx, where Noel Concepcion works as a departmental director for homeless adult services for the nonprofit group BronxWorks, prefer the J&J vaccine because it requires only one dose. But the interruption and misinformation make it harder to communicate the importance of vaccinations to a group already skeptical about the government, Concepcion said, and it could spark some hesitation about all three vaccine options.
According to Concepcion, BronxWorks had to cancel a vaccination event to use the existing stock of J&J shots.
J&J is more convenient for many working people
Other barriers to vaccination of a Covid vaccine, such as an inflexible work schedule or childcare responsibilities, have made the single-shot vaccine Johnson & Johnson an essential option for some.
Liz Schwandt, who runs a volunteer group called Get Out the Shot, which aims to help people discuss vaccinations in Los Angeles, said many of the callers in their team’s helpline do not have traditional job benefits or protection did not, like a free time. Many of them are domestic helpers, such as household cleaners, private babysitters or gardeners who are paid cash from the books. Some are employees who do not work a 9-to-5 job, such as the group of night shift guards for whom Get Out the Shot recently made appointments.
Elizabeth Raygoza gets her Pfizer vaccine shot, March 17, 2021, from Alyssa Hernandez, medical assistant, while City of Vernon’s health department staff used the new mobile health unit clinic to deliver COVID-19 vaccinations to nearly 250 essential food processors at Rose & Shore , a major producer of locally based prepared food products serving supermarkets, schools, restaurants, airlines and others.
Al Seib | Los Angeles Times | Getty Images
“We hear stories like hey all the time, my employer lets me get the vaccine, but does not give me time,” she said, adding that “for a working family, four hours of shift are missing. [for a vaccination appointment] can be a huge wage loss. ‘
Responsibilities for child care and reliance on public transportation also make it tedious to go by multiple appointments, according to Schwandt.
While offering Get Out the Shot appointments for all three vaccines, Schwandt said the FDA’s initial approval of the J&J vaccine in February was welcome news.
“We were so excited about it,” she said. “We loved having the one-of-a-kind option for people.”
A CDC panel on Wednesday postponed a decision on Johnson & Johnson’s Covid vaccine while the investigation into the blood clotting disorder continues. The panel is expected to meet again next week, when it decides what it recommends for the CDC.