In North Dakota, health officials this week are sending their first Johnson & Johnson Covid-19 vaccines to pharmacies and emergency clinics where people who don’t necessarily have a regular doctor can get the only push. In Missouri, cans are dispensed to community health centers and rural hospitals. And in North Carolina, health care providers use it to vaccinate meat packers, farm and food workers.
Ever since Johnson & Johnson revealed data showing that its vaccine, while very protective, had a slightly lower rate of effectiveness than the first shots made by Moderna and Pfizer-BioNTech, health officials have feared that the new shot might be considered by some Americans as the could be considered worse choice.
But the early days of the rollout suggest something else: some people are excited to get it because they want the convenience of a single shot. And public health officials are excited about how much faster they can distribute a single shot, especially in vulnerable communities that may otherwise not have access to a vaccine.
“This is a potential breakthrough,” said Dr. Joseph Kanter, the chief health officer in Louisiana. With its first allotted doses, the state is hosting a dozen large Johnson & Johnson vaccination events in community centers and other public places, modeled on flu vaccines.
As Johnson & Johnson’s production grows over the next several months, Dr. Kanter, the shot would allow his state to cut the staff and surgery costs associated with the second dose: “The J&J vaccine brings a lot to the table.”
In terms of how well it prevents serious illness, hospitalizations, and deaths, the Johnson & Johnson shot is comparable to that of Moderna and Pfizer-BioNTech. And while there is a lower overall effectiveness rate in the U.S. – 72 percent compared to around 95 percent in the others – experts say comparing these numbers is problematic because the companies’ studies were conducted at different times in different locations.
The Johnson & Johnson vaccine can also be stored at normal refrigerated temperatures for three months – ideal for distribution in non-medical locations such as stadiums and convention centers.
“There are circumstances when this will be a really good, or perhaps the best, option,” said Dr. Matthew Daley, senior investigator at Kaiser Permanente Colorado’s Institute for Health Research and member of the Centers for Disease Control and Prevention Independent Vaccine Advisory Board.
Only four million cans have been shipped this week, and the company’s production delays mean it will be at least a month before the states receive significant shipments. Because of this loophole, state officials are treating the first wave of doses as a moment to test different ways it can be used.
Patrick Allen, the director of the Oregon Health Authority, said the first doses in the state went to various facilities “to see if we could learn from their use.” This included mass vaccination sites in the Portland area, adult nursing homes, and pharmacies not included in the federal government’s pharmacy program. Health officials will evaluate the success of each of these locations to develop a plan for the larger shipments.
Many state health officials said they were focused on getting the vaccine to people who may be harder to reach for a second dose, such as the homeless or about to be released from prison. In North Carolina, this category includes the state’s mobile farming communities with three- or four-week working seasons. Mandy Cohen, the state’s health secretary, said large meat packers in the state such as Smithfield and Tyson Foods were interested in Johnson & Johnson’s vaccine and had consulted with their department.
And because the vaccine tends to have fewer side effects than the other options, it appeals to people who don’t want to risk missing a work day to recover from chills or a fever. She said, “There are a lot of people who are. For example,” I’m much more interested now that you tell me I only need to get one shot instead of two. “
“I don’t think it’s an inferior vaccine, so I’m taking it for myself,” said Ms. Cohen, who was supposed to get the shot from Johnson & Johnson on Friday.
The vaccine has caused a stir in small, independent pharmacies. Steve Hoffart, the owner of Magnolia Pharmacy in Magnolia, Texas, a small town outside of Houston, has received calls and emails from residents waiting to arrive this week. He hopes to hold a Johnson & Johnson teacher event on March 13th. Schools in the area struggled to find replacement teachers during the pandemic, and a vaccine that doesn’t require a second visit and more free time has been a significant development. he said.
Tim and Joyce Staab, who live in Chillicothe, Ohio, a town about 20,000 hours’ drive from Columbus, were two of the first Americans to receive the Johnson & Johnson vaccine. Both had general vaccination appointments scheduled for later in the week. But then they learned on Wednesday that an independent pharmacy near them had received 100 doses of Johnson & Johnson’s shot. Ms. Staab, 68, hesitates with needles and liked the one-and-do approach.
Mr Staab, 67, said he thought the vaccine would be a better choice for healthcare providers like the pharmacy where he got it. “You don’t have the resources, I don’t think, to deal with really hard-to-store vaccines,” he said.
States were able to adjust and craft distribution plans, in part because the federal government did not issue guidelines on where and to whom the vaccine should go.
That winter, as the Food and Drug Administration’s approval of the Johnson & Johnson vaccine approached, federal officials involved in vaccine distribution pushed for a more centralized use of the shot, either at large stadiums or at mass vaccination sites, which operated by the Federal Emergency Management Agency or only at pharmacies, according to officials familiar with these discussions. However, the White House preferred to allow states to tailor their own plans, as they had for the Moderna and Pfizer-BioNTech vaccines.
While health professionals are excited about the potential public health benefits of the new vaccine, some also fear that once vaccines run out, public interest will wane. When some people have a choice of brands, they may reject Johnson & Johnson’s, viewing it as an inferior choice.
In the mid-Atlantic black churches, Darrell J. Gaskin, professor of health policy at Johns Hopkins University and pastor, and Rupali Limaye, scientist at the university studying vaccine reluctance, have advised and reassured hundreds of people pastors and parishioners in Africa Methodist Episcopal Zion Churches in virtual presentations highlighting the safety of the Johnson & Johnson vaccine and the prevention of major Covid-19 and death, including among the black volunteers at the company’s trial.
Dr. Gaskin said it was vital for officials to highlight the benefits of the vaccine at the beginning of its distribution so that people “don’t feel like there’s a luxury vaccine and then the non-luxury vaccine”.
“We are facing differences when it comes to Covid,” said Dr. Limaye. “How do we reduce differences? We bring out a product that contains a dose and is stable. “
One of the members of the Church of Dr. Gaskin, Patricia Cooper, a teacher in Washington, DC, said President Donald J. Trump’s efforts to get a vaccine approved last year and the “Emergency Use Approval” label suggested that the federal government could I’ve rushed reviews of vaccines and made them nervous about their safety. But she said she was eager to get a vaccine, particularly from Johnson & Johnson.
“This one is more appealing to me,” she said. “Who likes to get stuck more than once?”
But Oregon health officer Mr. Allen warned that a more specific use could lead to skepticism about its quality.
“When you start getting a little too cute, when you specifically target its use, you may feed the distrust of, ‘Well why am I getting this vaccine? And I’m in that particular population and people who aren’t in that particular population aren’t getting this vaccine, ”he said.
Federal health officials have promised a way to crack down on the Johnson & Johnson vaccine, which may be used in unequal ways. Dr. Marcella Nunez-Smith, chair of the Biden administration’s new Health Justice Task Force, told a press conference at the White House this week that the vaccine distribution “should be evenly distributed among communities.”
“We’ll be tracking biometrics like zip code and social vulnerability to see where the vaccines are going,” she said. “And if certain vaccines are consistently delivered to certain communities, we can intervene.”
Some state officials believe pairing the new and old vaccines can help show that they are equally important.
Mr Allen said Oregon has similar sales plans for Johnson & Johnson and Moderna because both vaccines can be refrigerated for short term. The state treats the Pfizer BioNTech vaccine as the vaccine with “special considerations” as it has stricter shipping requirements and large packs of vials that are better suited for mass vaccination sites, he said.
Managing Johnson & Johnson and Moderna vaccines in a similar manner would help “avoid equity issues and potential concerns based on perceived differences between vaccines, some of which are real and some of which are not”.
