The US campaign to achieve herd immunity through vaccination involves a subtle – sometimes difficult – jump with side effects, public opinion, and viral variations. All three are unpredictable, and can change when you least expect it.
Deploying the coronavirus vaccine is not without its challenges, but the Biden administration’s strategy of not relying solely on one vaccine has placed potential failures with any product. However, as recent events have illustrated, discontinuing one vaccine can influence public opinion about the entire process.
The Food and Drug Administration and the Centers for Disease Control and Prevention Suggest suspending use of Johnson & Johnson vaccines on Tuesday when they examined six serious rare blood clots. J & J’s
‘It’s still a race between variants and vaccines.’
The vaccine is based on a biphasic mRNA made by Pfizer
and German partner BioNTech SE
the majority of injections are administered in the United States, and are about 95% effective in clinical trials. (The Mayo Clinic study says “the real world“Efficiency is close to 88.7%, still high.)
Currently, 22.7% the United States’ population has been fully vaccinated. On Wednesday, the CDC Immunization Practices Advisory Committee will meet to discuss the cases and the FDA has opened an investigation into the cause of the blood clots.
“It’s still a mid race variant and vaccines, ”Amesh Adalja, a senior scholar at the John Hopkins Center for Health Security and a spokesperson for the American Infectious Diseases Association, told MarketWatch.
Operation Warp Speed, the Trump administration’s vaccine development and distribution program, was key to this success, he said.
“Part of Operation Warp Speed is not knowing what will be past the finish line, and there is an alternative vaccine that can handle the J&J suspension and other vaccines in the pipeline,” Adalja said. “We are increasingly having no supply constraints in the US because of the large volume production of vaccines.”
The FDA and CDC said halting J&J would give their scientists time to investigate six cases of blood clots in vaccinated people. There were six cases of cerebral sinus thrombosis, a blood clotting disorder, out of about 6.8 million people in the United States who received the vaccine.
“When I was invited to be Moderna, J&J wasn’t even an option. I never considered not taking it, ”said Maury Newburger, a travel consultant in New York who received the Moderna vaccine in March. “Knowing what I know now, I probably won’t be in J&J. I still think I’ll get the two-shot vaccination. “
All six cases of blood clotting occurred in women aged 18 to 48. One woman died, and another woman remained in critical condition, according to details released by the FDA on Tuesday. “We recommend suspending the use of this vaccine because of extreme caution,” health officials said.
Dr. Andrew Pavia, Professor of President George and Esther Gross at the University of Utah and head of the Department of Pediatric Infectiousness, said: “Hiccups in the manufacturing process and failure in safety are inevitable.
“It’s a wise decision to spread the risk,” he told MarketWatch. “Factories can be hit by a hurricane, run out of supplies or be hit by pollution forcing them to close.”
Good news (and bad)
The good news is that Pfizer-BioNTech and Moderna supply the majority of vaccines in the US and currently ship about 23 million doses a week there. The White House said the suspension of J&J would have no “significant impact” on its US deployment
“We have done quite well and there is no result that Europe is experiencing,” Adalja said. “We have successfully vaccinated high-risk populations: nursing home residents and community residents. We are nowhere near winter. Nursing home deaths have fallen sharply ”.
White House COVID-19 response coordinator Jeff Zient said in a statement: “This announcement will not have a significant impact on our vaccination plan: Johnson & Johnson vaccines account for less than 5% of the shots recorded on weapons in the United States to date.”
‘These types of vaccine hesitant people worry even more.’
The latest complication has further delayed a difficult rollout in the European Union, which has ordered about 200 million doses of J&J vaccine by 2021. “We have made the decision to proactively delay the Its vaccine deployment in Europe, ”J&J said in statement Tuesday. The UK has ordered 30 million doses of the J&J vaccine, though it has yet to be approved for use there.
Now, the bad news: “Unfortunately, there are always halo effects in a negative way,” Dr. Aaron Glatt, the dean of medicine at Mount Sinai South Nassau in Oceanside, NY, told MarketWatch. “What happened to J&J is forcing people to question all vaccines.”
The J&J vaccine “remains an extremely important vaccine for a fatal disease,” he added. “These are even more troubling for those who are hesitant about vaccines.”
“Certainly, having other vaccines is extremely helpful because there can always be production problems, or different strains may or may not be effective for a particular vaccine. . It was not intentional, it was just how science works, ”said Glatt.
“Boosters, if and when they come, will be easier to get approved,” he added. “We have completed most of the related work. It is impossible to predict what will happen. It is possible that the vaccine will be effective against different strains. Time will tell, and different strains will answer as well. “
In a recent poll by the Kaiser Family Foundation done prior to the suspension of J&J vaccinations, 13% of Americans said they would definitely not get the vaccine and 7% said they would only get it if asked.
“As humans, we’re not good at translating risks into action,” said Pavia. “If I have a chance to be one of the 500,000 people who die from COVID, how do I balance that with someone with a fatal side effect, if it’s a side effect? It’s the same perceptual problem when we blindly drive to the airport texting, but we worry about planes.
Following the suspension of J&J vaccines, Barbara Alexander, president of the American Infectious Diseases Association, said that the American public must continue to receive clear, accurate and up-to-date information and answer questions from they, “so that we can maintain and build trust and confidence in COVID-19 vaccine.”
“The risk of COVID-19 infection, and the possibility of serious illness or death, is still a serious concern and we urge all eligible people to take advantage of the opportunity to be vaccinated with one. of the currently available options, ”she added.
The attraction of J&J and AstraZeneca
J&J’s blood clot problem is similar to the problem that caused many European countries to pause and / or limit their use of AstraZeneca.
and the coronavirus vaccine from Oxford University, which is also the adenovirus vector-based vaccine. The UK has restricted its use to people over the age of 30.
Moderna began vaccine rollout in the UK on Tuesday, offering an alternative to the AstraZeneca vaccine. In Ireland, where Pfizer-BioNTech and Moderna are also available, the authorities have decided to limit AstraZeneca to people over 60 for the same reason.
Bill Schaffner, professor of medicine in the Department of Infectious Diseases at Vanderbilt University School of Medicine, Nashville, Tenn, said the AstraZeneca vaccine is very attractive to poorer countries and rural communities.
‘We won’t get a zero COVID. It will stay with us season after season. ”
“AstraZeneca is supposed to be a relatively inexpensive vaccine and can be stored at normal refrigerator temperatures,” he said. “The problem with this vaccine is posing a significant question to its international distribution plan.”
Meanwhile, the J&J vaccine is an attractive prospect for those who particularly don’t like vaccines and / or needles, Schaffner added.
“The J&J vaccine was noticed because it was one and completed, so this pause will definitely slow us down,” he said. “In our state, when we tried to vaccinate more people in the countryside, we fell into a state of hesitation or apathy with the real vaccine.”
Elsewhere, Russian Gam-COVID-Vac (Sputnik V) coronavirus vaccine was the first vaccine in the world approved in August last year, and Hungary was the first country in the European Union to approve. That country also rolled out more vaccines. A second Russian vaccine, EpiVacCorona, was registered in October. Last month, Russia approved a third domestic COVID-19 vaccine, CoviVac.
The number of deaths from COVID-19 in the US has risen to 563,428 and continues to increase. More than 31.3 million people in the US have been infected with the coronavirus since the pandemic began. Worldwide, more than 2.9 million people have died from the disease.
Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, has said that a good “herd immunity” would be equal to 70% to 85% and that the United States will begin to see an improvement. normal again in the fall. Of course, it depends on each individual’s age, circumstances and basic conditions.
“Herd immunity is likely to happen later in the summer,” Adalja said. “We won’t reach a zero COVID – it will stay with us season after season, but it won’t be likely to cause a public health emergency. It is important to tame it, and the damage it does. “
The variety of vaccines also helps to protect against variations. So far, Israel has vaccinated more than 50% of the population. Previous print of a small study, published last Friday, says coronavirus variant B.1.351, first discovered in South Africa, is more likely to infect people in Israel who have been vaccinated with Pfizer.
The study has not yet been evaluated by colleagues, but it is still of particular interest in Israel, which is mainly based on the Pfizer / BioNTech vaccine.
Fauci said clinical data to date indicates that the mRNA vaccine developed by Pfizer and BioNTech and Moderna provides protection against B.1.1.7, first discovered in the UK, but their effectiveness is thought to be reduced compared to the variant. B.1.351, a rarer strain of the virus, is at least in the US
Newburger, a travel consultant, never had a flu shot until the coronavirus came along. “I have never believed in a flu shot,” he said. “I may get sick a day or two a year, but this is the first year I get a flu shot. It’s a combination of COVID, travel, and the ability to catch something, and this time I thought, ‘I’ll get it.’
He said there will always be vaccine stockpiles that are inconclusive for any coronavirus vaccine. “There is a very small group of people who don’t believe in it for religious or political reasons, or they just don’t know it,” he said. “It was difficult for me to understand.”