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How the Johnson & Johnson vaccine functions, differs from preexisting vaccines

Doctors explain the pros and cons of the new vaccine, comparing it to existing Pfizer and Moderna vaccines, but still encouraging its use

Governor Ralph Northam announced that all Virginians 16 years and older will be eligible to get the vaccine by April 18.
Governor Ralph Northam announced that all Virginians 16 years and older will be eligible to get the vaccine by April 18.

Following the one-year mark of the World Health Organization declaring COVID-19 a pandemic, the United States is steadily conducting vaccinations. For the past few months, the Pfizer-BioNTech vaccine and the Moderna vaccine have dominated the industry. However, the Center for Disease Control approved Johnson & Johnson’s single-dose COVID-19 vaccine for people 18 and older in the United States on Jan. 31. 

The Johnson & Johnson vaccine is unique from the preexisting Pfizer and Moderna vaccines by the way in which it delivers instructions for antibody production. Despite these differences, University physicians believe the Johnson & Johnson vaccine will play a role in lowering instances of severe COVID-19 infection and increasing vaccination levels around the globe. 

Vaccines cause immunity to develop by imitating an infection similar to the one that it is designed to prevent, causing the body to produce antibodies that will protect it from future exposure to the virus. Even though vaccines typically have side effects, they are known to be significantly milder than those caused by manifestation of the virus itself. 

Professor of Medicine William Petri explains that the Johnson & Johnson vaccine differs from the other types through its approach of delivering the spike protein to the body.

“The J&J vaccine uses a common cold virus — adenovirus — as the means to deliver the spike protein vaccine whereas the Pfizer and Moderna vaccines use mRNA that encodes the spike protein,” Petri said in an email to The Cavalier Daily.

Additionally, Costi Sifri, director of hospital epidemiology at the University, notes that the Johnson & Johnson vaccine is similar to the mRNA vaccines in that it will deliver genetic material into the body to produce proteins that will help us prevent the virus. In other words, it will “disable the virus inside of the body so that it cannot complete its life cycle,” which essentially means that it can’t make “baby proteins,” Sifri said.

Patrick E. Jackson, assistant professor of Infectious Diseases and International Health, said that the advantages of the Johnson & Johnson vaccine is “that it is easier to administer,” and “easier to schedule because there is only one dose.”

Additionally, Sifri mentions that the “period of protection [after getting the Johnson & Johnson] vaccine] is two weeks” which is relatively quick given that individuals will only need a single dose of this vaccine.

The period of protection is the number of days it takes after receiving a dose of the vaccine for it to manifest and have a greater chance of granting the vaccinated individual immunity from being infected with the virus. Each vaccine has a similar period of protection of approximately two weeks, regardless of the number of doses required.

The Johnson & Johnson vaccine also differs from Pfizer and Moderna in aspects of storage and efficacy. For example, instead of shipping two doses to every vaccination site, only one is needed. Additionally, the vaccine can be stored at refrigerator temperatures, making shipping of the vaccine much easier compared to Pfizer and Moderna vaccines. Storage of the latter two vaccines requires freezing conditions, with Pfizer vaccines kept at approximately -70 degrees Celsius and Moderna at -20 degrees Celsius. 

In comparison to the existing vaccines, Jackson said that the topline efficacy for the Johnson & Johnson vaccine is reported to be lower — 80 percent compared to 95 percent for the Pfizer and Moderna shots. However, Jackson wants to emphasize that this is not a straightforward “apples to apples comparison.” 

“We don’t know if the vaccine was tested on the same person because performing tests on different people will produce different results,” Jackson said. “Ultimately, none of the people who were tested with the Johnson & Johnson vaccine were hospitalized or died, so really, it has a 100 percent efficacy.”

He goes on to assure that at the end of the day, “all three vaccines performed very well in the clinical trials so we shouldn’t put too much weight on the topline efficacy trials.”

When comparing efficacies of the drugs, it’s important to note that efficacy percentages are not the same as drug effectiveness. Efficacy is measured based on how well the treatment works on the population while efficiency is how cost-beneficial a drug is to society — a measure of whether it is worth it for the general public to be receiving the vaccine. 

Jackson believes that any of the three COVID-19 vaccines will be effective in the human body and that the only reason he would choose one over another is if an individual showed symptoms of allergies.

Despite numerous concerns about the technology used to synthesize the vaccines and any long-term side effects, health professionals are optimistic due to past research involving mRNA vaccines, which show promising results.

“mRNA vaccines have been in practice before, so it is not as if we have 0 percent experience with these technologies,” Jackson said. “We know how these drugs work in the body.”

Sifri also said that another discrepancy between the Johnson & Johnson vaccine and the Pfizer and Moderna is that the Johnson & Johnson vaccine was that it was largely studied in the Latin America and South Africa strains of COVID-19.

This allows for the possibility for the strain to have already adapted to the vaccines by the time it is administered in the United States and Charlottesville area. If the current vaccines prove inefficient in fighting new strains, the country may have to restart the vaccination process from the beginning, making it imperative to take precautions against new strains when developing vaccines. The Johnson & Johnson vaccine was 80 percent protective in the region that it was studied in. 

On an ethical note, Petri also says that a “disadvantage of the [Johnson & Johnson vaccine] is that cell lines derived from aborted human fetuses were used to produce the vaccine.”

The new vaccine will first be distributed through health departments and “pharmacies throughout the state and country,” and will be “allotted for supporting health districts” first. The Blue Ridge Health District has received several shipments of the Johnson & Johnson vaccine since the beginning of March, allowing the vaccine to be distributed to Charlottesville community members eligible in Phase 1 of vaccinations.

Thus, the Johnson & Johnson vaccine will likely only be delivered to hospitals and primary care locations in the case of increased supply. Sifri further anticipates even more vaccines to be produced over the next few weeks.

“If this vaccine was offered to me, this is the one that I would take, and I would take it in a heartbeat,” Sifri said.