J & J’s Covid vaccine shows promising long-term endurance

When the results of the early Covid vaccine trials came out, durability, an important indicator of success, could not yet be assessed.

These first studies were only 3-4 months and were too short to determine how long the protection would last. But now, as public health officials are considering the possibility of a fourth dose of the Pfizer and Moderna vaccines, this question is receiving new attention.

This week, companies asked the FDA to approve additional boosters — Pfizer for people over the age of 65 and Moderna for all adults. At the same time, a study published Thursday in the journal JAMA Network Open estimated that one shot of Johnson & Johnson was 76, a percentage effective in preventing Covid infections, and 81 for at least 180 days of hospitalization. percent.

This study is consistent with data from the US Centers for Disease Control and Prevention, with weekly breakthroughs among those who took J & J shots from late December to February 19 (latest data available). It shows that the incidence of typical cases was the lowest. However, the death toll of J & J recipients was slightly higher than that of recipients vaccinated with the mRNA vaccine by January 29.

Taken together, this evidence suggests that J & J shots may be more durable than the two mRNA vaccines. None of the more than 422,000 J & J recipients in a recent study earned boosters during the study period that ended in August.

Sebastian Schneeweiss, co-author of the study and Deputy Chief of Pharmacoeconomics and Pharmacoeconomics at Brigham & Women’s Hospital, said:

“I’m not saying it’s limited to 180 days,” he said, saying it’s just the data available from insurance claims.

A spokesperson for Janssen, J & J’s pharmaceutical division, said in a statement: For breakthrough infections, Covid-19-related hospitalizations and deaths. ”

Danbaruch, director of the Virology and Vaccine Research Center at the Beth Israel Deaconess Medical Center in Boston, believes that a clearer picture of the different characteristics of the Covid vaccine is being revealed.

“MRNA vaccines increase antibody responses very quickly, after which their antibody response and defense rapidly decline, requiring multiple boosters,” said Baruch, who supported the development and research of the J & J vaccine. I am saying. Initially much lower and slightly lower protection at first, but both seem to be more maintained over time. “

Of course, studying durability is important in deciding if and when booster shots are needed.

“I’m not a doctor of infectious diseases, but as a consumer, as a vaccinated person, I can choose a similarly effective vaccine, or a vaccine that is almost as effective, and add at longer intervals. If you get vaccinated, you will prefer it. “

According to the CDC, only 44% of people vaccinated in the United States receive booster shots.

“I don’t think it’s a viable or desirable public health strategy to do multiple rapid boosts every 3-6 months, as people probably won’t get them,” Baruch said. .. Better durability will certainly benefit long-term pandemic measures. “

Still, the assessment of how long vaccine protection lasts depends on what is being measured.

Dr. Larry Corey, an immunology and vaccine development expert at the Fred Hutchinson Cancer Research Center, said, “If you’re asking,’Will preventing getting sick be ineffective? But when it comes to hospitalization and ER visits, he added, “there are some data that most people say is a bit vague at this point.”

Corey said he was waiting for more information before drawing any conclusions.

Dr. Robert Atmar, a professor of infectious diseases at Baylor College of Medicine, said long-term protection against the worst Covid outcomes was a priority, and in that sense “mRNA data is still very reassuring.”

Atmar points out a CDC study published Friday, with 79% of people vaccinated with the mRNA vaccine twice (without boosters) to prevent death from mechanical ventilation and Omicron infection until January 24. did. The median number of days was 256 after the second dose in those patients.

“It’s a long time because it’s over eight months,” Atmar said.

Experts hope that conversations about vaccine durability will continue to be in the limelight as the coronavirus transitions to endemic conditions.

But even if things get clearer, risk-benefit analysis varies from person to person, Corey said. In December, the CDC recommended that Americans choose the mRNA vaccine over J & J. Therefore, even if J & J’s shot durability is significantly improved, its benefits will be weighed against other factors.

“Don’t be surprised that the virus affecting 7 billion people requires an eclectic approach. In reality, we can’t even make as many as 7 billion effectively, and here’s a bit of diversity. So some people are confused, others say they really need this kind of option to solve the problem. “

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