Medicinal

Johnson & Johnson’s Covid-19 vaccine works better than gains credit and may play an important role in the future

In addition, a CNN analysis of information collected by the US Centers for Disease Control and Prevention showed that the J & J vaccine had the lowest breakthrough infection rate of all vaccines. Weeks ending December 25, the latest 5 weeks of available data.

At Omicron Surge in January, breakthrough infections were the most common among those vaccinated with the Pfizer / Bio-Ntech vaccine, followed by those vaccinated with Moderna, followed by those vaccinated with Johnson & Johnson Shot. Was the lowest.

As of the week leading up to January 22, there were 650 J & J vaccine infections per 100,000 people. Moderna had 757 per 100,000 and Pfizer had 862 per 100,000.

Unvaccinated people, like the original version of the coronavirus, were particularly vulnerable to illness during the Omicron and Delta surges, which could be 3.2 times more ill than those vaccinated with the J & J vaccine. The number of unvaccinated people was 2.8 times. It is more likely to be infected than those who get Moderna, and 2.4 times more likely than those who get Pfizer.

“What we saw in the summer and the fall of the Delta Surge was that all three vaccines were very well protected, but the Janssen vaccine breakthrough rates in August and September last year were slightly higher than Pfizer. , Moderna was slightly lower. But these differences were relatively small. ” Dr. Dumbarooch, director of the Virology and Vaccine Research Center at the Beth Israel Deaconess Medical Center in Boston, supported the development and research of the J & J vaccine.

“But over time, those differences have narrowed since then, and by the first week of December, what we saw in the data was the crossing of boundaries,” J & J / Janssen said. The incidence of vaccines is as follows: Lower than others.

“Safe” data for J & J recipients

In March 2021, the J & J vaccine was third approved by the US Food and Drug Administration, and the initial response was more modest than the milestone approval of the mRNA vaccine from Pfizer / BioNTech and Modana.

Vaccines work differently. The mRNA vaccine basically provides a blueprint for training the body to fight certain infections and similar infections in the future. Adenoviral vector vaccines like J & J use viruses that behave like Trojan horses. However, instead of the soldiers popping out, the adenovirus releases the gene that encodes the coronavirus’s peaplomer.

The J & J vaccine stood out for other reasons as well: it was a convenient single dose and did not require special refrigeration, while the mRNA vaccine requires two doses and Pfizer requires special refrigeration. was. I had a lot of shots or I didn’t have time to get 2 shots. It was also excellent for countries without a strong healthcare infrastructure.

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However, its performance has eased some of the enthusiasm, especially from the general public.

The mRNA vaccine was welcomed with a “amazing” efficacy of over 90%, but some news that J & J was 65% effective in preventing symptomatic Covid-19 among clinical trial volunteers. Overwhelmed.

The supply of the J & J vaccine was limited from the beginning, but after the vaccine was approved, the federal government temporarily stopped using it due to safety concerns about rare blood coagulation events. The pace of J & J vaccination did not recover when vaccination was resumed.

In December, the CDC changed its recommendations, stating that shots by Moderna and Pfizer / BioNTech take precedence over J & J. Also, people who get J & J shots will be encouraged to get one booster of the mRNA vaccine after 2 months.

The protection provided by the Covid-19 vaccine diminishes over time, and none of them work well against variants that emerge after the original coronavirus surfaced. But science is beginning to show that those who got J & J Covid-19 got J & J Covid-19. Vaccines have several advantages.

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Barouch told CNN “I wasn’t surprised at all” to make sure that the durability of the Johnson & Johnson vaccine appears to last longer than the mRNA vaccines (Pfizer / BioNTech and Moderna), based on the incidence of breakthroughs. rice field. A breakthrough infectious disease.

mRNA vaccine technology has been shown to rapidly elicit a strong and strong immune response after vaccination, but it can decline over time. Johnson & Johnson’s viral vector platform is known to be powerful and durable, although it may not fire at the time of an immune response in the short term.

“As expected, the efficacy of the Pfizer and Moderna vaccines declines over time, and the efficacy of the J & J vaccine remains stable. It converges and then crosses,” Barouch said. increase.

He said the J & J vaccine may also have a “certain advantage.”

“The immune system is actually made up of two arms, the antibody side and the T cells. The type of T cells that is important for the prevention of serious illness is called CD8 T cells. The J & J vaccine produces better CD8. Because T cells are superior to Pfizer and other mRNA vaccines, the J & J vaccine may have a special advantage over variants such as Omicron that have largely escaped the antibody response. . “

Overall, Baruch called this data “very reassuring” for J & J vaccine recipients.

“They need to be reassured that they have been vaccinated with a very good preventive effect over the long term,” Baruch said. , In the same way. “

What is your outlook as a booster?

“The J & J vaccine got some bad wraps for efficacy, but the stability of the response is interesting,” said David Montefiori, a virologist at Duke University Medical Center.

During the Omicron surge, antibody levels dropped with each vaccine, which may require additional booster immunity. Further research is needed to find this.

According to Montefiori, an unpublished study by the National Institutes of Health, which is considering a combination vaccine strategy, gave good results when J & J was included.

“People who were first vaccinated with the Pfizer vaccine and then boosted with the J & J vaccine had significantly higher levels of neutralizing antibodies to Omicron, ten times higher than those who received the J & J vaccine alone twice,” he said. Told. Therefore, the J & J vaccine may be a good booster for those who first received the mRNA vaccine. “

The Johnson & Johnson vaccine can be used as a primary dose or booster, but according to the CDC, the Pfizer and Moderna vaccines are recommended in most situations due to the risk of serious adverse events with the Johnson & Johnson vaccine.

The J & J vaccine is associated with a rare case of thrombocytopenia, known as thrombocytopenia syndrome or thrombosis with TTS.

Dr. Angela Branch, an infectious disease specialist and associate professor of medicine at the University of Rochester, said the side effect profile of the J & J vaccine is “still a concern for some groups at high risk.” Women between the ages of 30 and 49 According to the CDC, the risk of this rare adverse event has been high over the years.

However, if the study is successful, the J & J vaccine may serve as a booster for specific populations only.

“This may be a good strategy for some groups, such as the elderly, who are not at very high risk of developing a serious thrombosis,” Branch said.

Montefiori said vaccines are worth more research.

“I think there may still be a place for the J & J vaccine in this long-term pandemic,” Montefiori said.

CNN’s Jacqueline Howard and TasnimAhmed contributed to this report.

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