There seem to be a lot of differing opinions on the J&J vaccine. Some are concerned about the 66% efficacy number and the lack of trial data so far. But others point out that the efficacy numbers, as stated, are acceptable and point out that —
- Efficacy was 72% in the U.S. and L. America
- J&J vaccine reduced severe disease by 85% after 28 days
- J&J vaccine reduced hospitalizations and deaths to zero after 28 days, even in S. Africa
- Efficacy against severe disease increased over time with zero cases in the vaccinated group reported after day 49
- Single dose
- Lower cost
- No ultra-cold refrigeration requirement
-
J&J has stated that they can produce 1 billion doses per year starting in 2021
Here is another summary of the J&J vaccine.
Johnson & Johnson is running another large study, to test a two dose regime, given 57 days apart. The phase 3 trial started on Nov 15, 2020. Recruitment for 30,000 participants should be done by March 2021. Results of the two-dose study are expected in summer or fall.
There is also some negative coverage of the Novavax vaccine in that it is less effective (49.4%) against the B.1.351 from S. Africa. But keep in mind, that the number is 60% for HIV-negative patients and we do not have efficacy numbers for the mRNA vaccines against B.1.351. We cannot assume that the mRNA vaccines will do any better against B.1.351. The Novavax vaccine has a few other advantages -
- It is marginally better than the mRNA vaccines on the original virus strain
- It has proven results against both B.1.1.7 and B.1.352 strains
- No ultra-cold refrigeration requirement
- Lower vaccine amount is needed because of the effect of the adjuvant
- Novavax has stated that they can produce 2 billion doses per year
Vaccines reserved and administered around the world
www.bloomberg.com/… has this interesting tracker of vaccine doses reserved around the world by country and by manufacturer. Over 8.49 billion reserved!
From www.bloomberg.com/…, here are the stats on doses administered so far. We have a long way to go, but the pace is picking up.
|
WORLD |
USA |
| Doses administered |
98.3 million
across 62 countries
|
31.8 million |
| Recent doses per day |
4.2 million |
1.35 million |
| Population |
7,674 million |
328 million |
Discussion
Overall, the Novavax and J&J results bode well for the future, since we need billions of doses to get the world population vaccinated soon. The longer the virus lingers and thrives in the population, the higher the chances of it mutating, becoming more infectious and becoming resistant to existing vaccines. And others have pointed out, it does no good if one country is fully vaccinated but others aren’t; the virus will thrive and mutate in countries with low levels of vaccination and it will then land on other shores.
Speed of vaccination is of the essence right now, so that the virus spread can be brought under control soon.
Speed of vaccination is also driving the debate whether we should use up all vaccine stock right away and administer the first dose to the maximum number of individuals, and perhaps delay the 2nd dose by a few weeks, rather than reserve and store away the second doses and administer them on time. The other side of the coin is that the delayed 2nd dose might give the virus a chance to evolve against the vaccine inside patients where certain variants selectively survive against a diminished immune response.
There is genuine concern that the B.1.1.7 and B.1.351 variants, and possibly the variant from Brazil P.1, will become dominant worldwide in the next few months.
There is also concern that as vaccination levels rise, it will put selection pressure on the virus to evolve into B.1.351 or P.1 -like variants, that can evade antibodies generated by current vaccines. It might mean periodic updates to vaccines and annual shots, just like the flu.
And let’s not even talk about what would have happened with virus mutations if trump had won the election and gone ahead with the let-everyone-get-infected herd-immunity racket.
Epilogue
Which vaccine should you get? I do not have an opinion since I am not a medical professional. Most experts agree that we should get whichever one is available. The difference in efficacy values is not significant. More importantly, all of these vaccines prevent severe illness and death.
Speed of vaccination is of the essence right now, so that the virus spread can be brought under control soon. More virus means more chances of dangerous mutations.
All this also means that we should not let our guard down after getting the vaccine. Social distancing and masking will remain useful tools even after vaccination, until most of the population is vaccinated and infection rates reduce to a trickle.
OK, let’s discuss vaccines.
Further Reading
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