For quick, one-shot protection, Johnson & Johnson’s vaccine promised to be a key tool in the race to end the COVID-19 pandemic.
Now, more than two months after its rollout, it represents merely 5% of all inoculations in California’s ambitious vaccination campaign.
Supplies are down, with no new doses delivered this week while a manufacturing plant is suspending production during an inspection by U.S. regulators. But demand has dropped, also.
“People always request Pfizer,” said Luz Gallegos of TODEC Legal Center, which vaccinates farmworkers and immigrants in California’s vast Inland Empire and Coachella Valley. “That’s the one they trust.”
Faced with unused J&J doses, San Jose’s Gardner Health Services may return its vaccines to Santa Clara County, so they can be used elsewhere
Despite the vaccine’s precipitous fall from grace and troubled recovery, experts predict it will rebound – too late to become a major player in our nation’s inoculation drive, perhaps, but not for the vaccine-desperate populations elsewhere around the globe.
“It hasn’t lost its luster, or its potential to do good, globally,” said Dr. Charles Binkley, director of Santa Clara University’s Markkula Center for Applied Ethics. “The Johnson & Johnson vaccine will have a huge role to play in getting the world immunized.”
Created with $1 billion in federal support, the vaccine is 72% effective and far more rugged than the Pfizer and Moderna vaccines, surviving for up to three months in normal refrigeration. Its design is similar to familiar vaccines, and it can be given as a single dose, so is ideal for hard-to-reach populations.
“Its value is extraordinary,” said San Jose physician Dr. Walter Newman, who led J&J vaccination clinics at Monterey Mushrooms, where a stunning 80% of workers are now protected.
But the vaccine’s rollout is a tale of setbacks and stumbles.
Even during testing, the company fell behind on its original manufacturing schedule. Clinical trial results were initially expected in January 2021, putting the vaccine just a month or two behind its competitors. But because of delays, federal authorization didn’t come until Feb. 27.
The vaccine’s official launch met with criticism in some communities of color. With a slightly lower efficacy rate than the Pfizer and Moderna vaccines, and a distribution chain that targeted people in poorer ZIP codes and rural regions, the vaccine triggered suspicions of racism.
Next came a series of major quality control problems at a partner’s manufacturing plant. The Food and Drug Administration issued a harsh inspection report of the Baltimore-based Emergent BioSolutions, finding unsanitary conditions and a lack of training and procedures to prevent contamination of vaccine batches.
With about 15 million doses ruined, J&J’s domestic supplies were derailed. Emergent was its only domestic manufacturer, so doses had to be imported from The Netherlands.
Then there was another startling setback, triggering a pause in its use: serious, potentially life-threatening blood clots in six women. Since then, 28 people, including six in men, have been diagnosed.
The 11-day pause interrupted the vaccine’s delivery pipeline. For two weeks, fewer than 2,000 total doses were administered in the entire state of California. On one day — April 18 — only 14 doses were given.
A federal investigation gave it a clean bill of health, concluding that more 9 million doses have been safely administered. Labeling was revised and distribution resumed.
“There is no drug – none — that is as safe, including Tylenol or aspirin,” said Newman.
The strict scientific scrutiny should have put people at ease, said Katie Foss of Middle Tennessee State University, who is studying the shift in the vaccine’s cultural perceptions. But instead the pause was perceived as a significant flaw in the vaccine, she said, causing a major backslide in public confidence.
“People were apprehensive,” said Reymundo Espinoza, CEO of Gardner Health Services, which works with community groups to vaccinate high-risk South Bay populations.
“It took a big effort to educate people and help motivate them,” he said. “There was misunderstanding, and miscommunication.”
Then it met criticism from six Catholic bishops, who deemed the J&J vaccine “morally compromised” because it was manufactured with cells originally derived from a fetus aborted in 1985. The Internet rumor mill kicked in, with kooks and conspiracists falsely claiming that aborted fetal tissue was used as an ingredient in the vaccine.
Experts say the J&J vaccine deserves far much more respect.
“It was always a safe and effective vaccine — and it still is,” said epidemiologist Mark Cameron of Case Western University’s School of Medicine, who studies vaccine design. “There’s not a problem.
“What is really comes down to is vaccine hesitancy,” he added. “And people have choices.”
To be sure, some specific populations continue to prefer the J&J vaccine. It is ideal for migrant farmworkers, who are unable to return for a second dose, according to Gallegos.
The homeless also value it, said Dr. Margot Kushel, director of the UC San Francisco Center for Vulnerable Populations.
“For certain populations who face so many barriers and such a high risk of COVID, we shouldn’t be abandoning the use of this vaccine,” she said. “When offered full information about the trade-offs, the vast majority (of homeless) are choosing the one-dose regimen.”
The company said it is still on track to deliver 100 million doses of the vaccine to the federal government, although it did not provide a timeline.
“Johnson & Johnson remains committed to helping end this deadly pandemic as rapidly as possible and to supporting appropriate use of our single-shot COVID-19 vaccine,” according to a statement by company spokesperson Rich Ferreira.
There will be a growing role for it in the future, predict experts. It could potentially supplement the Pfizer and Moderna vaccines, for greater immunity. It could serve as a simple annual “booster” shot in doctors’ offices. Used internationally, it could save millions of lives.
“The Johnson & Johnson vaccine was seen as a godsend. These ongoing problems are frustrating,” said Christian Arana of the Latino Community Foundation. “At this point in the pandemic, we should have multiple options.”By LISA M. KRIEGER | firstname.lastname@example.org | Bay Area News Group
PUBLISHED: May 20, 2021 at 6:00 a.m. | UPDATED: May 21, 2021 at 10:57 a.m.