@JNJNews vaccine results are in! While not as efficacious as Pfizer or Moderna it’s still great news—it was 85% efficacious at preventing severe disease requiring hospitalization.

Not a “knockout punch” but still will be very useful. https://www.statnews.com/2021/01/29/jj-one-dose-covid-vaccine-is-66-effective-a-weapon-but-not-a-knockout-punch/

The J&J vaccine is an adenovirus-vectored vaccine. That means it uses another virus, called Ad26, to deliver the spike protein from SARS-CoV-2 for your immune system to respond to. Ad26 is a human pathogen that normally causes common colds.

(AstraZeneca is also an Ad-vectored vaccine, but uses a chimpanzee adenovirus rather than Ad26 as its vector backbone)

It was 66% efficacious overall which is much lower than Pfizer and Moderna. HOWEVER it was 85% efficacious at preventing severe disease, which is still a result with important public health implications.

Unlike mRNA vaccines like Pfizer and Moderna, this is a one-shot vaccine regimen. Also Ad-vectored vaccines don’t require strict ultracold storage like mRNA vaccines so they’re much easier to distribute. Both of these things are crucial as we face supply and distribution issues.

It will be much, much easier to roll out a one-shot regimen with less stringent cold chain requirements in many communities all over the world. While efficacy varied by region, keeping people out of the hospital everywhere will save lives, which is what this is all about.

And this will be very important for ensuring equitable vaccine access *globally*, because that’s the thing about pandemics: they affect the entire world. They don’t end when you vaccinate people in one country or another. We need to immunize the world.

So in that regard J&J will be tremendously useful. It’s going to be an important addition to our vaccine toolkit in the US and abroad.

Now you might say “But Angie, what about the variants like in South Africa? Isn’t it less effective there?”

Yeah all the vaccines are shaping up to have reduced efficacy, but this one still does offer substantial protection against severe disease. It will still keep a lot of people out of the hospital and that has a huge public health impact. Not as sick=less likely to die.

And while J&J has trials still ongoing for a 2-dose regimen, this also leaves the door open to evaluate heterologous boosting. That’s giving an initial vaccine with J&J, then boosting with a different vaccine.

As Pfizer, Moderna, & Novavax are all reformulating boosters to address the B.1.351 variant discovered in S. Africa, this is an option we should look into. A heterologous boost with a fast-to-manufacture platform like mRNA or protein could help us flexibly adapt to new variants.

In addition, heterologous boosting could increase the J&J vaccine’s efficacy overall. Between that and the 2-shot regimen currently being tested, I think these data can only get better.

So while this may seem disappointing on the surface because it’s not as efficacious against all symptomatic disease as Pfizer or Moderna, it’s still great news. High efficacy against severe disease + one shot + less cold chain = more vaccines for all.

This is still going to play an important role in containing and ultimately ending the pandemic in the US and the rest of the world. This is cause for celebration, not disappointment. Vaccines work and we have another one!