Opinion: The case for the J&J COVID vaccine in the herd-immunity quest

COVID-19 vaccines are finally helping us see light at the end of this long, dark tunnel.

Unfortunately, early reporting suggested that the most-recent vaccine entrant — from Johnson & Johnson — doesn’t live up to the standard set by the first two, from Pfizer and Moderna. Some speculated that it would be “dumped” on populations as a second-rate alternative.

To the contrary, the J&J vaccine very effectively prevents severe disease and death — and should be celebrated as another tool speeding protection for all of us.

Compared to the Pfizer and Moderna mRNA vaccines, the J&J inoculation requires only a single dose, appears to trigger peak immunity faster, seems to have fewer side effects, is more stable and portable and is less expensive.

Yes, the initial clinical trial data showed roughly 20% lower effectiveness of the J&J “jab” against mild to moderate COVID-19 disease in the United States, compared to the mRNA vaccines. But these results should not be a deterrent to using it.

If we consider the primary objective of COVID-19 vaccination to be preventing severe illness and death, the J&J vaccine was as potent as the mRNA vaccines. No one who received the J&J, Moderna or Pfizer vaccines died of COVID-19 during the clinical trials, and very few were even hospitalized. That’s incredibly effective! And evidence is building that these vaccines will offer at least some level of protection against the current crop of variant viruses.

We must get to herd immunity by vaccinating 70%-80% of the population — and we’re only at about 15% now. In California, there simply aren’t enough doses of the mRNA vaccines currently available. Adding the J&J vaccine to the arsenal will accelerate reaching herd immunity. Think of it as a faster passport — individually and collectively — out of isolation and quarantine and severe disease and death.

Who might relish a one-stop shot? We work at a university, and college students immediately come to mind. They party, they live 10 to a house, they travel — and they unknowingly spread COVID-19. They like one-and-done. But they aren’t the only ones. People who hate needles, lack easy access to transportation or are paid an hourly wage could find a single trip for a single shot to be very helpful.

The rollout of the J&J vaccine could be slowed by vaccine hesitancy, particularly among communities that have been historically mistreated and underserved by the medical establishment. Such racism has bred mistrust. In our view, treating people with dignity and respect includes not forcing anyone to get a shot that they believe is ineffective or harmful.

A truly equitable COVID-19 response requires education and outreach to hard-hit communities, easy access and transparency and fairness in the distribution of all of the COVID vaccines. A stable, single-shot vaccine such as J&J can work well for mobile vaccination clinics. But that should be supplemented by strategies such as health workers from the community explaining vaccine safety and effectiveness in various languages, transportation to vaccination sites and alternatives to internet-only registration systems.

The vaccination effort is a race against a virus that delights in exploiting social divisions and health disparities. All the approved vaccines work well, and we need them all to help win this race, a race toward justice for people who have borne the brunt of infections and death.

The authors are from Santa Clara University. H. Westley Clark is dean’s executive professor of public health. Margaret McLean is associate director of the Markkula Center for Applied Ethics. Craig Stephens is professor of biology and public health.

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Author: H Westley Clark, Margaret Mclean, Craig Stephens

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