Health

“Encouraging” data suggests Johnson & Johnson’s vaccine may continue to have an impact against covid-19

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(CNN) — The American public and even some health experts may have underestimated the Covid-19 vaccine made by Janssen, a division of Johnson & Johnson, according to new data. And there is emerging evidence that it could still play an important role in the future.

A study published Thursday in the medical journal JAMA Network Open found that J&J’s vaccine remains long-lasting and effective, even despite the rise in cases caused by the delta variant. It was 76% effective overall in preventing COVID-19 infections and 81% effective in preventing COVID-19-related hospitalizations. The study also showed that it provided lasting immunity for at least six months after the injections.

And a CNN analysis of data compiled by the US Centers for Disease Control and Prevention (CDC) showed that the J&J vaccine had the lowest rate of post-vaccination infections of all vaccines since the week ended. on December 25, the last five weeks of data available.

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In January, during the omicron wave, post-vaccination infections were highest among those who received the Pfizer/BioNTech vaccine, followed by those who received the Moderna vaccine. People vaccinated with the Johnson & Johnson vaccine had the lowest incidence of post-vaccination infections.

In the week ending January 22, there were 650 infections per 100,000 people with the J&J vaccine. With Moderna, there were 757 per 100,000, and with Pfizer, the rate was 862 per 100,000.

Unvaccinated people were especially vulnerable to getting sick during omicron and delta waves, just like with the original version of the coronavirus. They were 3.2 times more likely to get sick than people who had received the J&J vaccine. The unvaccinated were 2.8 times more likely to be infected than those who received Moderna and 2.4 times more likely than those who received Pfizer.

“What we saw in the summer and fall during the delta surge is that all three vaccines protected very, very well. But post-vaccination infection rates in August and September of last year with Janssen’s vaccine were slightly higher than Pfizer’s, and Moderna’s were slightly lower. But those differences were relatively small,” said Dr. Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston. He helped develop and study the J&J vaccine.

“But what we saw over time is that those differences then narrowed,” he said. “And for the first week of December, what we saw in the data is that the lines are crossing,” with incidence rates for the J&J/Janssen vaccine getting lower than the others.

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Data “encouraging” for those who received the J&J vaccine

In March 2021, J&J’s vaccine was the third to be licensed by the US Food and Drug Administration (FDA), and the initial response was more subdued than the authorizations of Pfizer/BioNTech’s mRNA vaccines and Modern.

Vaccines work differently. mRNA vaccines basically deliver blueprints that train your body to fight that particular infection and any similar ones in the future. Adenovirus vaccines, like J&J’s, use a virus that can act like a Trojan horse. But instead of jumping soldiers, the adenovirus releases genes that code for the spike protein of the coronavirus.

J&J’s vaccine stood out for other reasons, too: It came in a convenient single dose and didn’t require special refrigeration, while mRNA vaccines required two doses, and Pfizer’s required special cold storage. The flexibility was attractive to people who were afraid of vaccinations or didn’t have time to get two shots. It was also better for countries without strong health infrastructure.

But her performance dampened some of the enthusiasm around her, especially from the public.

While the mRNA vaccines were hailed for their “astonishing” efficacy of over 90%, the news that J&J’s was 65% effective in preventing symptomatic covid-19 among clinical trial volunteers disappointed some. .

From the beginning, J&J’s vaccine supply was more limited. After the vaccine was licensed, the federal government briefly suspended its use due to safety concerns around rare blood-clotting events. Even once vaccinations resumed, the pace of J&J vaccinations never picked up.

In December, the CDC changed its recommendations to say that vaccines made by Moderna and Pfizer/BioNTech are preferable to those made by J&J. It also urges people who have been vaccinated with J&J to get a booster of one of the mRNA vaccines two months later.

The protection offered by covid-19 vaccines has diminished over time, and none of them work as well against the variants that have appeared since the original coronavirus came to light. But science is beginning to show that people who received J&J’s covid-19 vaccine may have some advantage.

Barouch told CNN that he was “not at all surprised” to see that the durability of the Johnson & Johnson vaccine appears to be greater than that of the Pfizer/BioNTech and Moderna mRNA vaccines, based on the incidence of post-vaccination infections. .

mRNA vaccine technology has been shown to elicit a powerful and robust immune response rapidly after vaccination, but that this can wane over time. Johnson & Johnson’s virus-vector platform may not elicit as strong an immune response in the short term, but it is known to have great durability.

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“Over time, the efficacy of the Pfizer and Moderna vaccines decreases, the efficacy of the J&J vaccines remains stable, so that is exactly what you would predict: that they will converge and then interbreed,” Barouch said.

J&J’s vaccine might also have “a particular advantage,” he said.

“The immune system is actually made up of two arms: the antibody arm and the T-cell arm. And the type of T-cells that are critical to preventing serious disease are called CD8 T-cells,” Barouch said. “J&J’s vaccine generates better CD8 T cells than Pfizer’s and other mRNA vaccines, so J&J’s vaccine may have a particular advantage for variants such as omicron that largely escape antibody responses.” .

Overall, Barouch called these data “very encouraging” for recipients of the J&J vaccine.

“They should be calm because they have received a vaccine that offers very good protection over a long period of time,” Barouch said. “And I think the second message is that I think people should be aware of this new data in terms of looking at booster shots, too.”

Prospect as reinforcement?

David Montefiori, a virologist at Duke University Medical Center, said “J&J’s vaccine has gotten a bit of a bad rap because of efficacy, but the stability of response is intriguing.”

Antibody levels dropped with each shot during the omicron surge, and that could mean people need an extra booster. More research is required to find out.

According to Montefiori, an unpublished study from the National Institutes of Health on a mixed-vaccine strategy did well when J&J was included.

“In people who initially received the Pfizer vaccine and then a booster with the J&J vaccine, those people produced quite high levels of neutralizing antibodies against omicron: 10 times more than people who received two injections with just the J&J vaccine.” , said. “So the J&J vaccine could be a good booster for people who received an mRNA vaccine initially.”

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The Johnson & Johnson vaccine can be used for primary or booster doses, but the CDC says that 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 has been linked to rare cases of blood clots with low platelets, known as thrombosis with thrombocytopenia syndrome, or TTS. “It occurs at a rate of about 3.83 cases per million doses of Janssen and has caused deaths,” the CDC says.

Dr. Angela Branche, an infectious disease specialist and associate professor of medicine at the University of Rochester, said the J&J vaccine’s side effect profile “remains somewhat concerning for some groups where that risk is high.” Women ages 30 to 49 are at higher risk for this rare side effect, according to the CDC.

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But if that research pans out, the J&J vaccine might be useful as a booster only for certain populations.

“For some groups where the risk of developing serious blood clots is not very high, such as older adults, it may be a good strategy,” Branche said.

Montefiori said the vaccine deserves further study.

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

CNN’s Jacqueline Howard and Tasnim Ahmed contributed to this report.

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