Yes, we are all exhausted by the covid pandemic. Baffled by constantly changing science and guidelines. Concerned about the succession of new and fearsome variants, each with its own name, like hurricanes.
But a sizeable minority—nearly 17 millions of residents of the United States, myself included—she lives her own dilemma. Our initial vaccine was Johnson & Johnson (J&J), which was a single shot, and that has many of us confused.
Are we fully vaccinated, even with a booster, or should we get a third shot to catch up with the 92 millions of vaccinated who got two doses of Pfizer or Moderna at first and then got a booster?
Since J&J has practically disappeared from public opinion, information is scarce; not to mention that the guidelines are constantly changing, for everyone.
On April 4, 2021, I fulfilled my obligation and traveled through Los Angeles to stand in line at a public vaccination center where I was given the J&J. Like many of my J&J siblings, I followed the advice of public health officials to accept the first available vaccine.
At the time, J&J was something of a newcomer among covid vaccines -39. The protection it provided against the disease, although apparently less than that offered by the so-called messenger RNA (mRNA) vaccines from Pfizer and Moderna, seemed sufficient to prevent serious illness.
And while those vaccines required two injections, J&J’s was advertised as “single-dose,” which was a great advantage for people with needle phobias and transit populations such as farmworkers, the homeless, and prison inmates. county jails. Its easy storage, compared to the freezing required for Pfizer and Moderna vaccines, also made it a good option for remote rural populations.
But just a few days after receiving my vaccine, J&J’s reputation was plunged into what would turn out to be a disastrous disrepute, as the vaccine was linked to a rare but life-threatening blood clotting disorder.
This prompted health authorities The federal authorities declared a pause in its administration, only to eliminate it 10 days later and backtrack in December, recommending Moderna and Pfizer vaccines instead of J&J, mainly due to to studies that heightened concerns about blood clots.
Meanwhile, J&J was plagued by production problems and concerns about the efficacy of its vaccine. Research showed a disproportionate number of infections among those vaccinated with J&J during a wave of covid last summer. California state data covering most of 2021 paints a similar picture, not only for infections but also for hospitalizations and deaths.
Falling J&J’s prestige among covid vaccines in the United States was also left out of public discourse and guidelines on covid.
“The J&J vaccine is currently used very little, that’s why it’s not talked about much,” said Dr. William Schaffner, professor of infectious diseases at Vanderbilt University Medical Center in Nashville, Tennessee.
When the Biden administration first recommended boosters in August, initially excluded J&J vaccinates, citing a lag in the data.
No wonder citizens of the “J&J Nation” feel a bit like abandoned stepchildren.
“I wish I had chosen something that would put more people on so I could get more information,” said Leah Justman of 39 years old Los Angeles resident who preferred the J&J vaccine last April because she was breastfeeding her newborn baby at the time, was nervous about the new mRNA technology and thought the vaccine J&J was “more like getting a traditional vaccine.”
Now, she said, she feels as if there is a certain stigma attached to being vaccinated with J&J: “When I go to restaurants or show that I’m vaccinated, it’s as if they were saying to me: ‘My God, you have been vaccinated with J&J’. It’s almost like a joke, where people think: ‘Thank God I didn’t get vaccinated with that’”.
In December, Justman received the half booster dose of Moderna recommended by the Centers for Disease Control and Prevention (CDC). That puts her behind recipients from Moderna and Pfizer who received two full doses initially and a booster later. She is concerned about how long she will be protected and what her next step should be.
There seems to be a growing consensus, in scientific circles, that a single injection of J&J was never enough and that this could explain its lower efficacy compared to mRNA vaccines.
“Many of us believe it should have been a two-dose vaccine from the beginning,” said Bradley Pollock, dean of public health sciences at the UC Davis School of Medicine. In the coming months, he pointed out, “it is very possible that they will say that a three-dose schedule is a complete vaccination.”
That made me wonder if I am fully vaccinated. Considering the half booster dose of Moderna I received at the end of October, I’m still behind those who have had three Pfizer or Moderna shots.
I’ve talked to several J&J vaccinated who , for the same reason, sought a second booster even though the federal guideline at this time calls for a single mRNA booster, two months or more after the initial J&J vaccination.
I recently made an appointment at online for a second booster dose of Moderna.
On my first try, I got a message from the pharmacy saying I wasn’t eligible. A second pharmacy allowed me to make an appointment, but I canceled at the last minute after receiving dissuasive (albeit mild) emails from two of my knowledgeable sources.
“Not as quantitative as they make it out to be” wrote Dr. George Rutherford, a professor of epidemiology at UCSF. The J&J and mRNA vaccines work differently” so it’s not like one J&J plus one Moderna equals 1.5 doses of Pfizer. I don’t think it will make you sick, but I would stay calm. Omicron is going to disappear.”
New research suggests that just two injections against covid could be enough to protect most people from serious illness and death for many months, or even years .
If you are among the nearly 17 million people with J&J and have had a booster shot, consider staying that way, like I did Finally. But if you haven’t gotten a brace yet, do so as soon as possible. It seems clear, or at least as clear as everything regarding covid can be, that if you have been vaccinated and boosted, your risk of developing serious illness is very low.
The new guidelines Federal funds allow a second booster if your immune system is compromised, for example, from cancer treatment, HIV, or an organ transplant. If you are not immunosuppressed, but are worried about your poor protection, you can try to convince a pharmacist or the staff of a vaccination center to give you another vaccine. It won’t be easy, but it is possible. Or talk to your doctor, who may be willing to prescribe one.
Now that I’ve spent most of this column pointing out the problems with the J&J vaccine, it’s only fair that I say a few positive things about it.
First, although it appears to be less effective than the Pfizer and Moderna vaccines, the J&J vaccine still provides a high degree of protection against serious illness and is much preferable to not getting vaccinated . J&J, which is cheaper than mRNA vaccines and easier to transport, also has a critical role to play in low-income countries with large rural populations and poor transportation infrastructure.
Even in the United States, where the use of J&J’s vaccine has decreased considerably, it is useful to have it in stock. It’s a good alternative for those who don’t trust mRNA injections and might not otherwise get vaccinated.
And it’s always possible that demand will return. mRNA vaccines carry a risk of heart inflammation for young men, a side effect that appears to be short-lived in most cases. But if future studies show it can cause permanent damage or even death, “that would make J&J’s vaccine potentially just as attractive, if not more so,” said Dr. Walter Orenstein, a professor of epidemiology at Emory University in Atlanta. .
Vaccines are still new, many clinical trials have not yet given unequivocal results, and each new variant calls into question the data collected when a different strain was dominant.
“It may turn out to be true that three doses or two doses and a variant-focused booster would be best. We don’t know yet,” said Dr. Gregory Poland, director and founder of the Mayo Clinic Vaccine Research Group in Rochester, Minnesota. “And the way things have been, we’ll barely get answers to those questions, and more time will have passed and a new variant will come.”
This story was produced by KHN, which is published by California Healthline, an editorially independent service of the California Health Care Foundation.