Which Covid Vaccine Ought to You Get? Consultants Weigh the Impact Towards Extreme Illness

At first glance, the results reported on Friday of the long-awaited study of Johnson & Johnson’s coronavirus vaccine may have been disappointing. Overall effectiveness – the ability to prevent moderate and severe illnesses – was reported at 72 percent in the United States, 66 percent in Latin American countries, and 57 percent in South Africa.

These numbers are well below the high bar set by Pfizer-BioNTech and Moderna, the first two emergency vaccines approved in the United States, which had an overall effectiveness of 94 to 95 percent.

Dr. Anthony S. Fauci, the nation’s leading infectious disease expert and now President Biden’s leading medical advisor on the coronavirus pandemic, acknowledged the remarkable difference at a briefing Friday.

“If you woke up and say, ‘Well, go to the left door and you get 94 or 95 percent, go to the right door and you get 72 percent. ‘Which door do you want to go to? ”He asked.

Dr. However, Fauci said the most important measure is the ability to prevent serious illness, which means keeping people out of the hospital and preventing deaths. For Johnson & Johnson, that result was 85 percent in all of the countries it was tested in, including South Africa, where a rapidly spreading variant of the virus had shown some ability to evade vaccines.

More important than preventing “some pain and a sore throat,” said Dr. Fauci, is the defense against serious illnesses, especially in people with underlying diseases and in older adults who are more likely to become seriously ill and die of Covid. 19th

“If you can prevent serious illness in a high percentage of people, it will soothe the stress of human suffering and death in this epidemic that we are seeing it right now,” said Dr. Fauci, “As we know, over the past few weeks our healthcare system has been burdened by the number of people requiring hospitalization and intensive care.”

Dr. Francis Collins, director of the National Institutes of Health, compared the ability to prevent serious illness to the effects of flu vaccinations, which may not always prevent influenza completely, but make it less severe.

“The same seems to be true here, in circumstances where this variant clearly makes it a little harder to get the most forceful response you want,” said Dr. Collins. “But it still looks very good for serious illnesses.”

The Moderna vaccine also showed high 100 percent effectiveness against serious illnesses. The Pfizer BioNTech appeared to be too, but the total number of severe cases in the study was too few to be certain.

However, the researchers caution that trying to compare effectiveness between new and previous studies can be misleading because the virus is developing quickly and the studies have to some extent examined different pathogens.

“You have to realize that Pfizer and Moderna had an advantage,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University, in an interview. “They did their clinical studies before the variant strains became very clear. Johnson & Johnson not only tested their vaccine against the standard strain, but they also had the variants. “

The best way to stop the spread of mutants and prevent new ones from emerging is to vaccinate as many people as you can as soon as possible, says Dr. Fauci and other researchers. Viruses can’t mutate if they can’t replicate, and they can’t replicate if they can’t get into cells. Keeping them away from people by immunizing them can kill the process.

In addition to the Pfizer BioNTech and Moderna vaccines already in use in the US, three more may soon be available: those made by Novavax, Johnson & Johnson and AstraZeneca. AstraZeneca’s vaccine has already been approved in the UK and other countries.

Globally, the Johnson & Johnson vaccine is expected to play an important role, especially in low- and middle-income countries, as it works after just one shot, is relatively inexpensive, and is easier to store and distribute than Pfizer-BioNTech’s manufactured vaccines and Moderna, as it does not share their strict requirements for freezing and chilling.

People waiting to be vaccinated may wonder if they will be able to choose vaccines and if they should hold out and wait until the one that looks best to them becomes available.

Covid19 vaccinations>

Answers to your vaccine questions

Am I eligible for the Covid vaccine in my state?

Currently more than 150 million people – almost half of the population – can be vaccinated. But each state makes the final decision on who goes first. The country’s 21 million healthcare workers and three million long-term care residents were the first to qualify. In mid-January, federal officials asked all states to open eligibility to anyone over the age of 65 and adults of any age with medical conditions that are at high risk of becoming seriously ill or dying of Covid-19. Adults in the general population are at the end of the line. If federal and state health authorities can remove bottlenecks in the distribution of vaccines, everyone over the age of 16 is eligible as early as spring or early summer. The vaccine has not been approved in children, although studies are ongoing. It can take months before a vaccine is available to anyone under the age of 16. For the latest information on vaccination guidelines in your area, see your state health website

Is the Vaccine Free?

You shouldn’t have to pay anything out of pocket to get the vaccine, despite being asked for insurance information. If you don’t have insurance, you should still get the vaccine for free. Congress passed law this spring banning insurers from applying cost-sharing such as a co-payment or deductible. It consisted of additional safeguards prohibiting pharmacies, doctors, and hospitals from charging patients, including uninsured patients. Even so, health experts fear that patients will end up in loopholes that make them prone to surprise bills. This could be the case for people who are charged a doctor’s visit fee with their vaccine or for Americans who have certain types of health insurance that are not covered by the new regulations. If you received your vaccine from a doctor’s office or emergency clinic, talk to them about possible hidden costs. To make sure you don’t get a surprise invoice, it is best to get your vaccine at a Department of Health vaccination center or local pharmacy as soon as the shots become more widely available.

Can I choose which vaccine to get?How long does the vaccine last? Do I need another next year?

That is to be determined. It is possible that Covid-19 vaccinations will become an annual event just like the flu vaccination. Or the vaccine may last longer than a year. We’ll have to wait and see how durable the protection from the vaccines is. To determine this, researchers will track down vaccinated people to look for “breakthrough cases” – those people who get Covid-19 despite being vaccinated. This is a sign of a weakening of protection and gives researchers an indication of how long the vaccine will last. They will also monitor the levels of antibodies and T cells in the blood of people who have been vaccinated to see if and when a booster shot might be needed. It is conceivable that people might need boosters every few months, once a year, or just every few years. It’s just a matter of waiting for the data.

Does my employer need vaccinations?Where can I find out more?

Dr. Paul Offit, a vaccines expert at Philadelphia Children’s Hospital, told CNN that Pfizer-BioNTech and Moderna vaccines would be his first choice when they were abundant because of their higher overall effectiveness.

But right now there aren’t enough of these vaccines.

If he couldn’t get the Pfizer BioNTech vaccine or the Moderna vaccine, he would do the Johnson & Johnson shot, said Dr. Offit – as long as the data the company will submit to the Food and Drug Administration looks as good as the company reported on Friday.

He said Johnson & Johnson’s Serious Disease Reduction Report was a strong selling point.

“That’s what you want,” said Dr. Offit. “You want to stay out of the hospital and out of the morgue.”

He noted that the company was also investigating a two-shot regimen that could increase its effectiveness.

People taking the Johnson & Johnson vaccine should be able to safely get a Pfizer BioNTech or Moderna vaccine later if a booster shot is needed, he said.

Dr. Schaffner said he had just attended a meeting with other public health experts and they asked each other what they would say to their spouses or partners if they could get the Johnson & Johnson vaccine tomorrow or had to wait three weeks Pfizer- BioNTech’s or Moderna’s.

“We all said, ‘Get it tomorrow,” said Dr. Schaffner. “The virus is bad. You risk another three weeks of exposure instead of receiving protection tomorrow.”

He said the 85 percent effectiveness of Johnson & Johnson against serious illnesses is a little less than that reported by Moderna and Pfizer-BioNTech, “but it’s still damn high.”

It is not yet known whether it is safe to take a different type of vaccine every now and then, said Dr. Schaffner, adding, “We haven’t investigated this.”

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