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Got Questions About Johnson & Johnson's COVID-19 Vaccine? We Have Answers
A medical worker at South Shore University Hospital gets ready to administer the newly available Johnson & Johnson COVID-19 vaccine in Bay Shore, N.Y., Wednesday. Clinical research found it to be 85% effective in preventing severe disease four weeks after vaccination, and it has demonstrated promising indications of protection against a couple of concerning variants of the coronavirus. Spencer Platt/Getty Images hide caption
A medical worker at South Shore University Hospital gets ready to administer the newly available Johnson & Johnson COVID-19 vaccine in Bay Shore, N.Y., Wednesday. Clinical research found it to be 85% effective in preventing severe disease four weeks after vaccination, and it has demonstrated promising indications of protection against a couple of concerning variants of the coronavirus.
Spencer Platt/Getty Images
That's welcome news in a country that still faces high levels of circulating virus in most regions, and a demand for vaccine that still far outstrips supply.
The J&J vaccine has some significant advantages, health officials say. Unlike the Moderna and Pfizer vaccines, it can be stored for up to three months at regular refrigerator temperatures, so it's easier to distribute to more places. And you're fully vaccinated after just one dose — a welcome convenience for many recipients who dread the two-shot regimen of the Moderna and Pfizer vaccines.
How does the Johnson & Johnson vaccine compare to other vaccines?
At first glance, the Johnson & Johnson vaccine looks to be the inferior option compared to the vaccines from Pfizer-BioNTech and Moderna, both of which reported around 95 percent effectiveness in their Phase 3 clinical trials.
Experts say that in no way should those percentages be interpreted in a way that suggests that the Johnson & Johnson shot — with its 72 percent effectiveness — is 23 percentage points less effective.
The percentages can't be compared directly to one another, because the trials were run differently. The vaccines were studied at different times during the pandemic, when different variants were circulating.
SARS-CoV-2, the virus that causes Covid-19, has been changing ever since it was discovered in Wuhan, China.
"The virus that swept through China was not the virus that left China," Offit said. "The virus that left China was the first variant, and it was more contagious than the one that originally popped up."
That could account for the decreased effectiveness reported in Johnson & Johnson's trials — there's no way to know how the Moderna and the Pfizer-BioNTech vaccines would have fared in the same scenario.
"I am speculating," said Dr. William Schaffner, an infectious diseases expert at Vanderbilt University Medical Center, "but the notion is that, yes, we think that if the Moderna and Pfizer people had been in South Africa at the same time that Johnson & Johnson were testing their vaccine, we would probably get all very comparable results."
What are the benefits of this vaccine?
The Johnson & Johnson vaccine can be kept in regular refrigerators, and it doesn't require as stringent cold-storage conditions as the Moderna and the Pfizer-BioNTech vaccines do. That makes it easier to transport and distribute, which could make it a more practical option for mobile or drive-thru vaccination sites and for rural communities.
"It has the potential to reach many people who have had great logistical barriers," said Dr. Muriel Jean-Jacques, an assistant professor of medicine at Northwestern University. "It has literally taken the National Guard and the military to get the vaccine out effectively to many rural communities. How wonderful it is to be able to do that much more simply."
The Johnson & Johnson vaccine also requires only a single dose, which will alleviate the administrative burdens of scheduling two shots several weeks apart. As a result, it could be ideal for communities that have struggled to get the other vaccines.
"I have many homebound seniors who love the idea of having someone come to their home once — or if they have to leave their home, they only have to leave once — and then they're protected," Jean-Jacques said. "So there are many people who would be very happy with a one-shot vaccine."
Dr. Carlos del Rio, executive associate dean of the Emory University School of Medicine in Atlanta, agreed, saying the one-dose regimen might be preferable for some people whose work or home lives may make it more difficult to make two appointments.
Some people "cannot afford to take a day off to get a second vaccine," he said. "If you are unlikely to return for a second vaccine, I think the Johnson & Johnson may be better."
How Effective Is It?
Johnson & Johnson announced that its single-dose vaccine was 66% percent effective at preventing moderate to severe disease from COVID-19 and 85% effective at preventing severe disease. This effectiveness in the Phase 3 trial was reached 28 days after vaccination.
The trial had a temporary delay in October 2020 when it was paused due to a patient reporting an unexplained illness, although no specific details were provided about what happened due to patient privacy. Regulators determined that the event was not related to the vaccine and the trial was safe to resume.
The efficacy against moderate to severe COVID-19 infection varied by region in the trial. It was 72% in the United States, 68% in Latin America, and 64% in South Africa.
The vaccine was also found to be fully protective against hospitalization and death, and the protection against severe disease included multiple variants of COVID-19, including the B.1.351 variant found in South Africa.
Effectiveness Against COVID-19 Variants
According to information released by Johnson & Johnson, the vaccine was found be 85% effective against severe/critical disease from COVID-19, including that caused by the Delta variant. Data from a clinical study published in The New England Journal of Medicine also supported this finding.
In December 2021, the Centers for Disease Control and Prevention (CDC) endorsed updated recommendations made by the Advisory Committee on Immunization Practices (ACIP), “expressing a clinical preference for individuals to receive an mRNA COVID-19 vaccine over Johnson & Johnson’s COVID-19 vaccine.”
There is currently limited data available showing how effective the vaccine is at protecting against the Omicron variant. One study published in June 2022 found two doses of the vaccine to be 72% effective against hospitalization, 1 to 2 months after receiving the second dose. However, in their request to the FDA to revoke their EUA, Janssen stated they did not intend to update the vaccine to target emerging variants.
