With the authorization of Johnson & Johnson’s new COVID-19 vaccine and its encouraging data, you might be wondering how it stacks up against the Pfizer-BioNTech and Moderna vaccines.
Mount Sinai infectious diseases experts participated in the clinical trials for Johnson & Johnson’s one-dose vaccine and are excited about its effectiveness against moderate and severe COVID-19. What is most remarkable is that 28 days after a single dose, no vaccine recipient had been hospitalized for COVID-19 or died from COVID-19. And, protection increased over time: 49 days after that single dose, there were no cases of severe COVID-19 among the recipients.
This protection was consistent among all age groups. The emergency use authorization of this vaccine by the U.S. Food and Drug Administration allows for increased supply and access to vaccine and will help turn COVID-19 into a controllable and much less dangerous disease.
Dana Mazo, MD, MSc
In this Q&A, Dana Mazo, MD, MSc, Assistant Professor of Medicine (Infectious Diseases) at the Icahn School of Medicine at Mount Sinai, explains why this new vaccine’s ability to prevent hospitalizations and serious illness is so significant, and why this represents a potential game changer that can help lead to the end of the pandemic. Dr. Mazo, the Hospital Epidemiologist at Mount Sinai Queens, is also lead investigator of the Mount Sinai Queens COVID-19 clinical trials unit, which is a Johnson & Johnson COVID-19 vaccine trial site.
What does the data tell us about this new Johnson & Johnson vaccine?
The trials are ongoing, but the preliminary data is very exciting and shows really good protection against sickness severe enough to lead to hospitalization or death. The real excitement is that at 28 days after participants received the vaccine, there were no COVID-19-related hospital admissions or COVID-19 deaths.
How effective is the new vaccine from Johnson & Johnson?
In the United States, the vaccine had an efficacy of 72 percent against moderate and severe COVID-19, which is really impressive. That means the people who received the vaccine were 72 percent less likely to get moderate or severe disease. In all regions studied, the vaccine was 85 percent effective at preventing severe disease, and no one who received the vaccine needed to be hospitalized for COVID-19 or died related to COVID-19.
Some reports say this vaccine is less effective than others. Is that true, and is that important?
This is an important question that I get asked a lot. One of the differences with the Johnson & Johnson vaccine is that our trial was more recent, so the data we released is from this winter when we’re seeing more COVID-19 cases and new variants.
Looking at other countries, the Johnson & Johnson vaccine had lower efficacy in South America of 66 percent and South Africa of 57 percent, so the overall efficacy around the world was 66 percent.
It’s very important that the Johnson & Johnson trials included sites in eight countries, including sites in both South Africa and South America where new variants of SARS-CoV-2 are circulating. Even though the protection was not as high for those variants, it was still good protection at greater than 50 percent and there were no hospitalizations or deaths from COVID-19. That is really good news especially because we are concerned about these new variants. This is a huge piece of information we have for this vaccine that isn’t known for other vaccines, trials which were performed earlier in the pandemic so did not include communities where these highly transmissible variants were prevalent.
The Johnson & Johnson trial also included different racial and ethnic groups in the United States: 15 percent of trial participants identified as Hispanic and/or Latinx and 13 percent as Black/African American.
Another key aspect of the Johnson & Johnson vaccine is that it is only one dose. Other vaccines have released higher efficacy data at 90 percent or more, but that’s after two doses. The Johnson & Johnson vaccine has 72 percent efficacy after one. This is a huge benefit and has the potential to be a real game changer in our fight against the pandemic.
How does this vaccine compare with the other two vaccines? Is it better?
Each of the vaccines has pros and cons. The fact that the Johnson & Johnson vaccine is one dose is a real benefit because it allows more people to get full protection. Logistically it can be very hard for people to come back for the second dose required by other vaccines.
In addition, this vaccine is much easier to store and transport. Some of the other vaccines require ultra-cold storage, which is not possible for many places. This vaccine could be administered at a doctor’s office or community health fairs.
With one dose you may also have a lower risk of side effects, as opposed to two doses which present two opportunities for side effects. From the data already released, the Johnson & Johnson vaccine seems very well tolerated. Only nine percent of people reported fever after vaccination and 0.2 percent reported fevers bad enough to interfere with daily activities.
Does it matter which vaccine I get?
The first vaccine that you are able to get is what you should get. All these vaccines offer really good protection against severe COVID-19 disease, hospitalizations, and deaths. So just get the first vaccine that’s offered to you.
You were involved in the clinical trial. What did Mount Sinai do and why is that important?
There was a site at Mount Sinai Queens where I was the lead investigator, and there was a site at Mount Sinai Brooklyn. We recruited members of our community who were interested in taking part in a trial of an investigational vaccine and consented to participate knowing that they would either receive an injection of placebo (salt water) or the Johnson & Johnson vaccine. They then were asked twice a week if they had symptoms, and if anyone reported symptoms, we tested them to see if they had COVID-19.
Conducting clinical trials at Mount Sinai Queens and Mount Sinai Brooklyn opens up clinical research to our communities. We are located in areas that were hard hit by COVID-19, and in Queens we are near some of the most diverse neighborhoods in the world. We need to ensure that communities that were especially affected by COVID-19 have the opportunity to participate in trials and that a broad representation of people in the United States who could benefit from these treatments are included in the trials. We’re very happy to say that by having a site in Queens, we were able to include a diverse population.