News

Ask Dr. Halverson: Johnson and Johnson vaccine is a game-changer

web 4 17 Halverson photo
By Dr. Jim Halverson
The long-awaited Pfizer and Moderna vaccines are here and being administered to our Ventura County residents.
Happily, demand has been high for the vaccine, which is necessary to eventually provide herd immunity and end this pandemic. Unfortunately, available vaccine supply has not been able to match the demand. That situation is anticipated to improve significantly with the hoped-for approval of Johnson and Johnson’s COVID-19 vaccine in the near future.
According to Dr. Anthony Fauci, the vaccine could get emergency-use authorization from the Food and Drug Administration in as little as two weeks.
The Johnson and Johnson vaccine has two significant advantages over the current Pfizer and Moderna vaccines.
First, it is a one-dose vaccine. A single dose would mean more people could be vaccinated, as no vaccine would need to be set aside to give someone a second shot. This will be extremely helpful at a time when vaccines are hard to come by.
The other advantage is that, unlike the Pfizer and Moderna vaccines, it can be stored at regular refrigerator temperatures. This will accelerate vaccination efforts in the United States as the vaccine can be taken to people, rather than people needing to go to vaccination centers.
The Johnson and Johnson vaccine works similarly to both of the current vaccines. Scientists made this vaccine by taking a small amount of genetic material that codes for a piece of the novel coronavirus and integrated it into a weakened version of an adenovirus, a common respiratory virus. Johnson and Johnson scientists altered this adenovirus so it can enter our cells, but it is not able to replicate and make people sick.
The adenovirus carries the genetic material from the coronavirus into human cells, tricking them into making pieces of the coronavirus spike protein, the part it uses to attach to cells. The immune system then reacts against this spike protein by making antibodies and immune cells that will help protect people from the coronavirus.
This process is similar to the current Pfizer and Moderna vaccines, but with a small difference. The currently approved vaccines use a microscopic fat particle to carry the genetic material (messenger RNA) into our cells. Johnson and Johnson’s vaccine carries the gene within a virus that can’t replicate itself.
The technology used for the Johnson and Johnson vaccine has already been shown to work with the Ebola vaccine, developed several years ago. More than 200,000 people have been vaccinated using this vaccine technology.
Preliminary results from Phase 1 and 2a studies of this vaccine were published Jan. 13 in the New England Journal of Medicine and are very encouraging. The analysis showed that a single dose of Johnson and Johnson’s vaccine induced an immune response and was generally well tolerated across all study participants. Data demonstrated that neutralizing antibodies against COVID-19 were detected in more than 90 percent of study participants at Day 29 after vaccination, and in 100 percent of participants ages 18 to 55 at Day 57. According to the studies, these neutralizing antibodies remained stable through Day 71  in all participants ages 18 to 55 years. Data on durability of immune response in trial participants over 55 years of age will be available by the end of this month and longer-term follow-up to one year is planned. Roughly 45,000 people have participated in these trials and in the current Phase 3 trial.
If approved, Johnson and Johnson is hoping to have enough vaccine for 100 million Americans by April.
Two other vaccine candidates are also hoping to be able to submit data to the FDA by the end of March. 
The AstraZenaca vaccine is already being used in a few countries. It was authorized in the United Kingdom in December, and in Brazil in January, but the FDA will likely want to use U.S. data for any emergency-use authorization. This vaccine is also a viral-vector vaccine. Like the Johnson and Johnson vaccine, it employs an adenovirus to carry the genetic instructions for making the spike protein from the coronavirus into cells to generate antibodies. AstraZeneca’s vaccine, developed with Oxford University, uses a virus that infects chimpanzees, but doesn’t make humans sick.
As with the Pfizer and Moderna vaccines, this COVID-19 vaccine would require two shots.
The Novavax vaccine Phase 3 trial started in the United States in December. The trial is enrolling up to 30,000 volunteers at 115 sites in the United States and Mexico. The Novavax candidate is a protein-based vaccine created out of the genetic sequence for the novel coronavirus. This vaccine uses virus-like small particles to carry the genetically engineered pieces of the coronavirus spike protein. 
This vaccine is given in two doses, 21 days apart. This kind of vaccine has been successfully used to prevent other viral diseases such as human papilloma virus and influenza.

Current vaccination update
Our county continues to increase its capacity to give the coronavirus vaccine and is now capable of giving more vaccines per week than we currently receive from the federal government. The vaccination process also continues to improve in efficiency.
Ojai resident Doug Parker sent me the following: “I write to congratulate Ventura County on the vaccination program at the Fairgrounds. Experiences may vary, but today (Jan. 22), my wife and I found the procedure to be highly organized and operated by an efficient and courteous staff. We were in and out in less than an hour, including a 20-minute post-shot period to make sure we had no ill effects. (We didn’t.) I would urge all who are eligible to register as soon as additional appointments become available. You owe it to yourself and to the community.”
We are starting to see a drop in the number of cases in Ojai and in our county, thanks to your continued efforts. Please continue to follow all of the necessary precautions until all those who wish to be vaccinated have been, so we can bring this pandemic to an end.
Stay committed, stay properly informed, stay positive, stay safe and stay well.

— Dr. Jim Halverson is a longtime Ojai physician who writes a weekly column on COVID-19 for the Ojai Valley News. His column is translated into Spanish by Ojai resident Annika Forester and posted each week on the OVN website at www.ojaivalleynews.com.