As additional mRNA shots roll out, Johnson & Johnson vaccine recipients were told to wait

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It started last week, when the US Food and Drug Administration and the US Centers for Disease Control and Prevention recommended an extra dose for certain immunocompromised people who had received the Moderna or Pfizer/BioNTech vaccines.

But almost 14 million fully vaccinated people in the United States, none of those mRNA vaccines were given. They got the single dose injection from Johnson & Johnson, and so far they are not part of this booster conversation.

“Our J&J patients have not been overlooked or neglected. It’s just the way the data comes in,” said Schaffner, a professor in the Infectious Diseases Division at Vanderbilt University Medical Center.

For J&J vaccine patients calling and emailing about boosters, he says they should wait.

“You can’t make good recommendations without the data,” he said.

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Last month, J&J researchers reported the vaccine provides immunity that lasts for a minimum of eight months and possibly longer.
The J&J vaccine also appears to provide adequate protection against: the Delta variant, the predominant strain of the virus that sickens people in the United States today. J&J said in July that a second or booster dose of its vaccine would not be necessary at that time.

However, a Johnson & Johnson spokesperson told CNN on Tuesday that the company is collecting additional data to see if booster shots are needed.

“Ensuring long-term and sustainable protection against hospitalization and death is critical in curbing the Covid-19 pandemic,” the company said in an email to CNN. “Johnson & Johnson continues to diligently generate and evaluate evidence from ongoing studies and emerging real-world evidence as it assesses the need for a Johnson & Johnson Covid-19 vaccine booster.”

Different vaccines, different studies, different timelines

Many vaccines require more than one injection to provide complete protection. Some, like a tetanus shot, need an extra boost every 10 years because immunity wanes over time. Others, such as the flu shot, must be administered annually because each flu season brings new strains.

With Covid-19, scientists are still figuring out how long the protection lasts and how the vaccines work against different variants. That will all have to be determined by more research.

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More data is coming in for mRNA vaccines. Pfizer said Monday it has submitted the first data to support the use of boosters to the FDA. Moderna said last week it is still in the process of submitting its data.

The Johnson & Johnson vaccine works a little differently than the mRNA vaccines, which use a newer technology that delivers genetic material directly into cells via fat particles. J&J’s Janssen vaccine uses a viral vector, a common cold virus that has been genetically engineered to infect cells but will not multiply or spread in the body. It delivers genetic instructions to the cells and then trains them to identify and protect against the coronavirus.

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Johnson & Johnson has also always been on a different timeline. When Pfizer/BioNTech and Moderna were authorized in December, J&J was still collecting data. It received its emergency use authorization a few months later, in February.

And while there’s some evidence that immunocompromised people may benefit from a third dose of an mRNA vaccine, it’s still not clear whether immunocompromised people who received the J&J vaccine would benefit from getting another dose.

“We have reviewed the science and data almost daily to evaluate if and when boosters may be needed,” the CDC said in an email to CNN when asked about boosters for the general public and for the immunocompromised on Tuesday.

“As we said, boosters would probably be needed. We’ll be announcing more detailed plans soon, so we’ll have more to share by then. This will all be done in accordance with independent FDA and CDC review and recommendations.”

Mix and match vaccinations

It’s also not clear whether people who have received the J&J vaccine and who need a boost would benefit more from an additional J&J vaccine, or should receive a different vaccine type.

Currently, the CDC’s Official Position is that people have to stick to the shot they got in the first place. It says there isn’t enough data to know if mixing and matching works and is safe.
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In parts of Europe, doctors mix and match the single-dose AstraZeneca vaccine — which is similar to the J&J vaccine — with an mRNA vaccine.

In Germany, health officials advised people who received a first dose of the AstraZeneca vaccine, an mRNA vaccine for their second dose. early studies showed the mix generated a robust immune response. In June, German Chancellor Angela Merkel led the way and received the Moderna vaccine after her first dose of AstraZeneca.
In the United States, at least one city did not wait for data on whether or not to boost the J&J vaccine.
People vaccinated with the J&J vaccine can receive a supplemental mRNA vaccine dose in San Francisco, where Department of Health officials have created “accommodation” for those who have consulted a doctor, the department said on Aug. 4.

While Schaffner enthusiastically encourages everyone who has not yet received a scoop shot to get one immediately, for patients who have received the J&J vaccine and want a booster, he advises patience.

“Right now, all we can tell them is to sit quietly,” Schaffner said. “More information is on the way.”

Kaitlan Collins of CNN contributed to this report.

Sources

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2/ https://www.cnn.com/2021/08/17/health/johnson-covid-booster-wait-wellness/index.html

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