How New Is Adenovirus Technology
Researchers have been working with adenovirus vaccines since the 1970s. Another use of the same adenovirus-based vaccine platform from Johnson & Johnson is in development against Ebola, and another against HIV. “Thousands of people around the world received this type of vaccine in clinical trials for Ebola and HIV,” says Dr. Brett-Major. “One of the reasons it was approved quickly is that the safety data was already there.”
AstraZeneca has also developed an adenovirus vaccine for COVID-19. It uses a different adenovirus from the one employed by Johnson & Johnson. Also, unlike the Johnson & Johnson product which cannot replicate, the AstraZeneca replicates in the body a limited amount.
- mRNA vaccines: Moderna, Pfizer
- Adenovirus vaccines: Johnson & Johnson, AstraZeneca, Sputnik V
How Well The Vaccine Works
- The J& J/Janssen COVID-19 Vaccine was 66.3% effective in clinical trials at preventing laboratory-confirmed COVID-19 infection in people who received the vaccine and had no evidence of being previously infected. People had the most protection 2 weeks after getting vaccinated.
- In the clinical trials, the vaccine had high efficacy at preventing hospitalization and death in people who did get sick. No one who got COVID-19 at least 4 weeks after receiving the J& J/Janssen COVID-19 Vaccine had to be hospitalized.
- CDC will continue to provide updates as we learn more about how well the J& J/Janssen COVID-19 Vaccine works in real-world conditions.
Why Are Some Experts Talking About A Booster For J& j Vaccine Recipients
The current crop of COVID-19 vaccines cleared for use in the US were designed to protect against the original virus. But viruses have a knack for mutating, and SARS-CoV-2 is no different. The CDC is monitoring multiple variants circulating in the US, including Delta, which has been linked to more severe disease.
While there’s good evidence that the two-dose mRNA vaccines are effective against the new variant, less is known about the J& J one-dose vaccine.
Now a small new study finds that J& J’s one-dose vaccine falls short. The research, which has yet to undergo peer review, is based on blood samples from 17 people immunized with two doses of an mRNA vaccine and 10 people with one dose of J& J, the New York Timesreported. J& J’s vaccine started out with a lower rate of efficacy and showed a bigger drop against the Delta and Lambda variants, according to the Times.
“The message that we wanted to give was not that people shouldn’t get the J& J vaccine, but we hope that in the future it will be boosted with either another dose of J& J or a boost with Pfizer or Moderna,” study author Nathaniel Landau, a virologist at New York University’s Grossman School of Medicine, told the Times.
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The Link Between Myocarditis And Covid
Myocarditis, an inflammation of the heart muscle, became a trending topic this spring when the Centers for Disease Control and Prevention reported that it is monitoring a small number of cases of heart inflammation that have arisen in young adults not long after mRNA COVID-19 vaccination. The side effect is considered important but uncommonarising in about 12.6 cases per million second doses administered. And now the Food and Drug Administration has announced it will place a warning on the mRNA vaccines. Its important to note that the vaccination is still recommended for everyone who is eligible.
Cdc: If You Got J& j Vaccine Consider Moderna Pfizer Booster
March 30, 2022 — The 17 million Americans who received the one-shot Johnson & Johnson COVID-19 vaccine are less protected against serious illness and hospitalization than people who got an mRNA vaccine, according to a new CDC study.
The latest data suggests that those who got the Johnson & Johnson vaccine should get a booster dose of the Pfizer or Moderna vaccine — or maybe even two boosters for the best protection.
âOne priority is making sure that people who only received one dose are aware that they should go and get, preferably, a messenger RNA vaccine,â Natalie Dean, PhD, a biostatistician at Emory University, told The Washington Post.
The CDC research team looked at how well mix-and-match vaccine booster combinations worked after one dose of the Johnson & Johnson vaccine. They used data from more than 80,000 emergency room and urgent care visits, as well as more than 25,000 hospitalizations, in 10 states between mid-December 2021 and early March 2022, when the Omicron variant was dominant.
The researchers found that three shots of messenger RNA vaccines were 83% effective in preventing emergency room or urgent care visits, followed by 79% for a Johnson & Johnson vaccine plus a messenger RNA booster. Two J& J shots were 54% effective, and a single J& J shot was 24% effective.
Now the data is becoming clearer about how well the different vaccines work, but Americans may still be confused about which shot to take next — or if theyâre eligible for another booster.
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Dna Inside An Adenovirus
The researchers added the gene for the coronavirus spike protein to another virus called Adenovirus 26. Adenoviruses are common viruses that typically cause colds or flu-like symptoms. The Johnson & Johnson team used a modified adenovirus that can enter cells but cant replicate inside them or cause illness.
DNA inside
DNA inside
an adenovirus
Johnson & Johnsons vaccine comes out of decades of research on adenovirus-based vaccines. In July, the first one was approved for general use a vaccine for Ebola, also made by Johnson & Johnson. The company is also running trials on adenovirus-based vaccines for other diseases, including H.I.V. and Zika. Some other coronavirus vaccines are also based on adenoviruses, such as the one developed by the University of Oxford and AstraZeneca using a chimpanzee adenovirus.
Adenovirus-based vaccines for Covid-19 are more rugged than mRNA vaccines from Pfizer and Moderna. DNA is not as fragile as RNA, and the adenoviruss tough protein coat helps protect the genetic material inside. As a result, the Johnson & Johnson vaccine can be refrigerated for up to three months at 3646°F .
How Does The Johnson & Johnson Vaccine Work
The Johnson & Johnson vaccine is whats called a viral vector vaccine.
To create this vaccine, the Johnson & Johnson team took a harmless adenovirus the viral vector and replaced a small piece of its genetic instructions with coronavirus genes for the SARS-CoV-2 spike protein.
After this modified adenovirus is injected into someones arm, it enters the persons cells. The cells then read the genetic instructions needed to make the spike protein and the vaccinated cells make and present the spike protein on their own surface. The persons immune system then notices these foreign proteins and makes antibodies against them that will protect the person if they are ever exposed to SARS-CoV-2 in the future.
The adenovirus vector vaccine is safe because the adenovirus cant replicate in human cells or cause disease, and the SARS-CoV-2 spike protein cant cause COVID19 without the rest of the coronavirus.
This approach is not new. Johnson & Johnson used a similar method to make its Ebola vaccine, and the AstraZeneca-Oxford COVID-19 vaccine is also an adenovirus viral vector vaccine.
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Should I Be Worried About Blood Clots If I Got J& j
If you got your Johnson & Johnson shot more than four weeks ago, you are not at increased risk of side effects, CDC Director Dr. Rochelle Walensky tweeted. So, if you got your Johnson & Johnson shot months ago, there is no cause for concern. Symptoms of the blood-clotting disorder typically appear within one to two weeks after receiving the vaccine, according to a fact sheet by the FDA.
Although cases of the blood-clotting disorder that occurs after vaccination with Johnson & Johnson’s and AstraZeneca’s vaccine are rare and have occurred in men and women , the risk is higher for women ages 30 to 49, occurring in one in 100,000 women.
The vaccine-induced blood clots, TTS, also require different treatment and appear to be more fatal than other blood clots that can happen in people more at risk because they take birth control pills, for example. Cases of TTS after vaccination have been fatal in 15% of cases, the FDA says, or about one in seven people. All cases of TTS required hospitalization or ICU admission, nine people have died and some needed to be treated at a post-acute care facility after their hospitalization.
In a , Johnson & Johnson said the company “remains confident in the overall positive benefit-risk profile of its COVID-19 vaccine.”
What Steps Are Taken To Help Make Sure The Covid
Safety is always a top priority as federal agencies work with vaccine manufacturers and independent scientific organizations to develop, study, authorize and approve new vaccines. Here are some of the steps taken for COVID-19 vaccines, as well as other vaccines:
Demographics of the COVID-19 Vaccine Trials
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Mixing And Matching Is Ok
The language CDC uses in the recommendation for the kind of booster to give is neutral and vague. It doesn’t specify what kind of booster to give, and this is not an oversight, said Dr. Fryhofer. The bottom line: you can boost with any authorized COVID vaccine.
The booster doesnt have to match the primary vaccine series type. This is called heterologous boosting, she added. On the other hand, boosting with the same type of vaccine as the one you originally received is called homologous boosting. Either strategy is permitted.
Are There Risks Or Safety Concerns Regarding The Covid Vaccines
As part of their normal activities, the CDC and FDA monitor possible safety issues with the COVID-19 vaccines. These agencies are thorough and transparent about COVID-19 vaccine side effects. While millions in the U.S. have been vaccinated with only mild side effects, some rare issues have been reported and reviewed.
- In April 2021, the CDC and FDA temporarily paused administration of the Johnson & Johnson vaccine so they could review data on a small number of cases of serious blood clots following shots with that vaccine. Most of these incidents occurred in women under age 50. After this review, the FDA and CDC determined that the benefits of the J& J vaccine outweigh the risk of this very rare side effect, and resumed authorization of vaccination with the J& J shot. Read more about side effects related to a rare blood clot.
- After observing rare occurrences of myocarditis following the second injection of the Pfizer and Moderna COVID-19 vaccines, the CDC released information for the public. Most of these myocarditis events happened in teens and young adults, and the majority of the cases were mild and cleared up on their own. Read more about side effects related to myocarditis.
This review process continues to monitor vaccine safety. Potential risks of COVID-19 vaccines are reviewed and weighed against the benefits of protection that the vaccines offer as well as the known, serious risk of harm due to COVID-19.
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There Are Three Safe Vaccines
Dont get caught up necessarily on the numbers game, because its a safe and effective vaccine and what we need is to have as many effective vaccines as possible, said Dr. Irons. Rather than focusing on efficacy rates, accept the fact that now you have three highly effective vaccines.
We do have three safe and highly effective COVID vaccines. COVID vaccines continue to maintain high protection against severe disease, hospitalization and death, said Dr. Fryhofer. However, we are seeing breakthrough infections. Its all about waning immunitywith time and with the Delta variant, along with concern about vaccine effectiveness against future variants of concern.
Studies presented to FDA and others reviewed by ACIP show some waning of immunity with time, she added. For example, a recent study published in Sept. 28 MMWR looked at COVID vaccine effectiveness against hospitalization from mid-March through mid-August. VEvaccine effectivenesswas higher for Moderna vaccine at 93% as compared to Pfizer-BioNTech vaccine at 88%.
Pfizer vaccine effectiveness declined significantly from 91% down to 77%at more than four months after the second vaccine dose. Moderna vaccine effectiveness did not wane as much as Pfizer, Dr. Fryhofer explained. VE for both mRNA vaccines was higher than Janssen. Janssens single dose vaccine had the lowest vaccine effectiveness at 71%.
Do I Still Have To Wear A Mask If I Get A Vaccine
The CDC continues to monitor the spread of COVID-19 and makes recommendations for wearing face masks, both for those who are fully vaccinated as well as people who are not fully vaccinated.
The CDC also recommends that masks and physical distancing be required when going to a doctors office, hospital or long-term care facility, including all Johns Hopkins hospitals, care centers and offices.
Johns Hopkins Medicines mask safety guidelines have not changed, and we still require everyone to wear masks inside all of our facilities.
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A Piece Of The Coronavirus
The SARS-CoV-2 virus is studded with proteins that it uses to enter human cells. These so-called spike proteins make a tempting target for potential vaccines and treatments.
Spikes
gene
CORONAVIRUS
The Johnson & Johnson vaccine is based on the viruss genetic instructions for building the spike protein. But unlike the Pfizer-BioNTech and Moderna vaccines, which store the instructions in single-stranded RNA, the Johnson & Johnson vaccine uses double-stranded DNA.
How Is It Different From The Moderna And Pfizer Vaccines
The most basic difference is that the Johnson & Johnson vaccine is an adenovirus vector vaccine, while the Moderna and Pfizer vaccines are both mRNA vaccines. Messenger RNA vaccines use genetic instructions from the coronavirus to tell a persons cells to make the spike protein, but these dont use another virus as a vector. There are many practical differences, too.
Both of the mRNA-based vaccines require two shots. The Johnson & Johnson vaccine requires only a single dose. This is key when vaccines are in short supply.
The Johnson & Johnson vaccine can also be stored at much warmer temperatures than the mRNA vaccines. The mRNA vaccines must be shipped and stored at belowfreezing or subzero temperatures and require a complicated cold chain to safely distribute them. The Johnson & Johnson vaccine can be stored for at least three months in a regular refrigerator, making it much easier to use and distribute.
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What Booster Should I Choose If I Got Johnson & Johnson
You should get a Pfizer or Moderna booster, the CDC says, at least two months after your Johnson & Johnson vaccine. This “mix and match” approach for COVID-19 boosters was authorized by the FDA after early studies from the US and other countries found it’s safe and effective. In fact, some research shows that people who originally got J& J’s shot have a better response to Moderna’s and Pfizer’s booster than to another shot of Johnson & Johnson.
Boosters are recommended for everyone age 12 and up for maximum protection against the omicron variant, which appears to lower the effectiveness of all the COVID-19 vaccines, as well as protection from past COVID-19 infections.
However, you can still receive Johnson & Johnson’s booster if you choose. The reason that the CDC is now recommending Pfizer and Moderna over Johnson & Johnson is because neither mRNA vaccine carries the rare but dangerous blood-clotting side effect, and both also appear to be more effective than J& J. What’s more, vaccines are widely available in the US now, unlike earlier in the pandemic when the public health advice was to get whatever vaccine you could as soon as you could.
What This Means For You
Even though the FDA is scaling back the use of the J& J COVID vaccine, it is still an option, especially for people who are allergic or have limited access to the Pfizer or Moderna mRNA vaccines.
The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.
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You Have Other Vaccine Choices
The FDA updated the J& J Janssen vaccine EUA with an additional warning, noting that women under 50 should be made aware of a rare risk of blood clots and low platelets following vaccination, said Dr. Fryhofer. They also need to know there are other COVID vaccines out there that dont pose this small risk.
That empowers patient choice. It also means vaccination clinics should make clear which vaccine or vaccines are being offered and when, she added.
With the J& J Janssen vaccine, the benefits of the one-dose regimen far outweigh the risks. But, if people are worried, they can access Pfizer or Moderna COVID-19 vaccines. There have been more than 180 million doses of mRNA vaccines by Pfizer and Moderna administered with no reports of cerebral venous sinus thrombosis with thrombocytopenia.
Should I Choose One Vaccine Over Another
Although the overall efficacy of the Moderna and Pfizer vaccines is higher than the Johnson & Johnson vaccine, you should not wait until you have your choice of vaccine which is likely a long way off anyway. The Johnson & Johnson vaccine is nearly as good as the mRNA-based vaccines at preventing serious disease, and thats what really matters.
The Johnson & Johnson vaccine and other viral-vector vaccines like the one from AstraZeneca are particularly important for the global vaccination effort. From a public health perspective, its important to have multiple COVID-19 vaccines, and the Johnson & Johnson vaccine is a very welcome addition to the vaccine arsenal. It doesnt require a freezer, making it much easier to ship and store. Its a one-shot vaccine, making logistics much easier compared with organizing two doses per person.
As many people as possible need to be vaccinated as quickly as possible to limit the development of new coronavirus variants. Johnson & Johnson is expected to ship out nearly four million doses as soon as the FDA grants emergency use authorization. Having a third authorized vaccine in the U.S. will be a big step towards meeting vaccination demand and stopping this pandemic.
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