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Johnson & Johnson’s COVID-19 vaccine is effective with just a single dose—but concerns swirl about lowered protection against one viral variant.
AS THE BIDEN administration promises to accelerate the U.S. coronavirus vaccine rollout, it could soon have a new tool: A single-dose vaccine that can survive up to three months in an ordinary refrigerator. Manufacturer Johnson & Johnson released data today showing that its single-dose version provided strong protection against COVID-19. Yet the news came with two caveats: The candidate’s efficacy rate—72 percent in the United States—is lower than the 95 percent rates boasted by the two-dose versions from Pfizer-BioNTech and Moderna that are currently approved for use in the U.S.
The Johnson & Johnson vaccine also provided less immunity among trial participants in South Africa, where a set of mutations threatens to accelerate the deadliness of the global pandemic. In that study, the efficacy rate was just 57 percent. The manufacturers of Pfizer-BioNTech and Moderna have reported similar concerns with their vaccines, and are studying different dosing and formulation strategies in the event new variants of the coronavirus outwit their vaccines.
The new vaccine candidate is expected to be reviewed for emergency use authorization by U.S. Food and Drug Administration as soon as next week. If approved, experts say the Johnson & Johnson single-dose vaccine could streamline a national COVID-19 vaccination administration campaign that has to date been criticized as scattered and lethargic. Currently, the Pfizer-BioNTech and Moderna versions must be given in two doses several weeks apart. “This could be a game-changer because it’s one dose,” says Bruce Y. Lee, professor of health policy and management at the City University of New York Graduate School of Public Health, who studies pharmaceutical supply chains. “It’s easier to administer. With two doses, you have to get people to come back for a second. It’s going to be easier to manufacture; you have to produce half as many doses.”
Vaccines are here, bringing hope of the pandemic’s end. But even when you get your dose, it won’t mean an immediate return to life as you knew it. Scientists cite several reasons for staying masked and cautious as you start your post-vaccine life. Vaccines don’t offer perfect protection; we don’t yet know whether vaccinated people can spread the virus; and coronavirus is likely to continue its rapid spread until a large majority of the population is vaccinated or has survived a natural infection.
Because vaccines will not be a ticket back to 2019, Uma Karmarkar, a neuroeconomist at the University of California, San Diego, recommends that people think about “how we are moving forward” instead of “getting back to normal.” (Neuroeconomics bridges neuroscience, psychology and economics.)
Vaccination provides you and society the best way to move forward. Some parts of life will begin to feel different as soon as the vaccine kicks in. Other changes will take longer. When it comes to thinking about what’s safe, it may help to think of post-vaccine life in several phases.
When people are fully vaccinated (a week or two after the second dose), but most others aren’t yet, their lives probably shouldn’t change very much, experts say. It will most likely be safer for them to do things like visit the grocery store or the post office. People who work in places that leave them highly exposed will significantly decrease their risk — which is why frontline workers are among the first to be eligible for the vaccine. But vaccinated people should still wear masks and avoid large groups and indoor gatherings when possible.
That’s important for both their health and the health of others, experts said. Scientists are waiting to learn if vaccinated people can spread the virus to others. (Early data on transmission seems promising, but vaccines are very unlikely to curb contagiousness entirely.) Also, while early evidence suggests that the first vaccines in the U.S. reduce people’s risk of developing Covid-19 by around 95 percent, that still means a small fraction could get sick — and as long as the virus is as widespread as it is now, even that small share could be a big number.
“Five percent of a really high number is still a high number, and what you want is 5 percent of a relatively medium or low number,” said Dr. Ashish Jha, a physician and the dean of the School of Public Health at Brown. In an informal survey of 700 epidemiologists by The New York Times, less than a third said they would change their behavior after they were vaccinated; half said they would wait until at least 70 percent of the population was vaccinated.
EKelsey Vandersteen, a trauma I.C.U. nurse at UW Health University Hospital in Madison, Wis., will receive her first injection on Wednesday — probably months ahead of her young daughters and husband, who works from home for a software company. Even after her second shot, she doesn’t intend to change her behavior, including wearing a mask. She says she hopes this will model good behavior for others. Besides, she said: “I prefer the mask. It protects me from other stuff as well. We’ve been completely healthy — not a sniffle since March.”
Scientists initially estimated that 60 to 70 percent of the population needed to acquire resistance to the coronavirus to banish it. Now Dr. Anthony Fauci and others are quietly shifting that number upward.
At what point does a country achieve herd immunity? What portion of the population must acquire resistance to the coronavirus, either through infection or vaccination, in order for the disease to fade away and life to return to normal? Since the start of the pandemic, the figure that many epidemiologists have offered has been 60 to 70 percent. That range is still cited by the World Health Organization and is often repeated during discussions of the future course of the disease.
Although it is impossible to know with certainty what the limit will be until we reach it and transmission stops, having a good estimate is important: It gives Americans a sense of when we can hope to breathe freely again. Recently, a figure to whom millions of Americans look for guidance — Dr. Anthony S. Fauci, an adviser to both the Trump administration and the incoming Biden administration — has begun incrementally raising his herd-immunity estimate.