Commentary: Vaccine challenges abound, yet there is room for optimism

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On Feb. 4, Johnson & Johnson and partner Janssen Pharmaceuticals submitted an application to the Food and Drug Administration for emergency-use authorization for their single-dose COVID-19 vaccine. Review and approval are anticipated by late February or early March. The Johnson & Johnson vaccine could be a game changer for the U.S. and for Delaware.

The Johnson & Johnson vaccine does not require low temperatures for transport and storage, expanding the settings in which the vaccine can be provided. This will make it easier for public health, pharmacy and other community partners to reach more people with the vaccine, including those living in rural areas and urban centers, as well as locations without major medical centers, which typically have on hand the types of freezers needed for the Pfizer and Moderna vaccines.

The vaccine is also effective in just a single dose, making the implementation of a vaccination campaign with the Johnson & Johnson vaccine much simpler for state public health authorities. While there have been some well-publicized challenges to the vaccine campaign to date, overall, it’s been a great success, with Delaware ranking ninth among the 50 states for the percentage of population that has received at least one dose of COVID-19 vaccine and 14th for the efficiency of administering doses delivered to the state.

Speed in getting this vaccine distributed is essential. In the Phase 3 trial, the Johnson & Johnson vaccine was most effective in the U.S., where the South African variant of COVID-19 is not yet widespread. While new cases and hospitalizations are trending down in Delaware, with Feb. 6 data showing the lowest number of residents hospitalized since Nov. 30, another surge is possible. Fortunately, deaths are also on the decline in Delaware, and with long-term care facilities, whose residents make up 83% of the deaths from COVID-19 in Delaware, prioritized for vaccination, this trend should continue.

The optimal situation for the health of the population is to get as many people vaccinated as quickly as possible. While supply chains and logistics are complex and not as robust as we would like, progress is being made on these fronts every day. Many more people could soon have the ability to get a vaccine, and, for the most part, they should get the vaccine they can get soonest. For example, using the Johnson & Johnson vaccine in younger populations, who are relatively far down the priority lists for currently available vaccines, means we can still dramatically reduce or even eliminate their risk for severe disease, hospitalization and death.

The Johnson & Johnson vaccine allows public health officials to take a two-pronged approach that will be more effective at ending the pandemic: continuing to vaccinate those at highest risk — the elderly, those in long-term care and front-line health care workers — while at the same time, vaccinating younger people and other essential workers later in Phase 1 and in Phases 2 and 3 as supplies expand and systems get better.

While receiving the COVID-19 vaccine does not end the need to wear masks and practice physical distancing and good hand hygiene, the benefits to the health of individuals and populations are many. The Johnson & Johnson vaccine was 85% effective against severe COVID-19 infections globally and 100% effective against hospitalization and death among all who received the vaccine in the trial. The critical takeaway is that the addition of the Johnson & Johnson vaccine is likely to be a huge step forward for our battle against COVID-19. And we think that’s some good news we can all look forward to.

Abby Hopkins is an undergraduate student at the University of Delaware. Dr. Jennifer A. Horney, Ph.D., MPH, is a professor in the university’s epidemiology program.

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