The US Food and Drug Administration’s (FDA) recent approval of the one-dose Johnson & Johnson (J&J) vaccine, which is easier to store and transport than others and reportedly causes fewer side effects, offers opportunities for states to improve vaccination outreach.
At a time when supply remains one of the largest barriers to vaccine administration, the new J&J vaccine helps boosts supply and allows more people to be vaccinated. However, efforts to distribute the newest vaccine have been complicated by mixed messaging around its efficacy. States, with federal guidance, are working to emphasize the benefits of the J&J vaccine and the importance of getting vaccinated as soon as any vaccine is available.
In clinical trials, the J&J vaccine had a 72 percent efficacy overall in the United States, with an 85 percent efficacy against severe COVID-19 infection. While there is some public concern that the J&J vaccine has a lower efficacy than Pfizer and Moderna’s, experts are stressing two facts:
- The (J&J) vaccine has a high efficacy against severe disease and is just as effective at preventing hospitalization and mortality as the older vaccines. Those who do get COVID-19 after J&J vaccination are likely to only experience only mild symptoms.
- Unlike the Moderna and Pfizer vaccines approved in December, J&J was tested in Brazil and South Africa in the presence of the new 1.351 variant. It proved to be highly effective at preventing infection and severe disease from these COVID-19 variants.
J&J Vaccine Advantages
In addition to its success against virus variants, the J&J vaccine has a number of different characteristics that make it easier to transport, store, and administer than the Moderna and Pfizer vaccines.
First and foremost, the vaccine requires one dose rather than two. State officials have shared that scheduling second doses, reminding patients to come in for their second dose, and following up when individuals miss their appointments have been significant challenges in their vaccine rollout. The one-dose J&J vaccine eliminates this issue.
Additionally, the J&J dose is easier to store and can be kept in a regular refrigerator for up to three months. This makes it possible that more and different types of health care providers, such as those working in rural health centers or with communities that have limited access to health care, can keep the vaccine in their facilities so their patients can receive the COVID-19 vaccine from providers whom they view as trusted sources.
Many J&J recipients also report fewer side effects from the vaccine, making the vaccine ideal for individuals who cannot afford to miss a day of work because of severe side effects, or who might not be connected to a health care professional who can help treat symptoms if needed.
Importance of Messaging
Throughout the pandemic, federal and state governments and public health leaders have struggled to find a balance between managing public expectations and encouraging measures that prevent the spread of COVID-19. The introduction of the J&J vaccine has again highlighted the importance of crafting messages for the public to counter any misinformation about its efficacy.
After concerns began arising about the efficacy of the J&J vaccine, the Centers for Disease Control and Prevention (CDC) recommended that jurisdictions use the following language when promoting the J&J vaccine, “All the available vaccines have been proven effective at preventing serious illness, hospitalization, and death from COVID-19 disease.” The CDC also encourages individuals to get the first vaccine available to them. States are beginning to craft their own messages to reach their residents.
Before opening up new vaccine appointments, the Washington, DC Department of Health sent an email using the CDC’s language to all residents who signed up for vaccine alerts. The email noted that individuals will be able to see which vaccine is being administered at each site before choosing an appointment, but emphasized that all vaccines are effective at preventing “serious illness, hospitalization, and death from COVID-19,” and that residents are “highly encouraged to take the first vaccine available to them.” All appointments were booked within minutes, suggesting that Washington, DC residents were willing to take whichever vaccine was available.
In Iowa, Gov. Kim Reynolds received the J&J vaccine during a news conference to help promote the vaccine and emphasized her trust in the vaccine before her constituents. She also addressed concerns about the J&J vaccine’s efficacy, noting, “This information is misleading, and quite frankly, it’s irresponsible to position any vaccine as a less desirable option when it’s undergone the same rigorous clinical trials to test the safety and efficacy and has received approval by the FDA and the CDC.”
Gov. Jay Inslee of Washington State also issued a statement about the J&J vaccine in a recent interview, where he acknowledged the lower efficacy rates in clinical trials, but also praised the advantages of this vaccine compared to others. “It’s going to save your life, which we think is a pretty high value. It has a downside of slightly lower efficacy to prevent you from getting a headache — but you only have to have one shot instead of two,” he explained.
Federal and state governments are also navigating the tension between the value of setting aside allocations of the J&J vaccine for individuals who face more barriers to getting two doses, and the danger of targeting a vaccine that some constituencies believe is less valuable to more vulnerable and historically marginalized populations.
Supply remains a key concern in state and federal vaccination efforts. However, President Biden’s announcement that the United States will have enough supply to vaccinate the entire adult population by May, in part due to J&J’s partnership with Merck to ramp up manufacturing, creates even more pressure to ensure that public health messaging effectively promotes the benefits of all vaccines equally.
In the meantime, the J&J vaccine arrives as many states are broadening their vaccine eligibility guidelines. According to National Academy for State Health Policy analysis, 35 states are now vaccinating individuals age 65 and older and 43 states are vaccinating teachers and/or childcare providers. During the first week of March, 11 states began vaccinating teachers, and four states expanded eligibility to individuals age 50 and older. This new vaccine can help ensure that newly eligible individuals can be vaccinated promptly, bringing the nation closer to herd immunity.
Acknowledgements: This blog is supported by the Centers for Disease Control and Prevention (CDC) of the US Department of Health and Human Services (HHS) as part of a financial assistance award totaling $250,000 with 100 percent funded by CDC/HHS. The contents are those of the author and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS or the US government. CDC General Terms and Conditions for Non-research Awards, Revised: February 2021.