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IIt’s always good for consumers to have options, right? And indeed, the United States is expected to soon have three Covid-19 vaccines injected into people’s arms, with more potentially on the way in the coming months, speeding up the race to vaccinate hundreds of millions of people as quickly as possible. possible.
But not all vaccines are created equal, and increasingly, health authorities and providers will process injections with varying attributes: different storage requirements, efficacy, dosing schedules, and manufacturing platforms. That, coupled with the possibility of a more selective audience that might want one certain shot rather than another, could complicate an already messy rollout. But the different features also open the door to better access beyond an additional supply – a more convenient single-injection vaccine will likely be available soon.
The main point, experts point out, is how remarkable it is that the United States has several Covid-19 vaccines just a year after the start of the pandemic. All vaccinations authorized by regulators have been shown to be safe and effective, so you should get whatever you are able to get, they say.
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“If you have the choice to get vaccinated, I encourage you to take the vaccine that was given to you,” said John Brooks, the Centers for Disease Control and Prevention’s chief medical officer for the Covid-19 response. during a briefing on Friday.
Johnson & Johnson, which reported on Friday that its vaccine was 66% effective in preventing moderate to severe disease and 85% effective in preventing severe Covid-19 in clinical trials, plans to file an application for authorization of emergency use with the Food and Drug Administration in early February. . Assuming regulators act quickly, health officials will have the benefit of a third shot to distribute with millions more in supply.
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Unlike the two-dose mRNA vaccines already licensed by Moderna and Pfizer-BioNTech, the J&J vaccine requires only one dose. It is also inexpensive and can be stored in normal refrigerators, which makes it easier to store and transport than mRNA vaccines, which must be stored at sub-zero temperatures, sometimes in special freezers than small ones. clinics may not have.
“This is going to be huge for rural people,” said Alan Morgan, CEO of the National Rural Health Association, of the J&J shot.
Likewise, it might now be easier for vaccination campaigns to take place in communities instead of requiring people to go to hospitals to get vaccinated, which could reach people without access. care or who are wary of health facilities but may listen to community leaders. Survey data, for example, has shown that people of color, who have been victims of historic and ongoing abuse by medical providers, are less likely to get the Covid-19 vaccine as quickly as others. In addition, early data on vaccine distribution shows that a disproportionately small number of black and Latino adults have received vaccines.
“It’s easier to bring the vaccine to hard-to-reach areas,” said Mitchel Rothholz, chief of staff for the American Pharmacists Association, of J&J’s vaccine.
However, some people may want to choose their vaccine as if it is a product that they can squeeze to find the most suitable option. The results of clinical trials or reports of side effects could guide what people want.
It is difficult to compare clinical trials of different products against each other. The pandemic has also changed: J & J’s trial took place as at least one variant that appears to have some impact on vaccine effectiveness circulated, while the Moderna and Pfizer-BioNTech trials were completed before the variants. worrisome begin to spread widely. Without clinical data to assess each vaccine against the new strains, it is difficult to determine whether existing Covid-19 vaccines might be less effective against variants of the virus.
Still, some people might remember the headlines for Moderna and Pfizer products that are over 90% effective against Covid-19 and question J&J’s announcement of 66% effectiveness.
Public health officials were quick to tout J&J’s data as a solid result, especially since regulators initially said a vaccine would only need to be 50% effective to be cleared. . A 66% effective vaccine is an incredibly powerful tool in the fight against respiratory viruses, they pointed out. “We would celebrate a seasonal flu vaccine with 60% effectiveness,” Jay Butler, CDC deputy director of infectious diseases, told reporters.
In the US arm of the clinical trial, J & J’s vaccine was 72% effective, which, in the absence of mRNA data, “looked like it was an absolutely spectacular result,” Anthony Fauci , director of the National Institute of Allergies. and infectious disease, said at another White House briefing. Additionally, vaccination was 85% effective in preventing serious illness, and in the trial all hospitalizations and deaths occurred among people who received the placebo. None of the vaccinated people diagnosed with Covid-19 got sick enough to need hospital care.
“If it’s about getting my family members vaccinated, and all that’s available is J&J or Novavax, I would tell them to take it,” said Robert Hancock, president of the Texas College of Emergency Physicians.
Novavax is another vaccine maker who on Thursday reported that their vaccine was 90% effective in one trial in the UK, but 49% effective in another trial in South Africa, possibly due to variant B. 1,351 circulating in this country, which seems to elude certain aspects of the immune response. The company has not said when it might seek clearance from the FDA.
The different levels of efficacy between vaccines could also complicate the logistical advantages provided by the J&J vaccine. If states have started allocating J&J’s vaccine only to rural areas, “there may be concerns that this is unfair,” said Marcus Plescia, chief medical officer of the Association of State and Health Officials. territories. “People in rural areas may feel like they are running out of waste.”
Julie Swann, head of the industrial and systems engineering department at North Carolina State University, who advised the CDC during the H1N1 pandemic, agreed. She said providers should start surveying their communities to see if people have a preference for the vaccines they receive. “It would be a real mistake to distribute J&J solely on the basis of infrastructure,” she said.
Eventually, as more vaccines are licensed, health officials may recommend that certain people, based on age or other risk factors for more severe Covid-19, be given priority for certain vaccines. . Perhaps mRNA vaccines could be reserved for those most vulnerable to coronavirus, Swann suggested, while the J&J vaccine could be rolled out to more general populations.
At this time, federal health officials have not released guidelines on who should get which vaccines.
Another question arises for the vaccination campaign: the variants. It appears that B.1.351 is having some impact on at least some of the vaccines, although experts note that the immunizations don’t work like light switches that are either on or off. On the contrary, vaccinated people may be less defended against infection with B.1.351 than other forms of coronavirus, but vaccines could still protect them against severe Covid-19.
For now, health officials and businesses say the emergence of B.1.351 and other variants serves as a signal they need to be ready to adapt vaccine designs if and when a form of the virus emerges that emerges. could significantly “escape” the immune protection conferred by vaccines. Some vaccine makers have started investigating booster shots designed specifically against B.1.351, and federal health officials said on Friday they were reviewing contingency plans to fine-tune the vaccines if necessary.
“We will continue to see the evolution of mutants,” Fauci said. “We, as government, corporations, all of us who are in this business together, will have to be nimble so that we can easily adapt to create versions of the vaccine … specifically aimed at the mutation that is really prevailing at any given time.”
Variants add further pressures to vaccination campaigns. B.1.351 and other variants that have been confirmed in the United States appear to be more infectious than previous forms of the virus, meaning that a higher proportion of the population will need to be vaccinated to stem the American epidemic. If more people get vaccinated and cases decrease, it reduces the risk of even more harmful variants developing.
“The sooner we can get people vaccinated, the more likely we are that this will not happen again with more and more variants emerging because there is such a large population of viruses,” said Francis Collins, director of the National Institutes of Health. Friday.
Rachel Cohrs and Matthew Herper contributed reporting.
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