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In early April, Mark Dinan received the Johnson & Johnson single-dose vaccine on a college campus near his home in East Palo Alto, California. He felt lucky to have a single shot and the side effects were mild.
But this summer, as the delta variant of the coronavirus began to spread across the United States, he grew increasingly concerned.
He read a study suggesting that the single-dose J&J vaccine may be less effective in repelling coronavirus variants than two-dose mRNA injections. He was particularly troubled by one of the findings: the single-dose AstraZeneca vaccine, which is similar to the J&J vaccine, only showed about 33% effectiveness against symptomatic delta-caused disease. What if he’s vulnerable?
“It’s like you’re in a hurricane and someone gives you a garbage bag to put on your head to keep you dry. It’s not the same as the Gore-Tex bodysuit that the people at. Pfizer and Moderna are wearing in the same storm, ”said Dinan, who owns a recruiting firm based in the Bay Area.
So, on the morning of July 22, he walked into a local CVS pharmacy and received another injection. No big deal, he recalls.
The study Dinan read about was not peer reviewed or published in a medical journal. It looked at the response of antibodies in blood samples, the researchers said; other important components of the immune system response have not been examined.
Johnson & Johnson said the research does not show “the full nature of immune protection.”
Dinan is among a group of people in the United States who have researched additional doses of Covid vaccines after receiving the J&J vaccine, essentially mixing and matching vaccines from different companies. In recent weeks, people have said on social media that they have even misled vaccine suppliers that they have not been vaccinated and therefore would be eligible for another injection.
Yet these “booster” injections have not been authorized by the federal government, and it is not clear whether combining two different vaccines is safe or effective. Leading public health authorities in the United States insist that vaccines still offer strong protection against delta and other known variants, and nearly all recent hospitalizations and deaths are in unvaccinated people.
The Food and Drug Administration and the Centers for Disease Control and Prevention said in a joint statement last month that “Americans who have been fully vaccinated do not need a booster at this time.” Dr Peter Marks, a senior FDA official, said the agency does not recommend “taking charge” of booster shots.
“It’s actually not something you’re supposed to do under an emergency use authorization,” Marks said Tuesday at an event hosted by the Covid-19 Vaccine Education and Equity Project, referring to the federal approval given to Pfizer-BioNTech, Moderna and Johnson & Johnson.
The apparent wave of interest in more shots nonetheless underscores the heightened anxiety over the delta variant, which is the most contagious coronavirus mutation to have emerged in the pandemic so far.
Dr Kavita Patel, a primary care physician in Washington, DC, said she believed people who received the J&J vaccine were left “and dry”, injected with a vaccine that may not have been enough. effective against delta but without government. sanctioned way to get an extra hit.
“We’ve talked a lot about third doses, but we forgot that there are 13 million people who don’t have a third dose option because they have J&J,” she said, adding that ‘she had not officially counseled her own patients. to get boosters.
In a statement released Tuesday evening, Johnson & Johnson said its single-dose vaccine offered two protective mechanisms – immune responses of antibodies and T cells – which “persisted for eight months after vaccination.”
What’s more, a real-world study of healthcare workers in South Africa presented on Friday suggests that the Johnson & Johnson vaccine is 71% effective against the delta variant in preventing hospitalization and over 90 in preventing death.
Dinan, for his part, said he did not regret his decision.
“I would feel bad about it if I thought I was doing something illegal, immoral, immoral or wrong,” he said, adding: “I think it’s probably a little ahead of the curve. I bet you a dollar that by Oct. 1., that’s standard procedure. “
But some recipients of J&J have more qualms about stepping into a potential ethically gray area and seeking an additional technically unauthorized dose.
Tim, from Illinois, who requested that his last name and other identifying details not be disclosed because he was concerned about how his decision would be viewed by his employers and co-workers, said said he jumped at the first opportunity to get the shot, driving four hours to one spot. downstate on March 12 to receive single-dose J&J.
He did not question his decision for several months. But when he learned that the J&J vaccine might be less effective against delta, he was alarmed. He is on medication for an underlying disease that weakens his immune system and he was worried about being at risk.
He said his doctor recommended he look for a Pfizer “booster”. On Tuesday, he went to a local pharmacy where he assumed his insurance information was not recorded and claimed he was not already vaccinated against Covid.
“I’m someone who’s generally a rule follower,” Tim said. “It didn’t do me any good to bypass the system, so to speak, to do what I had to do and what my doctor told me to do.”
“It makes you feel like a criminal, to have to do it this way,” he added. “It’s unfortunate.”
Nonetheless, Tim said he now felt a “sense of relief” – and that he was better protected from the delta.
Even some medical experts have obviously decided to research what some see as thicker armor against the evolving threat.
Jason Gallagher, an infectious disease expert at Temple University’s Faculty of Pharmacy, received the J&J vaccine in November in a clinical trial. He told Reuters in June he was then given a dose of Pfizer at a Philadelphia vaccination clinic where he administered injections.
He said at the time that he was concerned about data from the UK showing less efficacy against the delta variant for people who received one dose of the vaccine.
“The Delta variant that is spreading … and gaining the upper hand in the United States very quickly seems a bit more of a concern in terms of breakthrough infections with single-dose vaccines,” Gallagher said in this interview. “So I took the plunge.”
The use of boosters is more common in Canada and some European countries. The German government said Chancellor Angela Merkel obtained a photo of Moderna in June after receiving one from AstraZeneca in April. Israel has started giving some vulnerable people a third chance.
At least one American city offers more flexibility. The San Francisco Department of Public Health announced last week that it would offer what it called an “extra” dose of Pfizer or Moderna vaccines to anyone who received single-dose J&J.
However, San Francisco officials have made it clear that the decision does not reflect a change in policy. They still do not recommend a booster injection, saying in a statement that they are simply allowing “accommodation” for people who have seen their doctors.
Guanyao Cheng, 41, a San Francisco lawyer who was shot in early April, said he was given a dose of Moderna Thursday afternoon on the advice of his sister, an emergency doctor.
“She strongly recommended that I get an mRNA booster shot, and she kept pestering me about it,” he said, adding that he finally made an appointment after having learned that San Francisco offered additional doses.
Cheng said he was aware that the additional fire was not officially sanctioned by the CDC, but he believed the risk was worth it as the delta looms over much of the country.
“I also really trust my sister,” he said.
The use of boosters in the United States comes as poorer countries struggle with vaccine shortages. The head of the World Health Organization on Wednesday called for a moratorium on recalls, citing the gap between rich and poor countries in total immunizations.
“I understand the concern of all governments to protect their populations from the delta variant. But we cannot accept that countries that have already used up most of the global vaccine supply are using even more,” said Wednesday. Tedros Adhanom Ghebreyesus.
Dinan, the East Palo Alto recruiter, said he recognizes he was extraordinarily ‘privileged’ to have received a booster with relative ease and convenience – not to mention a Covid-19 vaccine in the first place. .
“I’ve lived in England, Brazil, and Mexico, and I know it’s an incredible privilege as an American to have access to these vaccines. I don’t think people in the United States realize how much. how amazing it is to decide at 10 am, ‘Oh, I would like to get the vaccine’ and be done before noon, ”he said.
“I know friends in Brazil and Mexico who would crawl on broken glass at 3 a.m. on a Sunday to get the shot,” Dinan added.
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