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In North Dakota this week, health officials are sending their first Johnson & Johnson Covid-19 vaccines to pharmacies and emergency care clinics, where people who don’t necessarily have a regular doctor can receive just one. vaccine. In Missouri, the doses are intended for community health centers and rural hospitals. And in North Carolina, healthcare providers are using it to inoculate workers in the meat packaging, farm, and grocery store.

Since Johnson & Johnson revealed data showing that its vaccine, while highly protective, had a slightly lower efficacy rate than the first injections produced by Moderna and Pfizer-BioNTech, health officials feared the new vaccine may be viewed by some Americans as the inferior choice. .

But the early days of its rollout suggest something different: Some people are eager to get it because they want the convenience all in one fell swoop. And public health officials are excited about how quickly they could receive a single vaccine, especially in vulnerable communities that otherwise would not have access to a vaccine.

“This is a potential breakthrough,” said Dr. Joseph Kanter, Louisiana’s senior health official. With its first doses assigned, the state is hosting a dozen large Johnson & Johnson vaccination events in civic centers and other public places, modeled after what has worked for flu shots.

As Johnson & Johnson’s production ramps up over the next few months, Dr Kanter said this injection would allow his state to reduce personnel and operating costs associated with second doses: “The J&J vaccine brings a lot to the table. ”

Judged by its ability to prevent serious illness, hospitalization and death, the Johnson & Johnson vaccine is comparable to those manufactured by Moderna and Pfizer-BioNTech. And while it has a lower overall efficiency rate in the United States – 72%, compared to about 95% for others – experts say comparing these numbers is problematic because the companies’ trials have been conducted at different places at different times.

The Johnson & Johnson vaccine can also be stored at normal refrigeration temperatures for up to three months – ideal for distribution to non-medical sites such as stadiums and convention centers.

“There are circumstances in which this will be a very good option or maybe the best option,” said Dr. Matthew Daley, senior investigator at the Kaiser Permanente Colorado Institute for Health Research and a member of the Centers for Disease. Control and Prevention. independent advisory committee on vaccines.

Only four million doses were shipped this week, and the company’s manufacturing delays mean it will be at least a month before states begin receiving significant supplies. Because of this discrepancy, state officials view the first wave of doses as a time to test different ways of deploying them.

Patrick Allen, the director of the Oregon Health Authority, said the first doses in the state went to a variety of settings, “to see if we learn anything from its use.” These included mass vaccination sites around Portland, adult foster homes, and pharmacies not included in the federal government’s pharmacy program. Health officials will assess the success of each of these sites to develop a plan for larger shipments.

Many public health officials have said they are focusing on administering the vaccine to people who might be more difficult to reach for a second dose, such as those who are homeless or about to be released from prison. In North Carolina, this category includes the state’s mobile farming communities with three or four week work seasons. Mandy Cohen, the state’s health secretary, said the state’s major meat-packing plants, such as Smithfield and Tyson Foods, were interested in the Johnson & Johnson vaccine and had consulted with her department.

And because the vaccine tends to have fewer side effects than other options, it’s appealing to people who don’t want to risk missing a day of work to recover from chills or fever. like: ‘I’m much more interested now that you tell me I only have to take a photo once instead of twice. “

“I don’t think it’s a substandard vaccine, and that’s why I’m taking it for myself,” said Ms Cohen, who was due to be vaccinated against Johnson & Johnson on Friday.

In small independent pharmacies, the vaccine caused a wave of excitement. Steve Hoffart, the owner of Magnolia Pharmacy in Magnolia, Texas, a small town outside of Houston, has received calls and emails from residents planning his arrival this week. He said he hoped to host a Johnson & Johnson event for teachers on March 13. Schools in the area have struggled to find substitute teachers during the pandemic, and a vaccine that doesn’t require a second visit and more free time was an important development, he said.

Tim and Joyce Staab, who live in Chillicothe, Ohio, a town of about 20,000 people an hour’s drive from Columbus, were two of the first Americans to receive the Johnson & Johnson vaccine. The two had general vaccine appointments scheduled for later in the week. But then they were notified on Wednesday that an independent pharmacy near them had received 100 doses of the Johnson & Johnson vaccine. Ms. Staab, 68, hesitates about needles and appreciates the “one-and-done” approach.

Mr Staab, 67, said he believed the vaccine was a better choice for healthcare professionals like the pharmacy where he received it. “They don’t have the resources, I don’t think, to deal with vaccines that are really hard to store,” he said.

States have been able to adapt and modify distribution plans in part because the federal government has not issued prescriptive guidelines indicating where and to whom the vaccine should be sent.

This winter, as the Food and Drug Administration’s clearance for the Johnson & Johnson vaccine approached, federal officials involved in vaccine distribution lobbied for the vaccine to be used more centrally, whether in major stadiums and mass vaccination sites managed by the federal emergency. Management agency or only in pharmacies, according to officials familiar with these discussions. But the White House preferred to allow states to adapt their own plans, as they had done for the Moderna and Pfizer-BioNTech vaccines.

While health experts are excited about the potential public health benefits of the new vaccine, there are also concerns that public interest will wane once vaccines are less scarce. If given a choice between brands, some people may reject Johnson & Johnson, seeing it as an inferior choice.

In black churches across the Mid-Atlantic this winter, Darrell J. Gaskin, Johns Hopkins University health policy professor and pastor, and Rupali Limaye, university scientist studying vaccine reluctance , counseled and reassured hundreds of pastors and congregation members of the African Methodist Episcopal Churches of Zion in virtual presentations, emphasizing the safety of the Johnson & Johnson vaccine and the prevention of severe Covid-19 and death, including among black volunteers participating in the company’s trial.

Dr Gaskin said it was crucial that officials focus on the benefits of the vaccine early in its distribution, so that people “don’t feel like there’s a luxury vaccine and then a non-luxury vaccine ”.

“We are facing disparities related to Covid,” said Dr Limaye. “How to reduce disparities? We are bringing out a product that contains a dose and is stable. “

One of Dr. Gaskin’s church members, Patricia Cooper, a teacher in Washington, DC, said President Donald J. Trump’s efforts to claim credit for a vaccine last year and that the label “Emergency Use Clearance” suggested to her that the federal government might have rushed its vaccine reviews, leaving her nervous about their safety. But she said she was eager to get the shot, especially the one from Johnson & Johnson.

“This one is more appealing to me,” she said. “Who likes to get stuck more than once?”

But Mr. Allen, the Oregon health official, warned that its more specialized use could contribute to skepticism about its quality.

“If you start to get a little too cute about targeting its use, you might be harboring suspicion about, ‘Well, why am I getting this vaccine? And I am part of this special population and people who are not part of this special population do not get this vaccine, ”he said.

Federal health officials have promised a way to crack down on the potentially unfairly used Johnson & Johnson vaccine. Dr. Marcella Nunez-Smith, chair of the Biden administration’s new health equity task force, told a White House press conference this week that vaccine distribution “should be uniform across the board. the communities”.

“We’re going to track biometrics, like zip code and social vulnerability, to see where the vaccines go,” she said. “And if certain vaccines are systematically sent to certain communities, we can intervene.”

Some government officials believe that combining new and old vaccines can help show that they are just as important.

Mr Allen said Oregon is creating similar distribution plans for Johnson & Johnson and Moderna because both vaccines can be stored in refrigerators at short notice. The state treats the Pfizer-BioNTech vaccine as one with “special considerations”, with its stricter shipping requirements and large vial packages more suited to mass vaccination sites, he said.

Managing Johnson & Johnson and Moderna vaccines in a similar fashion, he said, would help avoid “questions of fairness and potential concerns, based on the perceived differences between vaccines, some of which are real and others don’t.



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