Johnson & Johnson Vaccine

The Johnson & Johnson vaccine or Ad26.COV2.S is a single dose vaccine developed by Janssen Pharmaceuticals of Johnson and Johnson.  The vaccine was approved for administration to persons above 18 years and has been found to have an efficacy of 85.4% and 93.1% against severe disease and hospitalization respectively. This comes from studies done 28 days after inoculation.  Further, clinical trials have shown that Johnson & Johnson has an efficacy of 66.9% against symptomatic moderate and severe SARS-CoV-2 infections. While this efficacy is lower than the rates of other vaccines such as Moderna and Pfizer, important to note is that the Johnson and Johnson vaccine underwent clinical trials in varying contexts. The trials were done when the United States was experiencing a significant rise in COVID-19 cases and across the world where different variants were highly prevalent (Livingston, Malani & Creech, 2021).

The Johnson & Johnson vaccine performs by utilizing a different and harmless virus which delivers the genetic instructions that makes the SARS-CoV-2 virus to trigger protein. This then causes the immune response in the body to produce antibodies. It therefore means that Johnson and Johnson vaccine does not contain the SARS-CoV-2 virus and thus cannot cause COVID-19.

According to the Strategic Advisory Group of Experts on Immunization (SAGE), the Johnson & Johnson vaccine satisfied the thresholds of safety, quality and efficacy and thus was recommended for use against the deadly Covid-19 virus. The experts consequently reviewed available data on performance of Johnson & Johnson on other variants of concern such as the South African variant (B1.351) and the Brazilian variant (P.2) (Stephenson et.al, 2021). The results were that the Johnson and Johnson vaccine is highly efficacious when used for the above variants and can be administered in the countries they are found present.

Why use Johnson & Johnson

New data has showed that Johnson and Johnson vaccine provides strong and long lasting protection against the virus; this includes related hospitalizations and death. Further, the data shows that a single shot of the Johnson and Johnson vaccine is responsible for generating strong immune responses as well as long-lasting immune memory. While a single shot is sufficient for protection against Covid-19 related complications, hospitalizations and death, studies have further shown that administration of a booster shot of the Johnson and Johnson vaccine significantly increases the strength of protection of the vaccine (Shay, 2021).

The booster shot of Johnson & Johnson also believed to extend the duration of protection n from the virus significantly. This data has been provided to the U.S Food and Drug Administration (FDA), the World Health Organization (WHO), the National Immunization Technical Advisory Groups (NITAGs) and other regulators worldwide in order to aid in decision making on immunization strategies. When administered at two months, the booster shot is capable of providing a 94% protection against the virus. Consequently, if the booster Johnson & Johnson shot is administered at six months, the level of antibodies increases to about nine times within the first week and to twelve times higher after four weeks of administration. This exponential increase was recorded for all recipients regardless of their ages (Livingston, Malani & Creech, 2021).

Possible side effects of Johnson & Johnson

The Johnson and Johnson vaccine has been found to cause side effects such as muscle aches, fever, headache, nausea, fatigue, irritation, pain, swelling and redness at the injection site. This is according to the information provided by the Federal Drug Agency (FDA). Johnson and Johnson vaccine, just like the other vaccines, bears a significantly low potential of causing allergic reactions such as respiratory problems, swelling and rashes. Others include vomiting, diarrhea, swollen lymph nodes and tinnitus. While the above represent the range of mild reactions, a more severe but quite rare anaphylaxis reaction was found to affect a small section of recipients. The presenting symptoms of this condition include difficulties in breathing, dizziness, swelling of face and throat, increased heartbeat rate and rashes (Livingston, Malani & Creech, 2021).

Contrary opinion Regarding Johnson & Johnson

However, the Johnson and Johnson vaccine has also faced its fair share of setbacks with the most significant one being the temporary pause recommended by the FDA as a precautionary measure after some incidences of a rare blood clot (Mahase, 2021). A few weeks later, the Johnson and Johnson vaccine administration was resumed after the regulating agencies declared that the benefits of the vaccine largely outweighed the associated risks. However, the regulating agencies noted that women below 50 years should be made aware of the rare blood clot incidences.  On its part, the WHO declared that while monitoring of the vaccine for safety is still ongoing, Johnson and Johnson is safe and effective against the devastating effects of the virus.

Johnson and Johnson vaccine has also suffered another blow where a rare paralyzing disorder has been listed  by the FDA as having a possibility of occurrence within 42 days of administration. In the United States, out of 12.8 million recipients of Johnson and Johnson vaccine as of June 30^th 2021, a total of a 100 preliminary reports of the rare Guillain-Barre syndrome (GBS) and one patient’s death have been tabled. This disorder occurs when the immune system attacks the myelin sheath by mistake leading to weakening of the muscles and eventually paralysis (Shay, 2021).

In their warning, the FDA indicated that during 42 days after Johnson & Johnson has been administered, the recipient is at a higher risk of suffering the GBS syndrome although its occurrence is very rare. The other side effect that has been associated with the Johnson and Johnson vaccine is thrombosis with thrombocytopenia syndrome (TTS) (MacNeil et.al, 2021). Majority of these rare cases have been reported from women below 50 years and involve clotting of blood combined with low counts of blood platelets. This rare condition is treated using two main approaches which include plasma exchange and intravenous immunoglobulin.

Efforts around the world are geared towards providing protection against the virus to as many people as possible and also in the shortest time possible. Johnson and Johnson vaccine therefore stands as one of the best options of fulfilling this mandate due to its ease of administration, distribution and usage. This is especially compounded by the fact that it is a single dose shot meaning that it is highly suited even for populations that would not be guaranteed of receiving the second shot as recommended with other vaccines. Most importantly, various recent studies have shown that the benefits of receiving the Johnson and Johnson vaccine by far outweigh the risks associated and thus it has been highly recommended by regulating agencies and medical experts across the globe.

References

Livingston, E. H., Malani, P. N., & Creech, C. B. (2021). The Johnson & Johnson Vaccine for COVID-19. Jama, 325(15), 1575-1575.

MacNeil, J. R., Su, J. R., Broder, K. R., Guh, A. Y., Gargano, J. W., Wallace, M., … & Oliver, S. E. (2021). Updated recommendations from the advisory committee on immunization practices for use of the Janssen (Johnson & Johnson) COVID-19 vaccine after reports of thrombosis with thrombocytopenia syndrome among vaccine recipients—United States, April 2021. Morbidity and Mortality Weekly Report, 70(17), 651.

Mahase, E. (2021). Covid-19: US suspends Johnson and Johnson vaccine rollout over blood clots.

Shay, D. K. (2021). Safety Monitoring of the Janssen (Johnson & Johnson) COVID-19 Vaccine—United States, March–April 2021. MMWR. Morbidity and Mortality Weekly Report, 70.

Stephenson, K. E., Le Gars, M., Sadoff, J., De Groot, A. M., Heerwegh, D., Truyers, C., … & Barouch, D. H. (2021). Immunogenicity of the Ad26. COV2. S Vaccine for COVID-19. Jama, 325(15), 1535-1544.