High Hopes for Johnson & Johnson’s COVID Vaccine Have Fizzled in the U.S.

When Johnson & Johnson’s single-dose coronavirus vaccine was licensed for emergency use in late February, it was seen as a breakthrough in reaching vulnerable and isolated Americans, a crucial alternative to vaccines that require two injections within weeks. difference and more complicated storage. It soon became popular on college campuses, in door-to-door campaigns, and in hard-to-reach communities that often struggle to access health care.

But with just 11.8 million doses administered in the United States, less than 4% of the total, the single, ready-made vaccine has failed. States have warned for weeks that they may not find recipients for millions of doses that will soon expire, in part because the vaccine’s appeal waned after it was linked to a rare but serious blood clotting disorder and injections were taken. They went on hiatus for 10 days in April.

The vaccine took another hit last week, when regulators told Johnson & Johnson that it should discard tens of millions of additional doses produced at a plant in Baltimore because they could be contaminated. Diminishing supply and enthusiasm for the vaccine means its role in the United States is fading fast, even though millions of Americans have yet to get vaccinated.

It’s just not what I think anyone would have expected it to be when it came out, said Dave Baden, chief financial officer for the Oregon Health Authority.

Health officials in several other states presented an equally bleak picture. The Johnson & Johnson vaccine pause, they said, effectively pushed it aside for good; Only about 3.5 million doses have been used since the hiatus was lifted on April 23. Kim Deti, a spokesman for the Wyoming Department of Health, said the uptake chart in her state told the story of the vaccine – a significant spike in the first few weeks after it was released. , followed by a plateau that started around the break.

State officials initially expected the Johnson & Johnson vaccine to be a workhorse – a versatile, easy-to-store tool that they could store at mass vaccination sites, quickly reaching thousands of people they wouldn’t need to track down for a second dose. But after demand dropped, his goals became more modest.

It is being used in a smaller way this week at the Fiesta festival in San Antonio, the University World Series in Omaha, Nebraska, a celebration of the 19th in Johnstown, Pennsylvania, and an aquarium in Long Beach, California. At a food bank in Reno, Nevada, 12 doses of the Johnson & Johnson vaccine were administered on Thursday, said Jocelyn Lantrip, director of marketing and communications for the Northern Nevada Food Bank.

Between the small number of doses distributed and a lack of interest in them, public health experts say, the United States missed a critical opportunity to address health disparities with a vaccine that should have been ideal for reaching vulnerable populations. Dr. Chip Riggins, the regional medical director who oversees vaccination events in south central Louisiana, said few organizers have already requested the vaccine, even in a state with one of the lowest vaccination rates in the country.

In the early days of J&J, working with the African American community and the churches, the faith community here, was a very, very popular option, Riggins said. It hurts me that I’m not being accepted like before the break.

Dr. Jose R. Romero, Arkansas’s secretary of health, called the vaccine’s rapid decline a missed opportunity to reach the vulnerable in his state.

This is a vaccine that is very well suited to populations that we have trouble entering, he said. Now we are at the point where there are five or three people; never mind, we’ll open a vial.

Riggins said she had limited success in recent months shipping the vaccine to churches, casinos and even gas stations, including one in LaPlace, Louisiana, where organizers offered the vaccine Thursday. An international crew on a ship was delighted to be shot last weekend, Riggins said. But not being able to fully protect more people with a single dose, he added, was hampering the state’s progress.

Johnson & Johnson’s decline in the United States has coincided with declining demand for COVID vaccines overall. Almost 30 million doses of the Pfizer-BioNTech vaccine are unused, as are about 25 million of Moderna. But a total of 135 million people have been fully immunized with those vaccines, 11 times more than with Johnson & Johnson. Two-dose vaccines have a higher efficacy rate overall, about 95% versus Johnson & Johnson’s 72%, but studies showed that all three were highly effective in preventing hospitalization and death.

Alex Gorsky, CEO of Johnson & Johnson, said last week that he was still hopeful that the vaccine, which has been used in 25 countries, will help contain the pandemic abroad. The company has promised up to 400 million doses to the African Union. Separately, COVAX, the global vaccine exchange program, is supposed to receive hundreds of millions of doses.

We still believe this will be a very important tool in the general arsenal, Gorsky said at an event hosted by The Wall Street Journal.

But manufacturing problems at a Baltimore factory run by Emergent BioSolutions, the Johnson & Johnson subcontractor, have had dire consequences for the vaccine. Due to a major production mishap that resulted in a two-month shutdown, Johnson & Johnson has essentially been forced to endure the brunt of the pandemic in the United States, while Pfizer and Moderna, the other vaccine makers Licensed by the federal government, they provided nearly all of the nation’s vaccine stock.

Johnson & Johnson has had to dispose of the equivalent of 75 million doses, and regulatory authorities in Canada, South Africa and the European Union also decided to recall millions more doses manufactured at the Baltimore plant. The company has been able to deliver only a quarter of the 100 million doses it promised to the federal government by the end of this month.

Dr. Anne Zink, Alaska Medical Director, said that in her state, the Johnson & Johnson vaccine had become a victim of her own moment. In late February, when it was cleared by the Food and Drug Administration, Alaska had figured out how to bring two-dose vaccines to remote areas, leaving the single-injection regimen less crucial than it had initially envisioned.

Dr. Clay Marsh, West Virginia’s COVID-19 czar, said the hiatus and subsequent authorization from Johnson & Johnson, more than two months after Pfizer and Moderna, deprived it of a halo effect. The moment West Virginia had an ample supply of all three vaccines, he said, people began to have this concept that perhaps there is something better than being immunized with Pfizer and Moderna.

The Johnson & Johnson vaccine had also suffered a social network effect, said Andrew C. Anderson, a public health professor at Tulane University who researches vaccinations. Most Americans who were vaccinated in the first months of the vaccine campaign received injections from Moderna and Pfizer, so their friends and family were less likely to deviate and accept a different brand.

In Louisiana, New Orleans-area hospitals have begun offering the Johnson & Johnson vaccine to people leaving the emergency room; the idea is that people will be more willing to accept the vaccine when a doctor who has treated them asks them to take it. And in Arkansas, where only a third of the population is fully vaccinated, state officials are offering doses of Johnson & Johnson to workers in agriculture, manufacturing, wastewater and poultry, with gift certificates for licenses. hunting and fishing as a reward.

I don’t think the book on J&J is closed, said Dr. Joseph Kanter, Louisiana’s top health official. It just won’t change the rules of the game.

In West Virginia, authorities now expect to use about 20,000 doses of the vaccine at summer fairs and festivals and in parks, Marsh said. And in Oregon, Baden, the state health authority official said providers were working to deplete about 150,000 doses at correctional facilities and higher-throughput sites in Portland. The sharp drop in interest, he said, was tragic.

Onisis Stefas, director of pharmacy at Northwell Health, New York State’s largest healthcare provider, said she was still working on the original allocation of Johnson & Johnson’s system as of March, a sign that demand is slowing down. had cut down a long time ago. Doctors’ offices have ordered just 10 doses at a time instead of the 50-pack that the vaccine normally comes in.

In Michigan, where more than 200,000 doses of Johnson & Johnson go unused, officials are rushing to redistribute the vaccine to high-volume sites in hopes of administering them before they expire.

It’s just one negative news story after another about the vaccine, said Dr. Joneigh S. Khaldun, the state’s medical director.

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