Johnson & Johnson vaccine: what happens next for the Covid-19 single dose vaccine

Last week, the director of the National Institute of Allergy and Infectious Diseases, Dr. Anthony Fauci, said Johnson & Johnson is “very close” to seeking emergency use authorization for its Covid-19 vaccine from the Food and Drug Administration USA.

The company said it is on track to have provisional data from its clinical trial by the end of January. The company has a shareholder call on its fourth quarter results on Tuesday.

Still, it may take weeks for the vaccine to go through the US Food and Drug Administration authorization process and it is still unclear when any of these major steps will take place.

The two vaccines already available in the United States are highly effective, but all eyes are on Johnson & Johnson, which is a single dose and would be much easier to administer.

“If this vaccine proves to be safe and effective, it could have important implications for the launch of the vaccine because J&J has committed to producing and implanting at least one billion doses of vaccine during this calendar year, including at least 100 million doses for the vaccine. US population, “said Dr. Dan Barouch of Harvard Medical School, who helped develop the Johnson & Johnson vaccine candidate.

“If it is a single dose vaccine, then one billion doses of vaccine would translate into one billion vaccinated people,” Barouch said on Monday on CNN’s Coronavirus Fact vs Fiction podcast.

Waiting for test results

The J&J Phase 3 trial involves 40,000 volunteers; the company reduced the trial to 60,000 because of the increase in Covid-19 cases across the country.

As with other Covid-19 vaccine tests, the goal is to see how well the vaccine protects participants. The company recruits people from different demographic groups and people with different health conditions. The researchers give the vaccine to half the group and half a placebo, which does nothing, and then monitor who gets sick and whether safety problems arise.

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The results of the J&J Phase 1 / 2a trials showed that the single dose of the vaccine induced a strong immune response in almost all people who received the vaccine. The immune response was similar in all age groups, according to the company.

“A single dose would have major logistical implications,” said Michael Haydock, senior director at Informa Pharma Intelligence. “In terms of implementation, it could really speed up and simplify things considerably.”

The United States has ordered 100 million doses and the company makes them while testing the vaccine. Typically, companies expect to make the vaccine after approval, but that changed during the pandemic.

“Sure, the big question is, will it work?” Haydock said.

Authorization steps

Once there is an answer to that question, the data will be closely examined by the FDA and consultants at the Centers for Disease Control and Prevention in the United States.

The process for the Johnson & Johnson vaccine should be the same as for the Moderna and Pfizer vaccines, according to Dr. Paul Offit, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia and a member of the FDA Vaccines and Related Committee Biological Products Advisory.

The change in leadership of the FDA and CDC should not make a difference in the length of the process.

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“I don’t think that will change with the new administration,” said Offit.

If data from the Phase 3 trial shows that J&J’s Covid-19 vaccine works and is safe, the company will request what is known as the FDA’s emergency use authorization, or USA.

Under a USA, the FDA will allow the use of unapproved medical products to treat or prevent serious or potentially fatal illnesses when there is no suitable or approved alternative. FDA career scientists and doctors will conduct a comprehensive review of the data to determine whether the results meet the criteria.

While the FDA analyzes the data, it schedules a public meeting of its Vaccine and Related Biological Products Advisory Committee. The committee is made up of independent scientists and public health experts who will discuss J&J data and make recommendations to the agency.

After the meeting, FDA team members consider the committee’s contribution along with the agency’s assessment of the company’s data and will make a decision on whether the vaccine should be authorized.

With the Pfizer vaccine, it took just over three weeks from the time the company sent its data to a USA. With the Moderna vaccine, it took just over two weeks.
Shortly after a USA, the CDC’s Immunization Practices Advisory Committee, also known as ACIP, analyzes the data as well.

ACIP is a group of medical and public health experts who make recommendations on how the vaccine should be used in the population. The committee’s suggestions become the guideline used to determine which demographic groups should receive the vaccine.

Once the CDC committee makes a recommendation and it is approved by the CDC director, vaccines can be sent and go to arms.

Amanda Sealy of CNN contributed to this report.

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