At a time when ongoing logistical challenges and new emerging variants of the coronavirus continue to threaten the global push for mass immunization against COVID-19, a new vaccine from Johnson & Johnson could provide critical assistance.
The vaccine, which is under review by the Food and Drug Administration for emergency use authorization, is more effective against new variants than other vaccines and does not require special freezers for storage or transportation.
Mansoor Amiji, distinguished university professor of pharmaceutical sciences, left, and chemical engineering at Northeastern and Brandon Dionne, assistant clinical professor in the department of pharmacy and health sciences. Matthew Modoono / Northeastern University Pictures
At the 66 percent effective in preventing COVID-19 in general, the Johnson & Johnson vaccine is less effective than the Moderna and Pfizer vaccines. Even so, the pros of this new vaccine outweigh the cons, says Mansoor Amiji, distinguished university professor of pharmaceutical sciences and chemical engineering at Northeastern.
“This is such a devastating disease. The need for vaccines is incredible, and being able to offer another vaccine candidate and increase production really overcomes any concerns about effectiveness, ”said Amiji.
Even with an overall efficacy of 66%, the Johnson & Johnson vaccine is considered a successful vaccine. The average flu vaccine is usually about 50% effective, says Amiji. In addition, the 66 percent effectiveness relates only to the overall clinical trial results. The Johnson & Johnson vaccine was 85 percent effective in the prevention of severe cases of COVID-19, and there were no deaths or hospitalizations among the group that received the vaccine in clinical trials.
“This is the challenge when it comes to effectiveness. Which endpoint are you using? For Johnson & Johnson, their definition was: How many people are diagnosed with symptomatic COVID-19? So, although the vaccine did not prevent symptomatic cases as well as the Moderna or Pfizer vaccines, it did a great job of avoiding hospitalizations and deaths, ”he says. Brandon Dionne, clinical assistant professor at the Escola de Farmácia do Nordeste.
A single dose regimen
Unlike the Moderna and Pfizer vaccines, which currently require a two-dose inoculation regimen, the Johnson & Johnson vaccine was designed to provide immunization in a single dose. The single injection system is preferable, Amiji says, as patient follow-up for the second injection may be inconsistent and delivery of the second dose is not necessarily guaranteed during the brief window of time when patients need to receive the second inoculation.
Although a single dose regimen is desirable, the company is also testing whether adding a second dose can increase effectiveness. The launch of a single dose system can now start the immunization process, while giving the company time to determine whether a second dose would be beneficial, says Dionne.
Storage and shipping
The Johnson & Johnson vaccine can be stored at the temperature of an ordinary refrigerator for up to three months, making it more accessible to smaller doctors’ offices or local pharmacies that do not have ultracold freezers needed to store other vaccines, such as Pfizer, a – 94 Fahrenheit.
In addition, the less temperature sensitive vaccine makes transport easier. Many trucks and transport planes are already equipped with the technology needed to cool the Johnson & Johnson vaccine, says Amiji.
“These vaccines need to reach large masses around the world,” says Amiji. “When we look at early vaccine distribution, most of the effort has been to vaccinate developed nations, but for this pandemic to come to an end, we have to think about going beyond those borders.” Fewer obstacles in transport and storage can help the vaccine reach more remote areas.
Protection against new variants
New variants of the virus, which have emerged in the UK, South Africa and Brazil, have raised concerns about whether vaccines currently in distribution will continue to protect patients from new strains. The South African and Brazilian variants, called B.1.351 and P.1 respectively, present the greatest challenges because of the mutations that affect the same part of the virus – the spike protein – that vaccines mimic to create immunity.
The South African government recently suspended AstraZeneca vaccine distribution plan after a study – although limited and not yet peer-reviewed – found that the vaccine provided only “minimal protection”Against B.1.351.
Clinical trial data for the Johnson & Johnson vaccine, which was collected in several countries while new variants were already in circulation, showed that the vaccine 66 percent effective in South America and 57 percent effective in South Africa.
Laboratory results for the Moderna and Pfizer vaccines, which underwent clinical trials before the emergence of these new variants, show that both vaccines provide comparable protection against the UK variant, called B.1.1.7, but decreased effectiveness against B.1.351 and P.1.
But even with these results, the researchers are not sure how the Modern or Pfizer vaccine interacts with the new variants. “You cannot fully imitate the immune system in a laboratory,” says Dionne. “Even though there appears to be reduced effectiveness in the laboratory, we don’t really know how it works in the human body.”
As a precaution, companies are test whether booster doses can increase protection against new variants.
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