Single-shot vaccine’s other advantages may soon outweigh lower efficacy, Fauci says

WASHINGTON — Johnson and Johnson’s forthcoming single-shot COVID-19 vaccine has more going for it than just a middling ability to prevent infection, the pre-eminent U.S. expert on infectious disease said Monday. 

Dr. Anthony Fauci, President Joe Biden’s chief medical adviser and the public face of the pandemic battle in the United States, is urging people to look past the shot’s 72 per cent efficacy rate. 

The Johnson and Johnson vaccine, expected to be the next one to receive emergency authorization from the U.S. Food and Drug Administration, has proven very effective at preventing death and hospitalization, Fauci said.

It’s also relatively cheap to manufacture. And it doesn’t require deep-freeze transportation and storage or double doses like its Moderna and Pfizer-BioNTech predecessors, both of which boast 95 per cent efficacy but are in short supply.  

“There’s a lot more to protection than just preventing (people) from getting infected,” Fauci told an online media briefing. 

“We want to keep people out of the hospital, and we don’t want people to die. And in that regard, this will be value-added, not only in the United States, but certainly in the developing world.” 

In South Africa, for instance, Fauci said his colleagues are looking forward to getting a vaccine that doesn’t have the logistical challenges of the Pfizer and Moderna offerings. 

“You cannot imagine how excited they are,” he said. “The idea of getting a minimal-cold-chain-required, cheap, one-shot vaccine means an awful lot.”  

Fauci, CDC director Rochelle Walensky and Andy Slavitt, the senior adviser to the White House COVID-19 response team, have been using their thrice-weekly briefings to educate the world about the many virtues of vaccination in a pandemic. 

It’s as much about denying the virus a “playing field” — an unvaccinated host, where it can continue to develop dangerous mutations — as it is about protecting individuals, they point out.  

And that requires as many vaccines and vaccinations as possible, as quickly as possible, everywhere around the world, not just in the United States.

“Not only are you going to protect individuals from getting disease, not only are you going to protect them from getting infected, but you are going to prevent the emergence of variants here in our country,” Fauci said. 

“The only way we’re going to completely stop mutants is if we stop this throughout the world.”

In an editorial in Sunday’s Wall Street Journal, former FDA commissioner Scott Gottlieb delivered a similar, if simpler, message: the more the merrier. 

“Crushing COVID will require making the most of the different vaccine candidates, which come with their own pros and cons, and tweaking them to stay ahead of viral mutations,” Gottlieb wrote. 

“New variants of COVID may demand vaccines that offer slightly different layers of protection and target slightly different parts of the virus. The regulatory process must encourage this kind of portfolio diversification, while allowing tweaks to keep ahead of the virus’s twists and turns.”

Dr. Theresa Tam, Canada’s chief public health officer, was asked last week whether different vaccines should be aimed at different demographic groups. 

Time will tell, Tam said. 

“We will have to look at the data in relation to that particular vaccine: in the clinical trials, what age groups were looked at and other specific information that will help us provide those recommendations,” she said. 

Different vaccines have different characteristics, and some may lend themselves to different applications than others, she added. 

“Those other kinds of characteristics and criteria — that will be reviewed for (on) who do we best use the supplies that we may get of new vaccines.”

More cases of the COVID-19 variants first identified in the United Kingdom and South Africa are being detected in the U.S. each day, although that could be in part because of improved detection methods, Walensky said. 

“CDC has been working on multiple fronts to improve our ability to adapt and understand these variants,” she said.

“The recent rise in the number of variants detected in the United States is likely due at least in part to our expanded ability to sequence their virus samples.”

This report by The Canadian Press was first published Feb. 1, 2021. 

—With files from Mia Rabson in Ottawa

James McCarten, The Canadian Press