Expert: Johnson & Johnson COVID-19 Vaccine Has Joined Group of Vaccines That Are 'The Path to Reclaiming Our Lives’

Pharmacy Times^® interviewed Amesh Adalja, MD, FIDSA, FACP, FACEP, a senior scholar at the Johns Hopkins Center for Health Security, on how the issuance of the proposed emergency use authorization (EUA) for Johnson & Johnson’s single-dose vaccine may impact the current COVID-19 vaccine distribution and administration process.

Alana Hippensteele: Hi, I'm Alana Hippensteele from Pharmacy Times. Today, I’m speaking with Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, on the implications of the recently released results of a new analysis by the FDA that show that the COVID-19 single-shot vaccine candidate by Johnson & Johnson provides strong protection against severe disease and may reduce the spread of the virus. With these results, the FDA could issue the EUA for this third COVID-19 vaccine candidate quite soon.

The vaccine was found to have 85% efficacy in the prevention of severe disease and 100% efficacy in the prevention of hospitalization and deaths. Why is this differentiation important to understand, and what does this mean in relation to the overall efficacy of the vaccine?

Amesh Adalja: It's important to remember that COVID-19 really garnered headlines because of its ability to kill, because of its ability to cause severe illness, and because of its capacity to compromise hospital capacity with a high rate of hospitalizations in certain individuals. That's what these vaccines are designed to combat, that's what this public health emergency is about, that's what flattening the curve was about—it was trying to keep the curve below hospital capacity.

So, when I look at a vaccine, the 3 things that matter are serious illness, hospitalization, and death—that's what I look at the most. I think that when you look at the Johnson & Johnson vaccine, it is very robust when it comes to those 3 variables and, as I said earlier, when you remove the ability of this virus to cause serious illness, to cause hospitalization, and to cause death, it's a much easier prospect to deal with.

We deal with many different respiratory viruses that spread every year, but they don't have the ability to cause disease at that level that requires hospitals to change their capacity management. I think that's the goal that I think of with these vaccines—it's not trying to get to COVID-19 zero. We're not going to get to COVID-19 zero. This virus has established itself in the human population, it's going to be with us. Our goal is to tame it, to defang it with these vaccines, so those are the numbers I look at: serious disease, hospitalization, and death. All of our vaccines, including the Johnson & Johnson vaccine, are very good at that. I think they are the path to normalcy, the path to reclaiming our lives.

Alana Hippensteele: Right. The FDA’s review found that the vaccine efficacy against severe COVID-19 was similarly high across the United States, South Africa, and Brazil, noting specifically a 64% efficacy rate against the South African variant. What does this mean in relation to this new vaccine’s ability to remain effective against COVID-19 variants that have emerged?

Amesh Adalja: It's great news because again what matters with the vaccine is its ability to stop serious disease, hospitalization, and death. The Johnson & Johnson vaccine, in the face of the South African variants, still was able to accomplish that, so I think that's great news.

Unfortunately, some of the headlines in the popular press had it the wrong way. I would have written the headline the way I just said, that the South African variant was no match when it came to severe disease, hospitalization, and death [in terms of] this Johnson & Johnson vaccine, and it did well in the face of [the variant]. I think that's what we have to keep focusing on is what we want these vaccines to do, and that's to reduce the harm that the virus is causing and never allow this virus to be able to compromise hospital capacity. The Johnson & Johnson vaccine doesn't even with the South African variant, where it may be a little bit more tricky when it comes to how well it blocks against symptomatic disease, but severe disease is where I draw the line, where it matters.