Johnson & Johnson’s vaccination break is making it harder to immunize hard-to-reach populations against Covid
A homeless man wearing gloves and a protective mask sits with a sign that reads “Seeking Human Kindness” amid the coronavirus pandemic on April 19, 2020 in New York City, United States.
Alexi Rosenfeld | Getty Images Entertainment | Getty Images
The Johnson & Johnson Covid vaccination break It may not slow the overall pace of US vaccine adoption much, but it will make it harder for hard-to-reach populations to get a chance.
In response to the Food and Drug Administration’s request on Tuesday that states temporarily suspend use of the J&J vaccine “out of caution” after six women developed a bleeding disorder, White House Tsar Covid Jeff Zients said the Announcement would have no impact on the US vaccination program.
“We have more than enough supplies of Pfizer and Moderna vaccines to continue the current pace of around 3 million shots a day,” Zients told reporters at a news conference.
So far, this has been the case. The country reports an average of 3.3 million daily vaccine doses given in the past week, and 3 million if only Pfizer and Moderna are counted. Only about 7.8 million of the total of 202 million recordings in the US are from J&J, according to data from the Centers for Disease Control and Prevention.
However, Johnson & Johnson’s single-shot vaccine makes up about 10% of all fully vaccinated people in the United States, a percentage that has been on the rise for weeks, and it has proven valuable in specific situations and communities.
“Because of the nature of the J&J vaccine, it is often used for specific circumstances and populations who have been more difficult to obtain vaccines for,” said Josh Michaud, associate director of global health at Kaiser Family Foundation.
Bulky vaccination centers and mobile vans that deliver doses to be administered on the go are likely to have an easier time with Johnson & Johnson’s storage requirements, Michaud said. This vaccine only needs to be kept in a standard refrigerator, while the requirements for Pfizer and Moderna are stricter.
And for certain population groups, such as B. Administering a two-dose regimen can be challenging for prisoners moving to another facility or homeless people who are not permanent residents. Many states have used the J&J vaccine on these groups because Michaud says it is difficult to find people to give a second dose.
The one-shot option may also be more appealing to those who are more reluctant to get a vaccine. A survey by the Kaiser Family Foundation in March found that among those who say they want to wait and see how the vaccines work before self-vaccinating, a greater proportion will get the J&J single-dose vaccine compared to either Dosage options would get.
One in six people in the “wait and see” group said they would “definitely get” the J&J vaccine, while roughly one in ten said the same thing about the Pfizer or Moderna vaccines.
“We know there is a significant section of the people on the fence who are concerned with vaccines in general,” said Michaud. “And I think the J&J vaccine is actually a plus for this group. It’s a big selling point for people on the fence.”
Add all of these factors together and the J&J hiatus could “have a major negative impact on US vaccination rates,” he said.
It is not yet clear how long the Johnson & Johnson vaccine discontinuation will last. The Chief Medical Officer of the White House, Dr. Anthony Fauci said the break could last anywhere from a few days to a few weeks.
Vaccinate homeless people
Shelly Nortz, assistant executive director of politics at New York City-based advocacy group Coalition for the Homeless, said Johnson & Johnson’s vaccination break will make it harder to get pictures of the populations she works with.
The coronavirus has hit the homeless in New York hard, especially those in community housing. An analysis by the Coalition for the Homeless and New York University found that the age-adjusted mortality rate for homeless homeless New Yorkers as of February was 49% higher than the citywide rate.
And while the New York homeless vaccination campaign is off to a solid start – Nortz said the city’s latest announcement showed about 4,500 fully vaccinated single homeless adults out of a total of 21,000, a pace not far below the nationwide rate – the J & J-stop will be a hurdle.
“Everyone was very excited about the unique situation with J & J,” she said, “especially for people who are unprotected and therefore not predictably in the same place.”
The Coalition for the Homeless recently partnered with the Center for Urban Community Services, which provides mobile medical care across New York, to deliver the Johnson & Johnson vaccine to one of its emergency food locations. This program is now on hold, as are discussions about offering the J&J vaccine at the group’s headquarters, where many customers come to collect their mail.
Dr. Van Yu, chief medical officer at CUCS, agrees that a Pfizer or Moderna two-dose schedule makes things a lot more complicated.
“If you live outside, how will I find you in four weeks?” he said.
Yu said the protection system can make it easier to keep track of people, but there is still a lot of churn as people come and go or be assigned to one of the hundreds of protected areas in New York City.
Nortz said the ease of keeping the J&J recordings is another benefit of vaccinating the homeless.
“The fact that the other two approved vaccines require freezer storage in one case makes it very difficult to do anything mobile or pop-up or with an unknown number of people,” she said.
Zients announced Tuesday that all vaccine delivery channels, including mobile delivery units, are equipped to deliver all three vaccines. Yu said the Moderna vaccine was easy to use in his group’s mobile locations, but due to the extremely cold refrigeration requirements of the Pfizer vaccine, it wasn’t an option.
He currently sits on 185 unused J&J doses and has no access to Moderna vaccines.
Some homeless people in the South Bronx, where Noel Concepcion works as the adult homeless service director for the nonprofit group BronxWorks, have preferred the J&J vaccine because only one dose is required. However, the hiatus and associated misinformation makes it harder to tell a group already skeptical of the government the importance of vaccination, Concepcion said, and this could lead to some reluctance to all three vaccine options.
According to Concepcion, BronxWorks had to cancel a vaccination event in order to take advantage of the existing range of J&J recordings due to the break.
J&J is more convenient for many working professionals
Other barriers to getting a Covid vaccine, such as an inflexible work schedule or responsibility for childcare, have made Johnson & Johnson’s single-shot vaccine an essential option for some.
Liz Schwandt, who leads a volunteer group called Get Out the Shot designed to help people book vaccination appointments in Los Angeles, said many of the callers on her team’s hotline don’t have traditional work benefits or protections like work interruptions. Many of them are domestic servants such as house cleaners, private nannies or gardeners who are paid in cash from the books. Some are employees who don’t have a 9-to-5 job, like the group of night shift guards that Get Out the Shot recently booked appointments for.
Elizabeth Raygoza receives her Pfizer vaccine from nurse-certified Alyssa Hernandez on March 17, 2021, when the City of Vernon Health Department staff used the city’s new mobile health unit clinic to provide nearly 250 food processing workers with COVID-19 vaccinations to be administered Rose & Shore, a major local convenience food manufacturer serving supermarkets, schools, restaurants, airlines and others.
Al Seib | Los Angeles Times | Getty Images
“We hear stories all the time like hey, my employer lets me get the vaccine but doesn’t give me any free time,” she said, adding, “for a working family that misses a four-hour shift [for a vaccination appointment] can be a huge loss of wages. ”
According to Schwandt, the responsibility for childcare and the dependence on public transport also make attending multiple appointments more tedious.
While Get Out the Shot is booking appointments for all three vaccines, Schwandt said the FDA’s first approval of the J&J vaccine in February was welcome news.
“We were so excited,” she said. “We loved having the one and done option for people.”
A CDC panel on Wednesday postponed a decision on Johnson & Johnson’s Covid vaccine while investigations into the bleeding disorder continue. The panel is expected to meet again next week and decide what to recommend to the CDC.