• September 27, 2023

With a Third Vaccine, from Johnson & Johnson, Are We Finally Winning Against COVID-19?

Optimism is one of the things that the coronavirus pandemic has made difficult to pin down or even measure. Browsing the data can affect a person’s state of mind. Last week, Johnson & Johnson announced that studies of the COVID-19 vaccine had an efficacy rate of greater than sixty-six percent in preventing moderate to severe illness and 85 percent in preventing severe to critical cases – and that no one had the vaccine received, hospitalized, or died of Covid-19. On Friday, the Food and Drug Administration’s Vaccine Advisory Board unanimously agreed that it would be the third vaccine to receive emergency approval in the United States. It could be used as early as this week.

Illustration by João Fazenda

Should sentiment be affected by knowing that Pfizer-BioNTech’s and Moderna’s two previously approved vaccines are more effective – around ninety-five percent? (Not really; the J. & J. numbers are still very good.) Alternatively, the mood should get a boost knowing that unlike the Moderna and Pfizer vaccines, only one J. & J. shot is required and that the vaccine can be kept in a normal refrigerator? (Definitely.) Are there any signs that, along with the end of the holiday season and increased willingness to wear masks, vaccinations will ultimately change the course of the pandemic? (Yes, the average daily number of new cases in the US has fallen by three quarters since the start of the year. Globally, the number is half what it was before.) Fortunately, the highs seem to be getting better.

However, joy can be hard to come by because of the weight of the land. The average daily death toll is around two thousand – a sharp drop from mid-January when it was well over three thousand, but four times what it was last July. And as February drew to a close, progress seemed to stagger a little – perhaps because extreme weather was causing disruption or, more threateningly, because seemingly more contagious varieties were spreading.

The biggest brake on optimism concerns these variants: the British, the Brazilians and the South Africans. The J. & J. vaccine has performed well in large-scale studies in South Africa. There is evidence that other vaccines against this variant, or apparently against the Brazilian variant, will not work quite as well, although vaccine manufacturers are working on boosters to address this problem. The vaccines appear to be effective against the rapidly spreading British variant. However, there are concerns that variants could outperform vaccinations. The race is still on: a new variant with worrying mutations appears to be gaining ground in New York City.

Two White House memorial services last week symbolized the alternation between pain and progress. The first took place on the south portico on Monday evening, which has seen half a million US COVID-19 deaths. Before calling for a moment of silence, President Biden urged Americans not to “go numb with grief.” Just three days later, Biden, with Vice President Kamala Harris and Dr. Anthony Fauci, how four front workers took their first pictures at an event entitled “50 million COVID vaccinations”. The “50 million”, as Biden clarified, only related to the number of doses given since his inauguration. The total approaches seventy million doses, with twenty million people fully vaccinated. Biden offered a stream of jokes about the shot not really hurting, then warned, “This is not a winning lap.” But he added, “We’re getting closer.”

It’s hard to cheer when the vaccine distribution has been so chaotic. Donald Trump had no real plan and left matters like eligibility to the states. The Biden administration was much more involved, but the system remains fragmented. Just because you are eligible to get a vaccine in New York doesn’t mean you are eligible in Massachusetts or Georgia. A controversial question is whether prioritizing K-12 teachers should be a requirement for schools to reopen. They are approved for vaccines in about thirty states, and only in certain counties in some others. Often times, if you’re eligible, you still need a lot of free time and technical access to make an appointment. Racial and class differences abound, along with a certain arbitrariness. However, if you just look at the raw numbers, people in the US are vaccinated almost twice as often as in Germany. (And both the US and Germany are better positioned than much of the developing world when it comes to supply.)

One measure of how difficult it can be to think about the next chapter in the pandemic is the discussion of “vaccination records”. The idea is that a person’s vaccination status – possibly documented by an app – could open doors that would otherwise be closed. But which doors? Obtaining a vaccination before traveling to another country is a familiar practice. There are difficulties with access to jobs and whether vaccinated people should be encouraged to act like COVID-19 is no longer a factor – going to large indoor weddings, crowded theaters, and busy restaurants – when vaccines are not widely available and vaccinated people may still be present, spreading the disease, albeit to a lesser extent.

Conversely, some fear that downplaying vaccines could increase people’s reluctance to vaccinate. (The hesitation about vaccines is worrying. A third of the military who have been offered a vaccine have turned it down.) With that in mind, the vaccines highlight, rather than addressing, a central dilemma of this brutal but unevenly experienced pandemic: how to be rational Balancing taking risks with community commitments and realism about what lies ahead. For example, it is reasonable to expect vaccinated people who gather at home with vaccinated friends and relatives to continue wearing masks in public settings.

The winter wave is coming to an end, and with luck and vigilance, there is every chance that we won’t see it again soon, even if the coronavirus and its offspring lag behind. Fauci recently told CNN that he thought life could return to its usual patterns by the end of this year and that Americans may still be wearing masks in 2022. As he put it, “It really depends on what you mean by normality.” One can get used to too many intolerable things in the course of a long pandemic. But it would be disastrous to go deaf to hope. ♦

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