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Johnson and Johnson single-shot vaccine appears 66% effective in global trial

186 points by heyheyheysome 6y ago

GizmoSwan 6y ago
66% effectiveness in one shot is better than 50% - 1/2 shots where there is not enough vaccines to go around. In some places people are not getting both shots of vaccines. FDA approved two different shots of 2 shot vaccines. At this time they should just immunize everybody with one shot at least.
- cj 6y ago
  Have any trials been done to determine the efficacy of just 1 shot for the double dose vaccines?
  - yread 6y ago
    Not yet, but you can kinda see it from the data. For Pfizer it was 60-70 after one dose already, iirc
    - bpodgursky 6y ago
      That's only if you include all infections within the two week window between shots. If you look at the tail end (ie, after the shot has time to be effective) it seems more like 90.
      - zeku 6y ago
        The issue with this is that it's the SECOND shot that gives you your long term immunity. If you only get one shot your immunity is allegedly going to wane somewhat quickly. edit: for pfizer & moderna.
        randomopining 6y ago
        Where did you see that part? Any reason why the 2nd one makes it last that much longer?
        bluGill 6y ago
        That is typically how the second shot works. We don't actually know. It is possible the second shot isn't needed at all. It is possible that the first shot works for 45 days and then stops working completely. Experts doubt both of these extremes, but cannot actually say they are false because they don't know.
  - GizmoSwan 6y ago
    Yes they have data for results of 1 shot of 2 shot vaccines. Moderna has 80% in single shot I believe but it degrades over time so there is a second shot. The 66% that does not degrade and can be kept in room temperature is not bad at all. Most vaccines are not 90%. Most flu vaccine don't cover all different types but they still protect people as they get some sort of immunity to major types A,B etc.
- fattire 6y ago
  Would a partial or half immunized population not end up culturing a more resistant strain?
  - elliekelly 6y ago
    Or could it end up culturing a more mild strain? More like a common cold?
    - eganist 6y ago
      Worth pointing out that two of the viruses[0][1] responsible for the Common Cold share the same exact Family (in fact, the exact Genus[2]) as SARS-CoV-2 [3]. This isn't to say that the progression is certainly in this direction (better evidence of that dates back to 2009 [4]), but hey, there's hope that that's the direction. [0] https://en.wikipedia.org/wiki/Human_coronavirus_HKU1 https://en.wikipedia.org/wiki/Human_coronavirus_HKU1 [1] https://en.wikipedia.org/wiki/Human_coronavirus_OC43 https://en.wikipedia.org/wiki/Human_coronavirus_OC43 [2] https://en.wikipedia.org/wiki/Betacoronavirus https://en.wikipedia.org/wiki/Betacoronavirus [3] https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndrome_coronavirus_2 https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndr... [4] https://www.scientificamerican.com/article/pandemic-payoff/ https://www.scientificamerican.com/article/pandemic-payoff/
  - syntheticnature 6y ago
    This isn't like antibiotics. The 66% is how many people are provided some level of immunity, just reducing the infectible population; it doesn't directly cause issues for the virus the way an antibiotic interferes with the functioning of a bacterium. It might culture a strain that's better at infecting folks for whom the vaccine doesn't prove effective, if there's a common factor there and the virus can use it. It is not yet known if any of the vaccines completely prevent infection; there are concerns the vaccinated might still be able to be asymptomatic carriers.
    - fattire 6y ago
      Yeah I guess I was asking if having only partial-immunity effectively acts as a filter or creates pressure so that rarer mutated strains make it through and are given a pathway to infection/reproduction. From your response: "It might culture a strain that's better at infecting folks for whom the vaccine doesn't prove effective, if there's a common factor there and the virus can use it." it sounds like the answer is yes.
JamesBarney 6y ago
66% protection against getting moderate to severe Covid but 100% protection against death and hospitalization. I have no idea how the FDA can hold back these vaccines in good conscience while peoples are dying by the thousands on a daily basis.
- gogopuppygogo 6y ago
  Unpopular opinion: the FDA has to justify their existence. If vaccines can be developed safely and deployed quickly, inexpensively, and in large quantities all without FDA then people would realize how bloated our government really is.
  - Traster 6y ago
    We saw this with Boeing - as the private company realised that the regulatory body wasn't going to hold it accountable, the private company started trading off profit versus safety with the result being lower short term costs and more dangerous planes.
  - happytoexplain 6y ago
    >If vaccines can be developed safely ... without FDA You forgot a critical distinction: safely every time
    - Jtsummers 6y ago
      Doesn't need to be every time, it "just" needs to meet or beat the current FDA record. The FDA has approved treatments in the past that turned out to be harmful for substantial numbers of people. If the industry could reliably replicate the FDA's present track record (which is, overall, very good) then the FDA could be shown to be unnecessary. However, having worked in regulated industries I do not trust industry to do any better than the FDA. At least not in the long term.
  - joncrane 6y ago
    I think this is a bit of a disingenuous approach. There's a slippery slope here. Just because "humanity, including giant healthcare conglomerates who stood to profit came together to fast track vaccines against a deadly global pandemic" it doesn't mean "regulation of the vaccine and drug industry is pointless." If the FDA were to relax its standards across the board due to this one success in the face of an anomaly, you'd better believe drug manufacturers would be fast tracking dangerous drugs. Heck even in the current regulatory environment dangerous products make it through. As evidenced by all the ads I see for litigation based on harm caused by various already-approved (in a non-fast track manner) drugs that have made it to the market in the last decade.
SubiculumCode 6y ago
imo 66% effectiveness is pretty good, not on a personal level, but at the population policy level. I'm glad to get another vaccine on the market soon.
- foepys 6y ago
  On the other hand it's quite sad that we as humanity have already developed two vaccines with 95% (or even higher) effectiveness but are not able (or rather: are too greedy) to share this knowledge to vaccine every human on earth as fast as possible. Instead the US and Europe are putting trade restrictions in place to keep the vaccines for themselves. India and China are more than capable to produce the vaccines in insane quantities but IP law doesn't let them.
  - aphextron 6y ago
    It's not a tech problem, it's a production problem. There are only a few companies on earth that are capable of producing the precursor chemicals for these mRNA vaccines, and until now they were geared towards producing small batch research drugs. They are expanding rapidly but production capacity is at 100%.
    - throwaway2245 6y ago
      If we could (globally) build emergency public hospitals, why can't we build emergency public production facilities?
  - formercoder 6y ago
    Yeah I just don’t understand why we can’t put the full industrial capacity of the U.S. government behind this. I’m genuinely curious about the on-the-ground details which make manufacturing this stuff hard. Would love to see the playbook for raw materials to vial of vaccine.
znebby 6y ago
I'm really struggling to understand these numbers. In some other articles I'm seeing that it offers 100% protection against hospitalisation and death. "The J&J vaccine was 85 per cent effective at preventing severe Covid-19. Twenty-eight days after the jab, it offered “complete protection” from hospitalisation and death." [1] Wouldn't having "severe" infection require hospitilisation? [1] https://www.ft.com/content/d05c7c57-da11-42a1-aa33-b66052c904ac https://www.ft.com/content/d05c7c57-da11-42a1-aa33-b66052c90...
- roywiggins 6y ago
  I've seen "severe" be measured by oxygen saturation; some people are able to manage severe COVID at home. Some people have to, because there simply isn't any hospital in their area with space for them.
  - spookthesunset 6y ago
    > Some people have to, because there simply isn't any hospital in their area with space for them. Citation needed on that one. There is a lot of media fearmongering out there that results in outliers and things that are normal practice getting taken out of context and blown up into something scary.
    - roywiggins 6y ago
      You can see it in statistics. When the hospitalization starts dropping while case counts are going up, it's because more cases are being managed at home. Prioritizing critical care is normal when care is in short supply, but it means that you are more likely to have to deal with COVID at home when the local healthcare system is overstressed. > on Nov. 1, the Covid Tracking Project’s seven-day average showed about 80,000 new cases — which we would predict should lead to about 2,800 new hospitalizations a week later, by Nov. 8. Instead, there were 2,600, a little fewer than expected. On Nov. 15, we had 146,000 new cases, which should have resulted in about 5,100 new hospitalizations by Nov. 22. However, there were fewer than 3,700. This pattern of declining rates of hospitalization continued through the end of November. > What is happening is pretty simple: Because hospitals are filling up, they are admitting fewer and fewer people. Any doctor or nurse will tell you that as the demand for beds soars, the threshold for admission rises with it... > The decision on whether to admit a patient depends on two things: clinical judgment and bed availability. Critically ill patients will always be admitted. But as hospitals start to fill up, those who are less sick — younger covid patients, or those whose oxygen levels aren’t yet dangerously low — get sent home. These patients would be safer in a hospital bed, but there isn’t one available for them anymore. https://www.washingtonpost.com/outlook/2020/12/07/covid-hospitalization-rates-dropping/ https://www.washingtonpost.com/outlook/2020/12/07/covid-hosp...
mchusma 6y ago
The contrast between the response to Astrazeneca and J&J is striking. Similar efficacy numbers, but Astrazeneca is still banned and got terrible headlines. J&J has all positive headlines. I don't know if this is just because more time has passed and people realize it was dumb to not approve Astrazeneca? Is "Supercovid" just making people realize we can't wait around? I think J&J, Astrazeneca, and Novavax all easily surpass the "net expected benefit" threshold and should all be approved immediately. In the US, this would allow us to end this thing within 90 days.
- deleted 6y ago
  [deleted]
- GizmoSwan 6y ago
  Germany is approving Astrazeneca with some sort of limitation.
  - eli 6y ago
    It was just approved by the EU and is already being distributed in the UK.
    - GizmoSwan 6y ago
      Yes but they don't have sufficient data for older adults on it so that is the limitation.
- mchusma 6y ago
  BTW - I do think it would be more helpful if you report on the numbers between vaccines to use your primary metric as "100% Effective at Preventing Death", then use 68% or whatever as your secondary metric. This better reflects the differences between the vaccines so far. All are amazing at protecting against what people care about most.
- UncleOxidant 6y ago
  Yeah, I don't get why the Astrazeneca vaccine approval in the US is being delayed till (reportedly) March. Is it because Pfizer and Moderna are US companies charging a lot more money vs. Oxford/Astrazeneca being UK and not making any money on their vaccine?
Exmoor 6y ago
I suspect the title was abbreviated to fit HN length requirements, but it cut out perhaps the most important part. This data is for a single shot. There is an ongoing trial for boosting with a second shot down the line, but having a single shot that's known to be effective at eliminating the disease and extremely effective at reducing severe cases and hospitalizations is a game changer. We can vaccinate lower risk populations with this vaccine and do it twice as fast. Once everyone is vaccinated, we can invite people to come back for a second shot as a booster. From the phase 1/2 trial data I saw, I'd expect a second shot to boost the efficacy to numbers approaching the mRNA vaccines. Edit: It also only needs to be refrigerated so it eliminates a lot of coordination related to frozen transportation, scheduled appointments, etc. will be eliminated.
- interestica 6y ago
  What is the optimal vaccination strategy? So far, it just seems like we're following "vaccinate healthcare workers and the most vulnerable" and that, on the surface, seems intuitive. But is there some other sort of algorithm that can determine the best way to reduce overall transmission the fastest? Random vaccinations? Targeted groups in different regions? Double shots for vulnerable before single shots for others? Mobile vaccination services?
  - bagacrap 6y ago
    well we definitely shouldn't be vaccinating people who've had and recovered from the virus before we vaccinate other who haven't, and we most likely shouldn't be giving out second shots before more people get a first shot. Of course individual risk and exposure plays a role, but the incremental protection conferred by the second shot in the arm of a person who's already recovered from covid is pretty low, even if they are a healthcare worker.
    - interestica 6y ago
      > we most likely shouldn't be giving out second shots before more people get a first shot. It's mostly thinking out loud because sometimes the most effective solution is a bit counter-intuitive. There may be some value in getting more people to a guaranteed 100% protection. Right now, in Canada, we seem to be following an intuitive route. But in BC, they've already administered ~4000 second doses. (Likely only in long term care facilities). https://www.cbc.ca/news/canada/british-columbia/covid-19-update-jan-29-1.5894208 https://www.cbc.ca/news/canada/british-columbia/covid-19-upd... So it seems like the strategy there may be to get those residents to 2 shots before others.
lurkmurk 6y ago
Is there some resource that compares all the vaccines, an article or a blog post? I would guess that a vast majority of people don't have time/knowledge to look into official reports. One big table with different companies, number of people in trials, results etc. would be nice. For example, what I just found out is that Moderna is actually not 95% effective on all age groups but on 18-65 [1]. Back to J&J. How old were the 15% that did develop the most serious symptoms? The article says that "more than 40 per cent had other illnesses [...] including obesity, diabetes and HIV." Isn't the base rate for obesity in a population something like that or higher? Finally, if we just look at the numbers (if they are even comparable), can we objectively rank these vaccines by how good they are? No ones feelings should be hurt if we can conclude that their vaccine is close to useless (think of how vaccinated population will demand loose measures although 40% of them are still at risk). [1] https://www.bbc.com/future/article/20210114-covid-19-how-effective-is-a-single-vaccine-dose https://www.bbc.com/future/article/20210114-covid-19-how-eff...
- matteotom 6y ago
  It's not exactly a table, but NYT has a vaccine tracker with much of this information https://www.nytimes.com/interactive/2020/science/coronavirus-vaccine-tracker.html https://www.nytimes.com/interactive/2020/science/coronavirus...
boulos 6y ago
I find the Johnson and Johnson Press Release [1] more informative. It gives a lot more detail on the study, including linking to their protocol [2]. It’s unfortunate, but the different vaccine trials all have different demographics and different measures of efficacy. IIRC, the Moderna “95%” is not “only 5% developed COVID” but rather “95% didn’t end up showing any symptoms” while AstraZeneca was doing weekly testing (again this is from memory). With so many people being asymptomatic, the difference between “95%” and “66%” is in the details (which is definitely why Johnson and Johnson also highlight their 72% in the US, and 85% against hospitalization/death). tl;dr: each vaccine group made reasonable, independent choices for their effectiveness metrics, but they’re not the same metric. [1] https://www.jnj.com/johnson-johnson-announces-single-shot-janssen-covid-19-vaccine-candidate-met-primary-endpoints-in-interim-analysis-of-its-phase-3-ensemble-trial https://www.jnj.com/johnson-johnson-announces-single-shot-ja... [2] https://www.jnj.com/coronavirus/covid-19-phase-3-study-clinical-protocol https://www.jnj.com/coronavirus/covid-19-phase-3-study-clini...
- xiphias2 6y ago
  Also the results of this vaccine isn't that difference from just using 1 shot of another vaccine. It looks like as long as it's safe to do it, the 2nd shot is worth it.
- m-ee 6y ago
  They do not have different measures of eficacy. AZ did more testing to look at symptomatic infections but that was not used in the primary efficacy calculation. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32661-1/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
  - boulos 6y ago
    I believe AZ was doing weekly testing while Moderna (maybe?) was doing “test if symptomatic”. That’s a huge difference.
    - m-ee 6y ago
sradman 6y ago
The NIH news release Janssen Investigational COVID-19 Vaccine: Interim Analysis of Phase 3 Clinical Data Released [1]: > An investigational COVID-19 vaccine developed by Janssen Pharmaceuticals appears to be safe and effective at preventing moderate and severe COVID-19 in adults, according to an interim analysis of Phase 3 clinical data conducted Jan. 21. The vaccine, called Ad.26.COV2.S or JNJ-78436725, requires only a single injection and can be stored in a refrigerator for months. > The interim analysis assessed 468 cases of symptomatic COVID-19 among 44,325 adult volunteers in Argentina, Brazil, Chile, Colombia, Mexico, Peru, South Africa, and the United States. The investigational vaccine was reportedly 66% effective at preventing the study’s combined endpoints of moderate and severe COVID-19 at 28 days post-vaccination among all volunteers, including those infected with an emerging viral variant. [1] https://www.nih.gov/news-events/news-releases/janssen-investigational-covid-19-vaccine-interim-analysis-phase-3-clinical-data-released https://www.nih.gov/news-events/news-releases/janssen-invest...
azinman2 6y ago
Bloomberg quoted “No severe allergic reactions,” to the J&J, yet my cousin-in-law is in the hospital right now with Guillain–Barré syndrome following the J&J clinical trial shot. Granted this is rare and can happen with any vaccine (I believe?), but it’s pretty strange to read about the lack of negative reactions when I personally know someone who has been affected. NB: I’m not advocating there is anything largely wrong or unsafe about it.
- graeme 6y ago
  Guillan barré syndrome is not considered an allergic reaction to the best of my knowledge. So your brother’s case doesn’t contradict the claim. And yeah GBS can happen with any vaccine but more importantly also from viral infections. Generally more frequently from the viruses themselves.
xxel 6y ago
Nothing new from Johnsosn and Johnsons. Johnsons and Johnsosn shampoo wash hair 66% too.
tpmx 6y ago
The mRNA vaccines are obviously the gold standard, they're what you want, if you're in a position to pick. The traditional vaccines, like this one and the Astra Zeneca one appear to be efficient at preventing hospitalization/death. That's great - it will ease the extreme load on the hospitals, and also reduce deaths greatly. What I'm concerned about is the long-term chronical diseases that's been reported (https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-long-term-effects/art-20490351 https://www.mayoclinic.org/diseases-conditions/coronavirus/i...), hitting a substantial part of the infected. We need more clarity to which degree the non-mRNA-vaccines prevent these pretty horrobile chronic diseases.
- boulos 6y ago
  > The mRNA vaccines are obviously the gold standard, they're what you want, if you're in a position to pick. That might end up being true, but see my comment about the different “efficacy” measures and demographic differences [1]. We don’t have as clear cut a statement as that, and instead need to proceed (for now) with “all of the approved ones seem to prevent death or serious illness. Take what you can”. [1] https://news.ycombinator.com/item?id=25959872 https://news.ycombinator.com/item?id=25959872
  - tpmx 6y ago
    I would take a Johnson&Johnson or Astra Zeneca vaccine tomorrow if I were offered, don't misunderstand me.
    - thaeli 6y ago
      If it didn't disqualify me from receiving an mRNA vaccine later, sure. But right now it seems like you get one vaccine only and given that holding out for mRNA may be advisable.
      - tpmx 6y ago
        Yeah, that's also a concern. Any insights from people with knowledge - is this likely to be a problem or not?
nickpinkston 6y ago
Is it possible to get J&J first and then get the Moderna, etc. later on for more protection?
- m-ee 6y ago
  This hasn't been tested but there's little reason to think this would be an issue. If anything having two different vaccines might be an advantage.
justaguyOOL 6y ago
For a virus where 99+% recover naturally? Imo this was way overblown. The cure, in the form of RNA modification seems much scarier. What happens when new vaccines in this form interact with each other? I don't know, and no one else does. Hard pass for me.
- enchiridion 6y ago
  I think you might have a misunderstanding of how the mRNA vaccines work. The mRNA in the vaccines are simply read by your cells to produce the spike proteins to train your immune system. There is no RNA (or DNA for that matter) modification taking place in vivo.
  - justaguyOOL 6y ago
    Not a biologist, but from genome.gov: "Messenger RNAs, also known as mRNA, are one of the types of RNA that are found in the cell. This particular one, like most RNAs, are made in the nucleus and then exported to the cytoplasm where the translation machinery, the machinery that actually makes proteins, binds to these mRNA molecules and reads the code on the mRNA to make a specific protein. So in general, one gene, the DNA for one gene, can be transcribed into an mRNA molecule that will end up making one specific protein." Still doesn't address how modifications would interact together.

186 points by heyheyheysome 6y ago

66% effectiveness in one shot is better than 50% - 1/2 shots where there is not enough vaccines to go around. In some places people are not getting both shots of vaccines. FDA approved two different shots of 2 shot vaccines. At this time they should just immunize everybody with one shot at least.

cj 6y ago
Have any trials been done to determine the efficacy of just 1 shot for the double dose vaccines?
- yread 6y ago
  Not yet, but you can kinda see it from the data. For Pfizer it was 60-70 after one dose already, iirc
  - bpodgursky 6y ago
    That's only if you include all infections within the two week window between shots. If you look at the tail end (ie, after the shot has time to be effective) it seems more like 90.
    - zeku 6y ago
      The issue with this is that it's the SECOND shot that gives you your long term immunity. If you only get one shot your immunity is allegedly going to wane somewhat quickly. edit: for pfizer & moderna.
      - randomopining 6y ago
        Where did you see that part? Any reason why the 2nd one makes it last that much longer?
        bluGill 6y ago
        That is typically how the second shot works. We don't actually know. It is possible the second shot isn't needed at all. It is possible that the first shot works for 45 days and then stops working completely. Experts doubt both of these extremes, but cannot actually say they are false because they don't know.
- GizmoSwan 6y ago
  Yes they have data for results of 1 shot of 2 shot vaccines. Moderna has 80% in single shot I believe but it degrades over time so there is a second shot. The 66% that does not degrade and can be kept in room temperature is not bad at all. Most vaccines are not 90%. Most flu vaccine don't cover all different types but they still protect people as they get some sort of immunity to major types A,B etc.
fattire 6y ago
Would a partial or half immunized population not end up culturing a more resistant strain?
- elliekelly 6y ago
  Or could it end up culturing a more mild strain? More like a common cold?
  - eganist 6y ago
    Worth pointing out that two of the viruses[0][1] responsible for the Common Cold share the same exact Family (in fact, the exact Genus[2]) as SARS-CoV-2 [3]. This isn't to say that the progression is certainly in this direction (better evidence of that dates back to 2009 [4]), but hey, there's hope that that's the direction. [0] https://en.wikipedia.org/wiki/Human_coronavirus_HKU1 https://en.wikipedia.org/wiki/Human_coronavirus_HKU1 [1] https://en.wikipedia.org/wiki/Human_coronavirus_OC43 https://en.wikipedia.org/wiki/Human_coronavirus_OC43 [2] https://en.wikipedia.org/wiki/Betacoronavirus https://en.wikipedia.org/wiki/Betacoronavirus [3] https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndrome_coronavirus_2 https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndr... [4] https://www.scientificamerican.com/article/pandemic-payoff/ https://www.scientificamerican.com/article/pandemic-payoff/
- syntheticnature 6y ago
  This isn't like antibiotics. The 66% is how many people are provided some level of immunity, just reducing the infectible population; it doesn't directly cause issues for the virus the way an antibiotic interferes with the functioning of a bacterium. It might culture a strain that's better at infecting folks for whom the vaccine doesn't prove effective, if there's a common factor there and the virus can use it. It is not yet known if any of the vaccines completely prevent infection; there are concerns the vaccinated might still be able to be asymptomatic carriers.
  - fattire 6y ago
    Yeah I guess I was asking if having only partial-immunity effectively acts as a filter or creates pressure so that rarer mutated strains make it through and are given a pathway to infection/reproduction. From your response: "It might culture a strain that's better at infecting folks for whom the vaccine doesn't prove effective, if there's a common factor there and the virus can use it." it sounds like the answer is yes.

JamesBarney 6y ago

66% protection against getting moderate to severe Covid but 100% protection against death and hospitalization. I have no idea how the FDA can hold back these vaccines in good conscience while peoples are dying by the thousands on a daily basis.

gogopuppygogo 6y ago
Unpopular opinion: the FDA has to justify their existence. If vaccines can be developed safely and deployed quickly, inexpensively, and in large quantities all without FDA then people would realize how bloated our government really is.
- Traster 6y ago
  We saw this with Boeing - as the private company realised that the regulatory body wasn't going to hold it accountable, the private company started trading off profit versus safety with the result being lower short term costs and more dangerous planes.
- happytoexplain 6y ago
  >If vaccines can be developed safely ... without FDA You forgot a critical distinction: safely every time
  - Jtsummers 6y ago
    Doesn't need to be every time, it "just" needs to meet or beat the current FDA record. The FDA has approved treatments in the past that turned out to be harmful for substantial numbers of people. If the industry could reliably replicate the FDA's present track record (which is, overall, very good) then the FDA could be shown to be unnecessary. However, having worked in regulated industries I do not trust industry to do any better than the FDA. At least not in the long term.
- joncrane 6y ago
  I think this is a bit of a disingenuous approach. There's a slippery slope here. Just because "humanity, including giant healthcare conglomerates who stood to profit came together to fast track vaccines against a deadly global pandemic" it doesn't mean "regulation of the vaccine and drug industry is pointless." If the FDA were to relax its standards across the board due to this one success in the face of an anomaly, you'd better believe drug manufacturers would be fast tracking dangerous drugs. Heck even in the current regulatory environment dangerous products make it through. As evidenced by all the ads I see for litigation based on harm caused by various already-approved (in a non-fast track manner) drugs that have made it to the market in the last decade.

SubiculumCode 6y ago

imo 66% effectiveness is pretty good, not on a personal level, but at the population policy level. I'm glad to get another vaccine on the market soon.

foepys 6y ago
On the other hand it's quite sad that we as humanity have already developed two vaccines with 95% (or even higher) effectiveness but are not able (or rather: are too greedy) to share this knowledge to vaccine every human on earth as fast as possible. Instead the US and Europe are putting trade restrictions in place to keep the vaccines for themselves. India and China are more than capable to produce the vaccines in insane quantities but IP law doesn't let them.
- aphextron 6y ago
  It's not a tech problem, it's a production problem. There are only a few companies on earth that are capable of producing the precursor chemicals for these mRNA vaccines, and until now they were geared towards producing small batch research drugs. They are expanding rapidly but production capacity is at 100%.
  - throwaway2245 6y ago
    If we could (globally) build emergency public hospitals, why can't we build emergency public production facilities?
- formercoder 6y ago
  Yeah I just don’t understand why we can’t put the full industrial capacity of the U.S. government behind this. I’m genuinely curious about the on-the-ground details which make manufacturing this stuff hard. Would love to see the playbook for raw materials to vial of vaccine.

znebby 6y ago

I'm really struggling to understand these numbers. In some other articles I'm seeing that it offers 100% protection against hospitalisation and death. "The J&J vaccine was 85 per cent effective at preventing severe Covid-19. Twenty-eight days after the jab, it offered “complete protection” from hospitalisation and death." [1] Wouldn't having "severe" infection require hospitilisation? [1] https://www.ft.com/content/d05c7c57-da11-42a1-aa33-b66052c904ac https://www.ft.com/content/d05c7c57-da11-42a1-aa33-b66052c90...

roywiggins 6y ago
I've seen "severe" be measured by oxygen saturation; some people are able to manage severe COVID at home. Some people have to, because there simply isn't any hospital in their area with space for them.
- spookthesunset 6y ago
  > Some people have to, because there simply isn't any hospital in their area with space for them. Citation needed on that one. There is a lot of media fearmongering out there that results in outliers and things that are normal practice getting taken out of context and blown up into something scary.
  - roywiggins 6y ago
    You can see it in statistics. When the hospitalization starts dropping while case counts are going up, it's because more cases are being managed at home. Prioritizing critical care is normal when care is in short supply, but it means that you are more likely to have to deal with COVID at home when the local healthcare system is overstressed. > on Nov. 1, the Covid Tracking Project’s seven-day average showed about 80,000 new cases — which we would predict should lead to about 2,800 new hospitalizations a week later, by Nov. 8. Instead, there were 2,600, a little fewer than expected. On Nov. 15, we had 146,000 new cases, which should have resulted in about 5,100 new hospitalizations by Nov. 22. However, there were fewer than 3,700. This pattern of declining rates of hospitalization continued through the end of November. > What is happening is pretty simple: Because hospitals are filling up, they are admitting fewer and fewer people. Any doctor or nurse will tell you that as the demand for beds soars, the threshold for admission rises with it... > The decision on whether to admit a patient depends on two things: clinical judgment and bed availability. Critically ill patients will always be admitted. But as hospitals start to fill up, those who are less sick — younger covid patients, or those whose oxygen levels aren’t yet dangerously low — get sent home. These patients would be safer in a hospital bed, but there isn’t one available for them anymore. https://www.washingtonpost.com/outlook/2020/12/07/covid-hospitalization-rates-dropping/ https://www.washingtonpost.com/outlook/2020/12/07/covid-hosp...

mchusma 6y ago

The contrast between the response to Astrazeneca and J&J is striking. Similar efficacy numbers, but Astrazeneca is still banned and got terrible headlines. J&J has all positive headlines. I don't know if this is just because more time has passed and people realize it was dumb to not approve Astrazeneca? Is "Supercovid" just making people realize we can't wait around? I think J&J, Astrazeneca, and Novavax all easily surpass the "net expected benefit" threshold and should all be approved immediately. In the US, this would allow us to end this thing within 90 days.

deleted 6y ago
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GizmoSwan 6y ago
Germany is approving Astrazeneca with some sort of limitation.
- eli 6y ago
  It was just approved by the EU and is already being distributed in the UK.
  - GizmoSwan 6y ago
    Yes but they don't have sufficient data for older adults on it so that is the limitation.
mchusma 6y ago
BTW - I do think it would be more helpful if you report on the numbers between vaccines to use your primary metric as "100% Effective at Preventing Death", then use 68% or whatever as your secondary metric. This better reflects the differences between the vaccines so far. All are amazing at protecting against what people care about most.
UncleOxidant 6y ago
Yeah, I don't get why the Astrazeneca vaccine approval in the US is being delayed till (reportedly) March. Is it because Pfizer and Moderna are US companies charging a lot more money vs. Oxford/Astrazeneca being UK and not making any money on their vaccine?

Exmoor 6y ago

I suspect the title was abbreviated to fit HN length requirements, but it cut out perhaps the most important part. This data is for a single shot. There is an ongoing trial for boosting with a second shot down the line, but having a single shot that's known to be effective at eliminating the disease and extremely effective at reducing severe cases and hospitalizations is a game changer. We can vaccinate lower risk populations with this vaccine and do it twice as fast. Once everyone is vaccinated, we can invite people to come back for a second shot as a booster. From the phase 1/2 trial data I saw, I'd expect a second shot to boost the efficacy to numbers approaching the mRNA vaccines. Edit: It also only needs to be refrigerated so it eliminates a lot of coordination related to frozen transportation, scheduled appointments, etc. will be eliminated.

interestica 6y ago
What is the optimal vaccination strategy? So far, it just seems like we're following "vaccinate healthcare workers and the most vulnerable" and that, on the surface, seems intuitive. But is there some other sort of algorithm that can determine the best way to reduce overall transmission the fastest? Random vaccinations? Targeted groups in different regions? Double shots for vulnerable before single shots for others? Mobile vaccination services?
- bagacrap 6y ago
  well we definitely shouldn't be vaccinating people who've had and recovered from the virus before we vaccinate other who haven't, and we most likely shouldn't be giving out second shots before more people get a first shot. Of course individual risk and exposure plays a role, but the incremental protection conferred by the second shot in the arm of a person who's already recovered from covid is pretty low, even if they are a healthcare worker.
  - interestica 6y ago
    > we most likely shouldn't be giving out second shots before more people get a first shot. It's mostly thinking out loud because sometimes the most effective solution is a bit counter-intuitive. There may be some value in getting more people to a guaranteed 100% protection. Right now, in Canada, we seem to be following an intuitive route. But in BC, they've already administered ~4000 second doses. (Likely only in long term care facilities). https://www.cbc.ca/news/canada/british-columbia/covid-19-update-jan-29-1.5894208 https://www.cbc.ca/news/canada/british-columbia/covid-19-upd... So it seems like the strategy there may be to get those residents to 2 shots before others.

lurkmurk 6y ago

Is there some resource that compares all the vaccines, an article or a blog post? I would guess that a vast majority of people don't have time/knowledge to look into official reports. One big table with different companies, number of people in trials, results etc. would be nice. For example, what I just found out is that Moderna is actually not 95% effective on all age groups but on 18-65 [1]. Back to J&J. How old were the 15% that did develop the most serious symptoms? The article says that "more than 40 per cent had other illnesses [...] including obesity, diabetes and HIV." Isn't the base rate for obesity in a population something like that or higher? Finally, if we just look at the numbers (if they are even comparable), can we objectively rank these vaccines by how good they are? No ones feelings should be hurt if we can conclude that their vaccine is close to useless (think of how vaccinated population will demand loose measures although 40% of them are still at risk). [1] https://www.bbc.com/future/article/20210114-covid-19-how-effective-is-a-single-vaccine-dose https://www.bbc.com/future/article/20210114-covid-19-how-eff...

matteotom 6y ago
It's not exactly a table, but NYT has a vaccine tracker with much of this information https://www.nytimes.com/interactive/2020/science/coronavirus-vaccine-tracker.html https://www.nytimes.com/interactive/2020/science/coronavirus...

boulos 6y ago

I find the Johnson and Johnson Press Release [1] more informative. It gives a lot more detail on the study, including linking to their protocol [2]. It’s unfortunate, but the different vaccine trials all have different demographics and different measures of efficacy. IIRC, the Moderna “95%” is not “only 5% developed COVID” but rather “95% didn’t end up showing any symptoms” while AstraZeneca was doing weekly testing (again this is from memory). With so many people being asymptomatic, the difference between “95%” and “66%” is in the details (which is definitely why Johnson and Johnson also highlight their 72% in the US, and 85% against hospitalization/death). tl;dr: each vaccine group made reasonable, independent choices for their effectiveness metrics, but they’re not the same metric. [1] https://www.jnj.com/johnson-johnson-announces-single-shot-janssen-covid-19-vaccine-candidate-met-primary-endpoints-in-interim-analysis-of-its-phase-3-ensemble-trial https://www.jnj.com/johnson-johnson-announces-single-shot-ja... [2] https://www.jnj.com/coronavirus/covid-19-phase-3-study-clinical-protocol https://www.jnj.com/coronavirus/covid-19-phase-3-study-clini...

xiphias2 6y ago
Also the results of this vaccine isn't that difference from just using 1 shot of another vaccine. It looks like as long as it's safe to do it, the 2nd shot is worth it.
m-ee 6y ago
They do not have different measures of eficacy. AZ did more testing to look at symptomatic infections but that was not used in the primary efficacy calculation. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32661-1/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
- boulos 6y ago
  I believe AZ was doing weekly testing while Moderna (maybe?) was doing “test if symptomatic”. That’s a huge difference.
  - m-ee 6y ago

sradman 6y ago

The NIH news release Janssen Investigational COVID-19 Vaccine: Interim Analysis of Phase 3 Clinical Data Released [1]: > An investigational COVID-19 vaccine developed by Janssen Pharmaceuticals appears to be safe and effective at preventing moderate and severe COVID-19 in adults, according to an interim analysis of Phase 3 clinical data conducted Jan. 21. The vaccine, called Ad.26.COV2.S or JNJ-78436725, requires only a single injection and can be stored in a refrigerator for months. > The interim analysis assessed 468 cases of symptomatic COVID-19 among 44,325 adult volunteers in Argentina, Brazil, Chile, Colombia, Mexico, Peru, South Africa, and the United States. The investigational vaccine was reportedly 66% effective at preventing the study’s combined endpoints of moderate and severe COVID-19 at 28 days post-vaccination among all volunteers, including those infected with an emerging viral variant. [1] https://www.nih.gov/news-events/news-releases/janssen-investigational-covid-19-vaccine-interim-analysis-phase-3-clinical-data-released https://www.nih.gov/news-events/news-releases/janssen-invest...

azinman2 6y ago

Bloomberg quoted “No severe allergic reactions,” to the J&J, yet my cousin-in-law is in the hospital right now with Guillain–Barré syndrome following the J&J clinical trial shot. Granted this is rare and can happen with any vaccine (I believe?), but it’s pretty strange to read about the lack of negative reactions when I personally know someone who has been affected. NB: I’m not advocating there is anything largely wrong or unsafe about it.

graeme 6y ago
Guillan barré syndrome is not considered an allergic reaction to the best of my knowledge. So your brother’s case doesn’t contradict the claim. And yeah GBS can happen with any vaccine but more importantly also from viral infections. Generally more frequently from the viruses themselves.

xxel 6y ago

Nothing new from Johnsosn and Johnsons. Johnsons and Johnsosn shampoo wash hair 66% too.

tpmx 6y ago

The mRNA vaccines are obviously the gold standard, they're what you want, if you're in a position to pick. The traditional vaccines, like this one and the Astra Zeneca one appear to be efficient at preventing hospitalization/death. That's great - it will ease the extreme load on the hospitals, and also reduce deaths greatly. What I'm concerned about is the long-term chronical diseases that's been reported (https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-long-term-effects/art-20490351 https://www.mayoclinic.org/diseases-conditions/coronavirus/i...), hitting a substantial part of the infected. We need more clarity to which degree the non-mRNA-vaccines prevent these pretty horrobile chronic diseases.

boulos 6y ago
> The mRNA vaccines are obviously the gold standard, they're what you want, if you're in a position to pick. That might end up being true, but see my comment about the different “efficacy” measures and demographic differences [1]. We don’t have as clear cut a statement as that, and instead need to proceed (for now) with “all of the approved ones seem to prevent death or serious illness. Take what you can”. [1] https://news.ycombinator.com/item?id=25959872 https://news.ycombinator.com/item?id=25959872
- tpmx 6y ago
  I would take a Johnson&Johnson or Astra Zeneca vaccine tomorrow if I were offered, don't misunderstand me.
  - thaeli 6y ago
    If it didn't disqualify me from receiving an mRNA vaccine later, sure. But right now it seems like you get one vaccine only and given that holding out for mRNA may be advisable.
    - tpmx 6y ago
      Yeah, that's also a concern. Any insights from people with knowledge - is this likely to be a problem or not?

nickpinkston 6y ago

Is it possible to get J&J first and then get the Moderna, etc. later on for more protection?

m-ee 6y ago
This hasn't been tested but there's little reason to think this would be an issue. If anything having two different vaccines might be an advantage.

justaguyOOL 6y ago

For a virus where 99+% recover naturally? Imo this was way overblown. The cure, in the form of RNA modification seems much scarier. What happens when new vaccines in this form interact with each other? I don't know, and no one else does. Hard pass for me.

enchiridion 6y ago
I think you might have a misunderstanding of how the mRNA vaccines work. The mRNA in the vaccines are simply read by your cells to produce the spike proteins to train your immune system. There is no RNA (or DNA for that matter) modification taking place in vivo.
- justaguyOOL 6y ago
  Not a biologist, but from genome.gov: "Messenger RNAs, also known as mRNA, are one of the types of RNA that are found in the cell. This particular one, like most RNAs, are made in the nucleus and then exported to the cytoplasm where the translation machinery, the machinery that actually makes proteins, binds to these mRNA molecules and reads the code on the mRNA to make a specific protein. So in general, one gene, the DNA for one gene, can be transcribed into an mRNA molecule that will end up making one specific protein." Still doesn't address how modifications would interact together.