HEALTH

As new J&J vaccine arrives in Arizona, health leaders say take any vaccine that's available

Doses of the new, one-shot Johnson & Johnson COVID-19 vaccine are arriving in Arizona, leaving many Arizonans asking if they should get it or one of the two-shot Pfizer and Moderna vaccines.

The answer, health officials say, is get whichever is available to you when you become eligible, because they all protect against severe outcomes.

Some people are sure to still have preferences based on convenience, health or even religious reasons, because the three available vaccines are slightly different.

But the good news is researchers say all three are effective vaccines that prevent hospitalizations and deaths from COVID-19.

"Our general message at this point is to take the vaccine that's offered to you as they are all highly effective at preventing serious illness and death," Holly Poynter, an Arizona Department of Health Services spokesperson, wrote in an email. "They've all undergone rigorous trials and been reviewed and approved for emergency use by the federal government."

A key difference is that the Pfizer and Moderna vaccines require two shots three to four weeks apart, while Johnson & Johnson's Janssen vaccine requires just one dose.

The J&J vaccine was slightly less effective in clinical trials at preventing infections (66% against moderate to severe illness), but it still prevented hospitalizations and deaths from the disease. Pfizer and Moderna were about 95% effective at preventing illness. The J&J vaccine was tested later than the others and in areas with highly contagious new variants.

Dr. Rebecca Sunenshine, medical director for disease control at the Maricopa County Department of Public Health, said everybody has been wanting to know which vaccine to take.

"The answer to that question really is whatever vaccine is available to you is the best vaccine for you," she said at a recent community vaccine event.

"All of the vaccines were tested in slightly different ways, in different countries, with different strains, and they also used different outcome measures to measure effectiveness," she said.

"But the one thing that all of the trials agree on with all three vaccines is that they are 100% effective in preventing hospitalization and death. So, since all three are 100% effective in preventing hospitalization and death, they are all very good vaccines."

Members of President Joe Biden's COVID-19 Advisory Board during his transition wrote an op-ed in USA TODAY urging Americans to take whichever vaccine they can get.

"The varying 'effectiveness' rates miss the most important point: The vaccines were all 100% effective in the vaccine trials in stopping hospitalizations and death. Waiting for a more effective vaccine is actually the worst thing you can do to lower your risk of getting severely ill and dying of COVID-19," the doctors and scientists wrote.

How the one-shot vaccine might be used in Arizona

The state health department is allocating all J&J vaccine doses to counties, and it's up to the counties to use it as they see fit, state health director Dr. Cara Christ said during a recent news briefing.

Christ, who called the vaccine a "gamechanger," recommends it be used for front-line essential workers "because they are younger, they're healthier, (and) we want to make sure that we're protecting them as they have day-to-day interactions with the public, and so one dose would be able to get us there faster with those populations."

The J&J vaccine is easier to store and is one shot, so using the vaccine for front-line agricultural workers who may move around for work would be "highly beneficial," Christ said.

The state expects to get 57,000 doses of the new vaccine this week.

Local health officials have been optimistic about how the J&J vaccine will help accelerate the vaccine rollout, especially in communities that are harder to reach or need to be immunized quickly.

Sunenshine of Maricopa County said the J&J vaccine is "really ideal" for populations that may be hard to get to twice or that may not be able to get to vaccine sites twice.

"We're using it to get to those essential workers where logistically it's going to be challenging to get to them twice and then other situations where people might be more transient," she said.

Cochise County health officials plan to use the doses for agricultural and other front-line workers, including by providing on a designated day vaccine sites at some of the larger farms to vaccinate agricultural workers.

Registered nurse Amy Wells draws a shot of Johnson and Johnson's COVID-19 vaccine in the pharmacy of National Jewish Hospital for distribution early Saturday, March 6, 2021, in east Denver.

Although the vaccine seems to be slightly less effective at reducing the chance of getting infected with the virus, it still does prevent deaths, Cochise County health director Alicia Thompson said, "so it makes sense, offering the Johnson & Johnson vaccine to younger, healthier essential workers."

Coconino County plans to open up appointments for the J&J vaccine as it has the other two types.

"Our message in Coconino County is, we're trying to get our hands on any vaccine that we can get. We believe they are all effective in doing what we want," Kim Musselman, director of the county's health and human services department, said in an interview last week. "It's going to be whatever's available, these are the appointments, and we are encouraging people to get vaccinated."

The J&J vaccine will first be going to the county's Northern Arizona Healthcare/Flagstaff Medical Center Elk's Lodge location and appointments will open up for the public there, she said. 

"We are absolutely excited that we're getting Johnson & Johnson."

Vaccine locations listed online at state and county health department websites typically show which vaccine is being offered where.

Individuals are considered fully vaccinated two weeks after their second dose of Pfizer or Moderna, or two weeks after their single dose of the J&J vaccine, per the CDC. That means someone can get protection in about two weeks if they get the J&J shot, versus five or six weeks for Pfizer or Moderna.

There's a clinical trial underway to see if two doses of the J&J vaccine might provide even more protection. There are also trials exploring how mixing vaccine types for first and second shots could impact protection.

So far the CDC recommendation is to get the same type of vaccine for the second shot if it's Pfizer or Moderna, or to just get one J&J shot and to not mix manufacturers.

Some have concerns about the J&J option

Some Catholic leaders have said the J&J vaccine is "morally compromised" because some of the cell lines the vaccine was produced with were originally derived from aborted fetuses.

Vials of the Johnson & Johnson Janssen COVID-19 vaccine.

The Roman Catholic Diocese of Phoenix issued a statement in mid-December saying that the Pfizer and Moderna vaccines are "morally acceptable," but the J&J vaccine is "morally problematic" because of its "direct connection with abortion."

Dr. William Chavira, a Phoenix-area OB/GYN, medical professor and deacon in the Catholic Church, said the aborted cell lines are from the 1970s, so it's not new material being used in the vaccine research and production.

"While we renounce the evil that was done in those initial decisions, and we can never accept that evil or make it OK, we're willing to permit the reception of the COVID vaccine under protest," he said.

Chavira encouraged people to get vaccinated to end the pandemic and acknowledged there's often not a choice right now for which type of vaccine you can get.

"It's very difficult at this time to find a vaccine that is completely devoid of any involvement with the fetal cell lines, so given the fact that we are in a global pandemic with extreme loss of human life both in the world and especially even here in Arizona locally, Catholics can morally accept any vaccine that is made available to them ... with the understanding that we're receiving it under protest and also an obligation that we should advocate for just testing and development of vaccines in the future so we're not in this situation when the next disease comes along."

The United States Conference of Catholic Bishops last week said that if "ethically irreproachable" vaccines are not available, it's morally acceptable to get a vaccine that used abortion-derived cells in research and production. But when there's a choice, individuals should opt for Pfizer or Moderna over J&J, the bishops said.

More broadly, there's also the question of which groups across the state will get which vaccine options, which could lead to an equity criticism.

If poorer or more rural or more vulnerable groups are only presented with the J&J vaccine, given its benefits in easy storage, quick immunization and preventing serious outcomes, that could be perceived as reserving the "worse" vaccine for only certain groups.

For more information about the three approved vaccines, including details on their ingredients, clinical trials, side effects and effectiveness, see the CDC's webpage.

To find vaccine locations in Arizona, visit www.azhealth.gov/findvaccine or local county health department websites.

Reach the reporter at Alison.Steinbach@arizonarepublic.com or at 602-444-4282. Follow her on Twitter @alisteinbach.

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