Is there a reason to choose the J&J covid vaccine instead of the others?
March 25, 2021 5:12 PM   Subscribe

Aside from the fact that it's a single dose vaccine, is there a benefit to getting the Johnson & Johnson vaccine instead of the vaccines by Pfizer, Moderna, etc? I'm asking because I may have the ability to choose based on which location I get vaccinated at.
posted by 2oh1 to Health & Fitness (14 answers total) 5 users marked this as a favorite
Well, unlike the Moderna and Pfizer vaccines it’s a traditional deactivated virus vaccine, not an mRNA vaccine. If you have any reason to believe you’re sensitive to the mRNA vaccines (or any qualms about them) that could be a reason.

To me the most obvious reason to prefer J&J is the single dose - you’re officially vaccinated like two weeks earlier!
posted by mskyle at 5:41 PM on March 25 [3 favorites]

I mean, is it a long or difficult trip to the vaccine places? If so, there could be significant upside to only going once.
posted by chesty_a_arthur at 5:45 PM on March 25

It's complicated because the testing methodology varies between the vaccines.

"Moderna arm" is a harmless rash that seems more common with Moderna's vaccine, if that's important to you.

If it's no big deal to go for a second dose, you might want to pick Pfizer or Moderna just because the cold chain is already spun up, and J&J vaccines can be more easily shipped somewhere else if demand lags in your area.
posted by RobotVoodooPower at 5:47 PM on March 25 [3 favorites]

There's some indications that j&j might be more effective against the south african or brazil variants than moderna / pfizer, but I'm not sure how much statistical significance it has, you'll have to do some googling.

1 shot and useful protection in a couple weeks vs 2 shots that take 5-7 weeks in total for the protection to be useful is a pretty significant time difference.
posted by TheAdamist at 5:51 PM on March 25 [5 favorites]

BTW, J&J is testing a two-dose regime, so you may end up wanting a second dose anyway if the trials go well.
posted by RobotVoodooPower at 5:54 PM on March 25 [1 favorite]

I went back and forth on this. The higher mRNA efficacy numbers seem important to me but I was reassured that if the J&J turns out to need a booster they can easily add one later. Still I had a preference for the mRNA vaccines. Right until I was given the choice of appointments.

I literally could get either Pfizer or J&J on the same day. And after consulting a friend I took the J&J and I am so glad I did. Solely for the convenience of it being one-and-done. I have a lot of friends who've had trouble or delays getting the second vaccine; that problem is entirely avoided. Also I'm going to be fully vaccinated at least 3-4 weeks earlier than I would have with the Pfizer. The moment I got the shot I relaxed and felt a great sense of relief having gotten it over with. I'm still waiting on the two week post-vaccine period for immunity, but that's still better than waiting a month for a second shot and then two weeks.

So J&J was the right choice for me. Truthfully any of them are fine and I believe the frequently repeated advice that you should get whichever one is first available to you.
posted by Nelson at 6:33 PM on March 25 [6 favorites]

I was vaccinated with the J&J through the health center at work, but didn't know which vaccine I would get until I was in line reading the info provided. I didn't have an medical issues or advice from my doctor about which to take (friends who are transplant recipients have had very specific advice from theirs) and so I vowed to take the first one offered. Light fever off and on for two days...and I hit my two-week mark tomorrow.

the feeling of relief is crazy good.
posted by th3ph17 at 6:47 PM on March 25 [5 favorites]

Bit of a tangent, but J&J is decidedly not a "traditional deactivated virus" vaccine. I'll let Derek Lowe explain:

This class uses some other infectious virus, but with its original genetic material removed. In its place goes genetic instructions to make coronavirus proteins, and when your infected cells do that, these proteins will set off an immune response. Note that this is different than being infected with a “real” virus, whose instructions are (naturally enough) to produce more virus, which go off and infect more cells. No, in this case each viral particle that you’re injected with will be able to infect one cell, and that’s it. An advantage of this approach is that it should appear to your immune system like a pretty realistic viral attack, and set off a full range of responses. A disadvantage is that this technique (as far as I can tell) has only once been used in human therapy (the Ebola vaccine), although it’s had a lot of work from a lot of groups over the years. Things have now accelerated, a phrase that you can just keep using these days. Another disadvantage is that if you pick a viral vector that infects people anyway, some of your patients may already have antibodies to that one. That can mean that your attempt to repurpose it might crash and burn as your carefully engineered vector gets attacked by antibodies and eaten by immune cells before it can even do its work. It also means that booster shots would have an uphill battle, since the antibodies from that first dose will be waiting for the second one. Antibodies to the viral payload: good. Antibodies to the viral vector itself: not so much.

As others have said, the benefit is just getting one shot. The "technology", as it were, though, is much the same as the mRNA vaccines: hijacking the body's cellular machinery to make a bunch of spike protein.
posted by booooooze at 7:03 PM on March 25 [9 favorites]

- Because of the differences in design of the vaccine trials--including the precise outcomes they were looking for, the timing of the trial, and location of the trial participants--it is literally impossible to say which of Pfizer, Moderna, and J&J is "best" at anything: preventing any infection at all, spread of infection, asymptomatic disease, mild disease, moderate disease, serious disease, or death. Make that double for all those questions when the new "variants" are involved. Pfizer & Moderna were tested before variants were widespread; J&J was tested at times & places where they were pretty prevalent. Good rundown on these issues here.

- That isn't a reason to prefer J&J over the others, but it is definitely a reason to keep it on exactly equal footing with the others.

- If J&J is available to you first, then that is alone is a reason to prefer it above the others. The one you can get (soonest) is the best, and that advantage trumps any possible others.

- J&J definitely has a different, and perhaps better, side-effect profile--which might make a difference depending on your exact side-effect concerns.

- J&J is a more previously-used, previously-approved vaccine platform and one that is a little more time-tested. Vs mRNA vaccines, for which this is the first outing in humans. If you're just a bit nervous about vaccines and would prefer a platform that has a pretty lengthy and good track record, you might prefer J&J. (FWIW I've heard rumblings of worries like this from people in the medical sector. Apparently they know just a little too much. In their minds, mRNA = new, untested, worrisome. If that sort of thing worries you, J&J just does an end-run around those worries.)

- The protocols, clinical trials, etc, of J&J seem to have been run pretty much impeccably. So that gives it a leg up over, say, Oxford/Astrazeneca, where the clinical trials had some clear stumbles with the result that their data and conclusions aren't really as clear as we would like. If you have a reason to worry a bit about Oxford/Astrazeneca due to the somewhat inept way the trials were run, you have every reason to be fully trusting of the J&J vaccine due to the fully professional and competent way those trials were run. (Though as far as I know the same can be said about Pfizer & Moderna.)

- Due to the timing of the J&J Phase 3 trial, we have solid data on how it responds to some of the now-common variants. It performs a little worse against them, but still pretty well. Whereas with the Pfizer & Moderna vaccines, we just don't have that data quite yet. So with J&J you can have good confidence it is going to be protective against variants--especially that it is protective against the most serious disease and death resulting from infection from the variants. There, the results were quite good. Whereas with Pfizer & Moderna, we have more of a hope they'll work well, and an expectation, but not enough solid data yet to come to a clear conclusion.

- J&J is almost certain to be more effective than both Pfizer & Moderna when you add the 2nd dose of J&J--in all aspects I listed in the first bullet point. It is "better" in the sense that J&J got across the finish line with just one dose, when it was very doubtful either Pfizer or Moderna would have. When you add the 2nd dose to the J&J regimen, it's almost certain to be stronger/more effective than the others (after their 2nd dose) just as it was stronger and "better" than the others after their first dose.

(None of the preceding paragraph is 100% verified by the trials yet. But the trials to prove at least part of it are underway. But there are pretty strong reasons and preliminary evidence to believe all the above will eventually pan out as true.)

So you get the first dose now, you're pretty good off. In say 2-6 months you get a booster and you're almost certain to be better off in all possible ways.

To your question, the fact that the first dose of J&J seems to be better/stronger/more effective than the first dose of the others is one way that J&J might be considered "better" than the others. This would certainly be a reason to consider J&J better, but do keep in mind it is a reason that is possibly or probably or likely true, but that does not yet have 100% solid scientific proof behind it.
posted by flug at 7:20 PM on March 25 [18 favorites]

I haven't so far heard of anyone taking J&J and having any possible allergy issues. That and the time duration seem to me to be the main advantages of that one.
posted by jenfullmoon at 8:25 PM on March 25

I would make the deciding factor ease of access. So J&J has a big upside in that it's essentially one dose. But if the Pfizer or Moderna locations has available slots sooner or are easier to get to, then I would go with that.
posted by plonkee at 5:14 AM on March 26

J&J is a more previously-used, previously-approved vaccine platform and one that is a little more time-tested. Vs mRNA vaccines, for which this is the first outing in humans


“While an mRNA vaccine has never been on the market anywhere in the world, mRNA vaccines have been tested in humans before, for at least four infectious diseases: rabies, influenza, cytomegalovirus, and Zika.“ (link)
posted by blue suede stockings at 6:29 PM on March 26 [1 favorite]

The mRNA in vaccines is sealed inside of little droplets of lipid (fat) called Polyethylene glycol (PEG for short).

Some people have allergic reactions to PEG. You have probably heard stories about vaccine recipients needing an EpiPen.

The J&J vaccine has no mRNA, and so it has no lipids like PEG to trigger that allergy.
posted by Harvey Kilobit at 2:01 AM on March 28

Some more context on the allergy question.

Information about COVID-19 Vaccines for People with Allergies (CDC).
If you are allergic to PEG, you should not get an mRNA COVID-19 vaccine.
If you are allergic to polysorbate, you should not get the J&J/Janssen COVID-19 vaccine
CDC says J&J Covid vaccine is OK for people who have allergic reaction to Pfizer’s or Moderna’s
Johnson & Johnson’s Covid-19 vaccine can be used as a substitute for a second jab of Pfizer’s or Moderna’s shots for those who have an allergic reaction to the first round of either company’s vaccine
Very few severe allergic reactions tied to mRNA COVID vaccines.
anaphylaxis in only 0.025% of employees of two Boston hospitals who received their first dose of the Pfizer-BioNTech or Moderna COVID-19 vaccine
The CDC previously reported an incidence of anaphylaxis of 2.5 to 11.1 per million doses
The Janssen/J&J vaccine may still have a chance of causing anaphylaxis in recipients. Here's CDC guidelines on administering the J&J vaccine which include the necessity of being prepared for anaphylactic reactions. OTOH, J&J Vaccine Offers Safe COVID-19 Protection, With No Severe Reactions at Trial.
There were no reports of anaphylaxis during the Phase 3 trial.
(Note I focussed here on anaphylaxis, the most severe allergic reaction. There are other very rare severe allergic reactions also possible, some of these links discuss ther risk.)

My interpretation (IANAD): there's a very, very small chance of an anaphylactic reaction to the mRNA vaccines. There may also be a very very small chance with the Janssen vaccine. But the primary allergent is different. If you have reason to think you might have an serious allergic reaction you should consult a doctor first. And of course disclose your concern at the vaccination center. The vast majority of people (99.9% or more) will have no severe allergic problem.
posted by Nelson at 7:34 AM on March 28 [3 favorites]

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