LETTER from RICHARD STERNBERG
On Friday, Jan. 29, Janssen/Johnson & Johnson announced its vaccine had proven effective in Phase 3 studies. This brings a third vaccine on line in the fight against COVID-19 and potentially increases the pace of vaccinations by 50 percent.
Additionally, the J&J protocol is for a single dose and the storage requirements are much less stringent than those of the two vaccines already available in the United States, Moderna and Pfizer.
On the other hand, the statistics on efficacy for the J&J vaccine are not as high as those reported for the other two. It is reported as 85 percent effective globally against severe disease and 70
percent effective against moderate to severe disease.
Many scientists consider this on balance very good news.
If we remember back to last year the goal for efficacy was 70 percent which would have made that equivalent to the flu vaccine. Only because of higher numbers with Moderna and Pfizer do 85 percent and 70 percent seem low.
Furthermore, the J&J vaccine is a one-dose regimen and requires only basic refrigeration to last for weeks, making it much easier to distribute and complete a course of vaccine (i.e., only one shot).
This should especially help in people hesitant to get a shot at all.
Furthermore, as J&J scientists point out, previous studies were performed when the viral outbreak was at an earlier, simpler stage.
There weren’t multiple strains, some considered more virulent and more infective, competing against each other and the concentration of the disease in the population was lower.
They state that given the changing conditions in the world, if the Moderna and Pfizer vaccines were retested now that they would probably have very similar profiles to theirs.
The negative news is the outbreak of new strains of the virus. These new strains appear to be at the same time more virulent and less responsive to the vaccines currently available.
We have been hearing in the news about a new strain from Great Britain for about a month, but in the last week we are also hearing about new strains from South Africa and Brazil that appear even worse and less affected by the vaccines currently available.
Other evidence suggests that vaccines are effective against severe episodes and the increase seen after vaccination are almost all mild to moderate cases.
Some companies are starting to make vaccines for the different strains though it appears that it will be some time before they even begin Stage II trials.
In my opinion, we will eventually need to get multivalent (multiple different varieties of the virus) vaccinations to SARS-CoV-2 yearly, or even more often, just like we do for the flu.
From the sports page of the Wall Street Journal (Feb. 1, 2021) comes one of the most interesting and statistically valid studies on the epidemiology of COVID-19.
The NFL, it turns out, has a wealth of data on the transmission pattern of the disease from what they have collected from their 32 teams.
It performed over 950,000 tests on more than 7,000 people and confirmed approximately 700 positive cases.
The key thing it found was that previous guidelines – that staying less than 6 feet away from someone for more than 15 minutes was necessary for transmission – was completely wrong.
The NFL had the resources to do excellent contact tracing and its data showed that one could catch the virus while being MORE than 6 feet away.
Wearing of masks mattered more than duration of contact.
If both people were wearing masks the risk of transmission went way down, regardless of contact time.
Many columns ago, I discussed the ridiculousness of the early pronouncements that 6 feet was a magic number: if you were more than 6 feet apart, you wouldn’t catch the virus.
Now we have solid data based on a sample of 7,000 subjects, all of whom were required to participate on transmissibility. The data does not support those early instructions; they were too lenient.
It reaffirms the importance of masks.
I can’t wait to read the scientific paper or papers that come from the NFL data. Considering the number of data points and the carefully tracking of all 7,000 subjects, I suspect that a paper on this will warrant publishing in the most prestigious journals like Science or the New England Journal of Medicine.