J&J Pause Risks Hesitancy Even as U.S. Sees Ample Shots

Johnson & Johnson’s Covid-19 vaccine represents only a sliver of the current U.S. supply, but pausing its use could present new hurdles for an immunization campaign that needs to overcome wider vaccine hesitancy to outpace fast-spreading variants.

The sidelining of J&J, however temporary, leaves the U.S. with two other shots that already made up the bulk of its vaccination campaign -- from Pfizer Inc. and Moderna Inc. Vaccines from those two companies account for 95% of the shots allocated in the U.S. this week.

Pfizer’s top executive said Tuesday that the company would speed up promised deliveries of its shots to the U.S. in coming weeks.

The U.S. Centers for Disease Control and Prevention and Food and Drug Administration said on Tuesday in a joint statement that they would pause use of the J&J shot after six women who received it developed a rare and severe form of blood clotting. The FDA signaled the pause would last a matter of days.

J&J Pause Risks Hesitancy Even as U.S. Sees Ample Shots

The White House on Tuesday said the vaccine campaign can continue at its current pace. President Joe Biden told reporters that, between Pfizer and Moderna, “there is enough vaccine that is basically 100% unquestionable for every single solitary American.”

Jeff Zients, the White House Covid-19 response coordinator, said at a briefing that “we have plenty of supply to continue our vaccination program and hit our goals.”

If the pause lasts only a few days as officials suggest, cancellations and rescheduled appointments could create a similar slowdown to those from winter storms earlier in the vaccination campaign. But doubt about the safety of any of the available Covid-19 vaccines could thwart the U.S. vaccination campaign just as it hits its stride.

J&J Pause Risks Hesitancy Even as U.S. Sees Ample Shots

“This is going to scare a lot of people, and rightfully so,” said Noel Brewer, professor of health behavior at the University of North Carolina at Chapel Hill. “We should all be concerned about the safety of medicines we receive. In this case, there’s not a lot of reason for concern. The actual risk is vanishingly small.”

Anthony Fauci, one of Biden’s top medical advisers, said the decision was made by scientists out of an abundance of caution.

“You want to make sure that safety is the important issue. We are totally aware that this is a very rare event; we want to get this worked out as quickly as we possibly can,” Fauci said at the news briefing. “I don’t think it was pulling the trigger too quickly.”

J&J’s shot has so far been only a small fraction of the vaccines administered in the U.S., though it was expected to play a growing role going forward because of the convenience of a single dose. Of the 189.7 million doses administered in the U.S. so far, only 6.86 million are J&J shots.

Pfizer CEO Albert Bourla said in a tweet that the company has ramped up production of the vaccine and “can deliver 10% more doses to the U.S. by the end of May than previously agreed.” This means it would deliver a total of 220 million doses, up from a pledge of 200 million, and the entirety of its 300 million-dose order by mid-July, two weeks ahead of schedule.

That effectively would mean enough Pfizer supply for 10 million more people by the end of May.

Pfizer has been expanding its facilities while adding suppliers and contract manufacturers, moves that have allowed the pharmaceutical giant to cut its production timeline nearly in half and double output, a spokesman said in a statement.

A number of states and pharmacy chains on Tuesday said they would follow the recommendation. New York plans to immunize people who were supposed to receive J&J’s shot with Pfizer’s vaccine at state-run sites. Virginia said it will reschedule appointments.

Pfizer and Moderna supplies will be adequate to satisfy U.S. demand, said one official who spoke on condition of anonymity, as signs emerge that the U.S. is beginning to shift from a shortage of shots to a shortage of willing recipients.

Vaccination Timeline

The U.S. expects to have received enough doses from Pfizer and Moderna by the end of May to fully vaccinate 200 million people. It expects enough doses from those companies by the end of July to vaccinate another 100 million.

Still, any lengthy delay in the use of one shot could fuel vaccine hesitancy and would cast doubt on some of the Biden administration’s supply pledges. The team has said repeatedly that all shots are safe and urged Americans to take whichever one they can.

“This is an outstanding time for people to talk to their own health-care provider to get their concerns addressed,” Brewer said.

Biden relied on J&J when he announced that the U.S. will have enough shots for all adults by the end of May, a pledge officials have regularly cited in recent weeks.

Hesitancy is a challenge that the administration needs to address, Biden adviser Zients said.

“And we are, as I’ve talked about, by going out to meet people where they are and following all that we’ve learned about who people trust: their doctor, their nurse, their faith leader,” he said.

The Biden administration has also pledged to boost equity in vaccinations, which have so far disproportionately gone to White people in a pandemic that has disproportionately sickened or killed people of color. The J&J shot was being widely used in pharmacies and community health centers, which target at-risk communities, though Pfizer and Moderna still make up the vast majority of shots used in those programs.

Of the 16.1 million J&J doses delivered around the U.S. so far, according to CDC data, many of the shots have been sent out through the federal program to get shots to pharmacies, community health centers and vaccine sites that can treat harder-to-reach populations.

J&J’s shot, which doesn’t require the same cold-storage conditions as Moderna and Pfizer, could also shrink the number of sites administering the shot if use is halted for an extended period. That would put at risk Biden’s pledge to make the vaccine available within 5 miles of 90% of Americans. Biden’s team has stressed the need to make vaccines easily accessible.

Pharmacy Halt

Walgreens Boots Alliance Inc. and CVS Health Corp. are immediately halting administration of J&J’s vaccine, spokespeople for the companies said Tuesday. The pharmacies are two of nearly two dozen chains receiving vaccines directly from the federal government in a bid to increase the number of vaccination centers.

In recent weeks, the U.S. has made available more than 25 million doses of Pfizer and Moderna each week, and this week expects to have 28 million doses available, according to Zients. “This is more than enough supply to continue the current pace of vaccinations of 3 million shots per day, and meet the president’s goal of 200 million shots by his 100th day in office – and continue on to reach every adult who wants to be vaccinated,” Zients said.

The U.S. vaccination effort has been gaining speed in recent weeks at the same time that a worsening outbreak driven by coronavirus variants is gripping the upper Midwest. And it is likely to heighten worry about vaccines around the world after similar issues caused delays in distribution of AstraZeneca Plc’s shot.

AstraZeneca hasn’t sought U.S. authorization but is already producing doses to fill a U.S. order placed last year. Biden’s team hasn’t said what they’ll do with that stockpile, though some have urged him to donate it to other nations.

The AstraZeneca and J&J shots are the same “platform,” or type, of vaccine. Pfizer and Moderna’s shots are based on a different platform.

©2021 Bloomberg L.P.

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