How does the J&J vaccine compare to other coronavirus jabs? Four questions answered
The US Food and Drug Administration (FDA) agency has authorised the use of the Johnson & Johnson (J&J) coronavirus vaccine in adults.
Maureen Ferran, a virologist at the Rochester Institute of Technology, explains how this third authorised vaccine works and explores the differences between it and the Moderna and Pfizer–BioNTech vaccines already in use.
1. How does the J&J vaccine work?
The J&J vaccine is a viral vector vaccine. To create this vaccine, the J&J team took a harmless adenovirus – the viral vector – and replaced a small piece of its genetic instructions with coronavirus genes for the SARS-CoV-2 spike protein.
After this modified adenovirus is injected into someone’s arm, it enters the person’s cells. The cells then read the genetic instructions needed to make the spike protein and the vaccinated cells make and present the spike protein on their own surface. The person’s immune system then notices these foreign proteins and makes antibodies against them that will protect the person if they are exposed to SARS-CoV-2 in the future.
The adenovirus vector vaccine is safe because the adenovirus can’t replicate in human cells or cause disease, and the SARS-CoV-2 spike protein can’t cause Covid–19 without the rest of the coronavirus.
2. How effective is it?
The FDA’s analysis found that, in the US, the J&J Covid-19 vaccine was 72% effective at preventing all Covid-19 and 86% effective at preventing severe cases of the disease.
While there is still a chance a vaccinated person could get sick, this suggests they would be much less likely to need hospitalisation or die from Covid-19.
A similar trial in SA, where a new, more contagious variant is dominant, produced similar results.
Researchers found the J&J vaccine to be slightly less effective at preventing all illness there – 64% overall – but was still 82% effective at preventing severe disease. The FDA report also indicates the vaccine protects against other variants from Britain and Brazil.
3. How is it different from other vaccines?
The most basic difference is that the J&J vaccine is an adenovirus vector vaccine, while the Moderna and Pfizer vaccines are both mRNA vaccines. Messenger RNA vaccines use genetic instructions from the coronavirus to tell a person’s cells to make the spike protein, but these don’t use another virus as a vector. There are also many practical differences.
The J&J vaccine can be stored for at least three months in a regular refrigerator, making it much easier to use and distribute.
Both the mRNA-based vaccines require two shots. The J&J vaccine requires only a single dose. This is key when vaccines are in short supply.
The J&J vaccine can also be stored at much warmer temperatures than the mRNA vaccines. The mRNA vaccines must be shipped and stored at below–freezing or subzero temperatures and require a complicated cold chain to safely distribute them. The J&J vaccine can be stored for at least three months in a regular refrigerator, making it much easier to use and distribute.
As for efficacy, it is difficult to directly compare the J&J vaccine with the mRNA vaccines due to differences in how the clinical trials were designed.
While the Moderna and Pfizer vaccines are reported to be approximately 95% effective at preventing illness from Covid–19, the trials were done over the summer and autumn of 2020, before newer more contagious variants were circulating widely. The Moderna and Pfizer vaccines might not be as effective against the new variants. The J&J trials were done more recently and take into account the vaccine’s efficacy against these new variants.
4. Should I choose one vaccine over another?
Although the overall efficacy of the Moderna and Pfizer vaccines is higher than the J&J vaccine, you should not wait until you have your choice of vaccine, which is likely a long way off. The J&J vaccine is nearly as good as the mRNA-based vaccines at preventing serious disease, and that’s what really matters.
The J&J vaccine and other viral-vector vaccines like the one from AstraZeneca are particularly important for the global vaccination effort.
From a public health perspective, it’s important to have multiple Covid-19 vaccines, and the J&J vaccine is a very welcome addition to the vaccine arsenal. It doesn’t require a freezer, making it much easier to ship and store. It’s a one-shot vaccine, making logistics much easier compared with organising two doses per person.
As many people as possible need to be vaccinated as quickly as possible to limit the development of new coronavirus variants. J&J is expected to ship out nearly four million doses as soon as the FDA grants emergency use authorisation. Having a third authorised vaccine in the US will be a big step towards meeting vaccination demand and stopping this pandemic.
- Maureen Ferran is an associate professor of biology at the Rochester Institute of Technology.
- This article was first published by The Conversation.
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