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J&J Vaccine - Booster Required after Just 3 Months? Panic Decision?

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  • 23-11-2021 11:21pm
    #1
    Registered Users Posts: 8,913 ✭✭✭


    Just picking up on the valuable information that @Lumen posted in the Booster Thread and to start a separate discussion about what seems a strange decision to give mRNA boosters to Jannsen vaccine recipients. I think there is around a quarter of a million adults potentially affected by this guideline...

    Following the studies that I'm grateful to Lumen for posting, it seems the decision is based upon this USA study: Comparative Effectiveness of Moderna, Pfizer-BioNTech, and Janssen (Johnson & Johnson) Vaccines in Preventing COVID-19 Hospitalizations Among Adults Without Immunocompromising Conditions — United States, March–August 2021 | MMWR (cdc.gov)

    This study on the J&J Vaccine was based on 113 individuals with an average age of 61 (Range 48-67) in the USA with the vast majority of participants reporting underlying conditions: 66.4% had chronic cardiovascular disease (including hypertension); 31% had chronic lung disease; 29% had diabetes; and ~47% were obese. Almost 48% have had one or more hospitalisation in the last year alone. The study was based on the Characteristics of participants in the vaccine effectiveness analysis, including case-patients hospitalized with COVID-19 and control-patients hospitalized without COVID-19, by COVID-19 vaccine product received — 21 hospitals* in 18 U.S. states, March–August 2021.

    When compared to a South African study across 480,000 individual healthcare workers which was reported in this article: Johnson and Johnson vaccine effective against Delta variant (irishtimes.com) and goes on to mention: It’s probably more protective against delta than it was with the earlier beta strain, she said in a presentation Friday. The single-dose shot was 71 per cent effective against hospitalisation and as much as 96 per cent effective against death, she said. It also demonstrated durability of eight months. “These results show there is no need for a booster yet,” said Gray, who is president of the South African Medical Research Council.

    ---

    So, my question is - why are guidelines being drawn up based on such selective data?



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Comments

  • Registered Users Posts: 26 Mr shmar


    I have been wondering the same thing. I can only think, because it is all being done on such little notice, there are very view articles being published that are providing any statistical analysis of the various trials being done because they can be quite complicated and take time to go from beginning a trial to point of completion and then to the point of having the results published.

    In short, it might simply be that these are the only stats that have recently been provided.



  • Registered Users Posts: 32,136 ✭✭✭✭is_that_so


    Even if it is the case the numbers lined up for boosters means it'll quite be a while. TBH it seems a silly thing to announce when nobody can get a shot.



  • Registered Users Posts: 32,136 ✭✭✭✭is_that_so





  • Moderators, Science, Health & Environment Moderators, Society & Culture Moderators Posts: 60,071 Mod ✭✭✭✭Wibbs


    So, my question is - why are guidelines being drawn up based on such selective data?

    I would say governmental panic because of a clear uptick in cases and the threat of overwhelmed health services, even in the face of a high percentage of vaccinated in the population is a large part of it.

    Rejoice in the awareness of feeling stupid, for that’s how you end up learning new things. If you’re not aware you’re stupid, you probably are.



  • Registered Users Posts: 354 ✭✭rachaelf750


    Is the Jannsen vaccine available in Ireland now or has it been removed?



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  • Registered Users Posts: 32,136 ✭✭✭✭is_that_so


    Yeah just Pfizer at present being given as boosters.



  • Posts: 0 [Deleted User]


    You make more money selling your product every 3 months than selling it every 8 months.



  • Registered Users Posts: 20,891 ✭✭✭✭Stark


    3 months is considered optimal timeframe for second dose of two-dose vaccines so makes sense that would be the recommended time for the J&J "booster". Which I don't really consider to be a booster because I can't see any reason for it not being a two-dose vaccine other than J&J looking to fill a market niche.



  • Registered Users Posts: 3,205 ✭✭✭Azatadine


    I had the J&J in May (52 YO) and I've received a Pfizer booster this morning. I had an aortic valve replacement 3 weeks ago. Hot the booster at my GP.



  • Registered Users Posts: 846 ✭✭✭keno-daytrader


    The HSE boss @paulreiddublin

    says it will be end of Dec / beginning of Jan before people in their 50s will be able to get boosters. Over 60s should mostly be done by end of Dec. @rtenews


    What an absolute joke, that will leave people with J&J in their 8th month with just one jab. NIAC said people with Janssen should be given a second MRNA jab after 3 months.

    Galway MVC closed on a Monday, wtf?

    But Paul Reid gets 8200 euros a week to operate this.

    The HSE and our Govt are truly pathetic.

    ☀️ 6.72kWp ⚡2.52kWp south, ⚡4.20kWp west



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  • Registered Users Posts: 32,136 ✭✭✭✭is_that_so


    This is not new information. 1m to do and 3-4 weeks to do so is why. Now you might counter with "Why didn't we start earlier?" but that's a different can of worms!



  • Moderators, Science, Health & Environment Moderators, Society & Culture Moderators Posts: 60,071 Mod ✭✭✭✭Wibbs


    Because though slightly lower overall than a full course of the two dose, the single dose of J&J showed a much higher effect than a single dose of the two dose vaccines, hence one was originally deemed sufficient. Indeed the two dose are now looking at having a third booster. A second shot of J&J at six months is as strong or stronger than three of the mRNA. Having a "one and done" approach was more than a "niche" too. For a start it doesn't require specialised refrigeration unlike the mRNA vaccines. It can be stored in a domestic fridge and lasts longer, so is a much better bet for use in less built up and advanced parts of the world and required only the one shot to give decent protection so much less of a requirement for a system of follow ups and that protection is in play more quickly. It's also cheaper than the mRNA vaccines, even though that tech has been promoted as the quicker to market cheaper option, and that was cheaper per dose with it. A requirement for two doses over doubling the price again.

    Rejoice in the awareness of feeling stupid, for that’s how you end up learning new things. If you’re not aware you’re stupid, you probably are.



  • Posts: 0 [Deleted User]


    if the reports around waning efficacy are to be believed (and I have seen nothing to convince me otherwise) the government is about to have 250,000 additional unvaccinated people to deal with, the majority of whom are in their fifties.

    There has been no joined up thinking. They simply vaccinated everyone and then stopped, there was no hint of any continuity despite being fully aware that there was a good chance this would be needed.



  • Moderators, Science, Health & Environment Moderators, Society & Culture Moderators Posts: 60,071 Mod ✭✭✭✭Wibbs


    if the reports around waning efficacy are to be believed (and I have seen nothing to convince me otherwise)

    Then maybe read the opening post on this very thread and look further? It's literally stated there:

    When compared to a South African study across 480,000 individual healthcare workers which was reported in this article: Johnson and Johnson vaccine effective against Delta variant (irishtimes.com) and goes on to mention: It’s probably more protective against delta than it was with the earlier beta strain, she said in a presentation Friday. The single-dose shot was 71 per cent effective against hospitalisation and as much as 96 per cent effective against death, she said. It also demonstrated durability of eight months. “These results show there is no need for a booster yet,” said Gray, who is president of the South African Medical Research Council.

    Far more numerous studies conducted across hundreds of thousands of test subjects in a few different nations and including the Delta variant have shown that efficacy remains high over a studied eight month period with the Jannsen vaccine and even today with talk of boosters all the rage researchers both inside and outside of J&J repeat that, but now add that a booster ideally at six months (or longer) gives even more protection, as far as antibody levels are concerned. Going on that the notion of "250,000 additional unvaccinated people to deal with" is more than a little melodramatic. Going by your assumption we're also dealing with the rest of the vaccinated Irish and their waning Pfizer/Moderna/AZ vaccines in need of boosters as more "additional unvaccinated" numbering in the millions. Eh, no...

    Rejoice in the awareness of feeling stupid, for that’s how you end up learning new things. If you’re not aware you’re stupid, you probably are.



  • Posts: 0 [Deleted User]


    what does "Durability" mean and how can an article written in August claim "Durability" of eight months, for a vaccine only approved for use in March?



  • Moderators, Science, Health & Environment Moderators, Society & Culture Moderators Posts: 60,071 Mod ✭✭✭✭Wibbs


    Durability means what the word means. The positive effects of the vaccine on serious illness and death from covid 19 remained durable over time. It was in human trials since the middle of last year and those subjects and others since in wider studies have been followed up, including nearly half a million healthworkers in South Africa where Delta's the main strain. All of this info is in plain English in the first post and the links contained within it. I'm not seeing the confusion.

    Yet your first post out of the gate suggests you're convinced about waning efficacy, it seems based on a single study, or more likely a media report on same. You then take a leap that would shame an olympic long jumper that this means we'll have quarter of a million unvaccinated people in Ireland. Then rewrite history regarding boosters where apparently they were "fully aware" that these would be required. They weren't. There was talk about maybes and how long immunity would last, even what type of immunity(active antibodies/Memory cells) would have real world impacts, but vanishingly few were talking about boosters until the Israeli experience and mostly Pfizer and mostly in the elderly demographic.

    Rejoice in the awareness of feeling stupid, for that’s how you end up learning new things. If you’re not aware you’re stupid, you probably are.



  • Registered Users Posts: 26 Mr shmar


    Although if you scroll down a good bit on this webpage, - - - covid19ireland-geohive.hub.arcgis.com/pages/vaccinations <- https:// (sorry, can't give direct link because of the new account) - - - there is a chart for "vaccinations administered by type" and as of the week ending on the 21st Nov, it shows that a handful of Jannsen vaccines are still being administered in Ireland. (easiest to see if you cross out Pfizer on the side of the chart so it zooms in.)

    I have been trying to find out where they might be administered. HSE helpline said they can only account for stats given on HSE website, but the woman I spoke with was kind enough to address what the chart that there were none being administered by any HSE facility etc., thus she said it would have to be coming from a pharmacy/pharmacies. Needless to say, my local pharmacies have found nothing and have been directing me to the HSE.


    This has all left me with the conclusion that one of three things is the case:

    a) these stats are simply wrong, which is absolutely possible, but then why are they there! If someone could tell me if the link I am providing is from an untrustworthy source I would appreciate any info about it.

    b) some random pharmacy or GP in Ireland is still administering a few. Who knows which one/ones!

    c) the few being administered are being used exclusively in emergency cases of some sort only.



  • Posts: 0 [Deleted User]


    are you saying waning efficacy isn't happening and is just a myth?

    then why are boosters jabs being given? it seems a bit mad.

    Or are you claiming that the one news report of a study (see, easy to do that isn't it?) claims that the Janssen vaccine is Durable, therefore it must still be trucking along at 90% efficacy, that's one hell of a hop, step and jump right there.

    Yay Janssen, the miracle vaccine.



  • Moderators, Science, Health & Environment Moderators, Society & Culture Moderators Posts: 60,071 Mod ✭✭✭✭Wibbs


    are you saying waning efficacy isn't happening and is just a myth?

    then why are boosters jabs being given? it seems a bit mad.

    It depends on where it's waning and how. The older someone is, or the more immunocompromised vaccine efficacy has long been understood to wane and can often be hard to achieve in the first place. For example the J&J waning study looked at just over one hundred people, mostly men with an average age of 61, with the vast majority suffering from serious underlying conditions. It would hardly be a shock that they would demonstrate waning and/or lowered immunity. The study also noted that they didn't check for cell memory immune response and the numbers involved in the studies were small. The actual study itself, if you'd bothered to read it concluded this: Although these real-world data suggest some variation in levels of protection by vaccine, all FDA-approved or authorized COVID-19 vaccines provide substantial protection against COVID-19 hospitalization.

    Boosters are being rolled out because nations like Israel showed a drop in serious illnesses and death among the elderly and chronically ill with comorbidities who got the boosters. It seems currently prudent to follow that lead.

    Or are you claiming that the one news report of a study (see, easy to do that isn't it?) claims that the Janssen vaccine is Durable, therefore it must still be trucking along at 90% efficacy, that's one hell of a hop, step and jump right there.

    That one news report contains links to more sources. There are any number of sources, actual peer reviewed studies out there a quick search engine of your choice away.

    Rejoice in the awareness of feeling stupid, for that’s how you end up learning new things. If you’re not aware you’re stupid, you probably are.



  • Registered Users Posts: 3,406 ✭✭✭chewed


    I got my J&J in July, so am I now to assume I have zero immunity to Covid now? Will I be expecting to be prioritised for a booster in coming weeks?



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  • Registered Users Posts: 32,136 ✭✭✭✭is_that_so


    January most likely. Under 50s then but if younger who knows.



  • Posts: 0 [Deleted User]


    I received it in May and i am in my fifties.

    I have no doubt that I still have some form of protection as the vaccine is a good vaccine and confident I am more protected now than before I received it.

    However, I am being more cautious until I see more evidence of the longer term efficacy or I receive a booster. I would be more than happy to receive a Janssen booster by the way. In fact, my little mind is telling m that this would be better for me than a Pfizer one, although I have nothing to base that on.



  • Registered Users Posts: 16,457 ✭✭✭✭astrofool


    That's a bad assumption to make, your antibody count will have dropped (our natural immune system loves to gradually get rid of coronavirus antibodies) but B-Cell and T-Cell response should remain strong so there will be higher latency to your response than if you'd just been vaccinated but much lower than if the virus was completely novel to your immune system.

    The question is if we can agitate the immune system once in a way that it doesn't get rid of the antibodies or have to agitate it in another way every X months/year for those people where that latency to respond causes severe disease. We may find that mild agitation occasionally is enough to keep the response quick and strong or that being exposed to essentially the same virus a few times may cause the immune system to keep the antibodies around for longer.

    For immuno-compromised people it looks like an extra dosage of whichever vaccine they got should be part of the initial course (difference between booster and 2nd/3rd dose).



  • Registered Users Posts: 1,402 ✭✭✭jammiedodgers




  • Registered Users Posts: 16,457 ✭✭✭✭astrofool


    See that tweet is just designed for clicks and views.

    20% what? Severe disease or infection? The former is a problem, the latter is an issue if you're vulnerable but not really otherwise.



  • Registered Users Posts: 8,913 ✭✭✭Danno


    Thats right up there with Oprah's infamous ''It has just stopped me cold from eating another burger! I'm stopped!''



  • Posts: 0 [Deleted User]


    there's an easy way to end this speculation. Carry out an actual study that people can trust.

    Maybe this "Leo" knows someone in the government that could arrange for this to happen



  • Registered Users Posts: 8,913 ✭✭✭Danno


    This is the small study they're basing it on to diss the J&J Vaccine.

    Comparative Effectiveness of Moderna, Pfizer-BioNTech, and Janssen (Johnson & Johnson) Vaccines in Preventing COVID-19 Hospitalizations Among Adults Without Immunocompromising Conditions — United States, March–August 2021 | MMWR (cdc.gov)

    Yet the USA (where this small study was conducted) are happy enough to administer a second shot of J&J as a booster.

    Leo knows more though, apparantly.



  • Posts: 533 ✭✭✭ [Deleted User]


    We haven’t bought any further viral vector vaccines since the summer. The EU programme is basically now Pfizer/BioNTech and Moderna.

    There were issues with supply chain bandwidth and there were the panics about blood clots, which changed focus to mRNA.

    The other issue is the Pfizer / BioNTech storage complications are largely resolved now. The extreme freezing temperatures were initially required but have turned out to have been unnecessarily conservative, so handling those vaccines is in reality far less complicated now.

    That’s why we’re running an mRNA booster programme.

    Only 236,277 J&J doses were administered vs 5.36m Pfizer/BioNTech



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  • Moderators, Science, Health & Environment Moderators, Society & Culture Moderators Posts: 60,071 Mod ✭✭✭✭Wibbs


    Well unless someone independently brings in the J&J or another viral vector, I for one will not be getting a booster based on mRNA.

    Rejoice in the awareness of feeling stupid, for that’s how you end up learning new things. If you’re not aware you’re stupid, you probably are.



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