Michigan Medicine has given the Washtenaw County Health Department 200 doses of the Johnson and Johnson Janssen COVID-19 vaccine that the hospital received, according to Mary Masson, director of public relations for Michigan Medicine.
In a March 15 email to The Michigan Daily, Masson wrote that Michigan Medicine has partnered with local health departments and other health systems across the region throughout the pandemic to deliver the vaccines quickly.
“Through this ongoing collaboration, we decided the most efficient way for the 200 Janssen vaccines that Michigan Medicine received to be administered was through the Washtenaw County Health Department,” Masson wrote. “Michigan Medicine has excelled in mass delivery of the Pfizer and Moderna brands across our sites, so we traded doses with the county to be able to best meet community needs.”
Masson also noted that the Johnson & Johnson vaccines are a small fraction of all the vaccines the hospital has received. The majority of vaccines administered by Michigan Medicine are the Pfizer vaccine, and a small amount are the Moderna vaccine.
Michigan Medicine has administered 74,692 COVID-19 total vaccination doses as of March 16. Of those, 41,148 have received the first dose, and 33,544 have received the second dose and are fully vaccinated.
As of March 5, roughly 26% of University of Michigan students and employees have been vaccinated. Michigan Medicine is currently in Phase 1B of vaccine eligibility which includes people over the age of 50 with specific medical conditions, people over the age of 65 and caregivers of children with special needs.
Once a vaccine receives authorization from the Food and Drug Administration, the Centers for Disease Control and Prevention makes recommendations on who should receive the vaccine, and doses are shipped to states and jurisdictions based on need and supply. State and local health departments can then allocate the doses they receive per public health guidelines.
The Johnson and Johnson vaccine received emergency use authorization from the FDA on Feb. 27 for individuals aged 18 years or older. Unlike the Pfizer and Moderna vaccines, both of which require two doses administered 21 and 28 days apart respectively, the Janssen vaccine will require only one shot. Studies show the Johnson and Johnson vaccine is 85% effective at preventing severe COVID-19 illness and protects against COVID-19 related hospitalizations and death starting 28 days after administration.
The CDC vaccination webpage states that the new Johnson & Johnson Janssen vaccine shows early evidence of providing protection against asymptomatic infections and that the vaccine is very effective at preventing hospitalization and death in people who fall ill. The CDC says other COVID-19 vaccines may also protect against asymptomatic infection, but a definitive conclusion has not been reached.
University community discusses Johnson & Johnson vaccine
In an email to The Daily, Jon Zelner, a social epidemiologist and assistant professor of epidemiology at the School of Public Health, wrote that whether the single shot versus a double shot affects accessibility for different communities remains to be seen. He said he believes the strategy for effective vaccine distribution should be focused on clinical implications.
“I think that our focus in allocating the different types of vaccinations should be focused on the clinical benefits of targeting them at different groups, to the extent that there are differences in the nature and strength of protection afforded by the different options on the market, all of which are very good,” Zelner wrote. “For example, it makes sense to me that people at higher risk of severe complications and death might be preferentially offered the mRNA vaccines from Pfizer and Moderna, which may be a bit more effective at blocking transmission and severe disease than the J&J vaccine.”
In preventing COVID-19 infection, clinical trials showed that the Pfizer vaccine is 95% effective and the Moderna vaccine is roughly 94% effective. Despite the differences in each vaccines’ efficacy, Zelner emphasized that the Pfizer, Moderna and Johnson & Johnson’s Janssen vaccines are all very good options and the choice between one or two shots has a marginal impact for most.
When asked about her preference for the single or double dose vaccine, LSA sophomore Gabrielle DeMott wrote in an email to The Daily that she would choose the single dose if the double dose could be given to someone who needs it more, namely the elderly and medically higher risk populations. She wrote she was also hopeful that the single dosage would have a wider outreach because it does not require the ultra-cold freezer temperatures of the Pfizer and Moderna vaccines.
“I think the J&J vaccine will be good for younger people who don’t need the higher levels of protection offered by Moderna or Pfizer,” DeMott wrote. “The J&J vaccine will also hopefully make vaccination more accessible for people in rural areas since it’s only one dose and has less extreme storage requirements.”
Though the method the Janssen vaccine prevents COVID-19 is different — specifically in that it is not an mRNA vaccine like those produced by the Pfizer and Moderna two vaccines — the CDC ensures both vaccine types undergo rigorous safety standards. They also emphasize that all three vaccines do not interact with the receiver’s DNA and cannot give the receiver COVID-19.
Zelner wrote he believes that while people will be happy to receive this vaccine in the long run, the potential perception of the J&J vaccine as a second-class shot compared to the Pfizer and Moderna shots is worrisome.
“It’s not helpful too that it has been discussed primarily in terms of its convenience relative to the 2-shot regimens, because that aids the perception that it is a less-good product that is being targeted to people who are less well-off,” Zelner wrote. “But this is also a function of our broken healthcare system that leaves opportunities for wealthier people to shop around for what is perceived to be the best, even when that runs counter to public health interests and/or reality.”
Rackham student Faith Ashmore echoed Zelner’s thoughts. She said she believes the single shot vaccine has the potential to shift the public mindset both positively and negatively towards COVID-19 vaccinations.
“I think it has the potential to make (vaccination) easier, but I think it also raises questions of (why) it’s one dose now (when it needed) to be two doses before,’” Ashmore said. “It raises doubt and without proper, easily digested information, it contributes to distrust.”
Unlike the Pfizer and Moderna two-dose vaccines, the Johnson & Johnson vaccine only requires one dose. This is because the Pfizer and Moderna are mRNA vaccines while the Johnson & Johnson is an adenovirus vector vaccine, which allows the vaccine to be stored for three months in a regular refrigerator instead of below-freezing or subzero temperatures the mRNA vaccines require.
Public Health junior Nithya Arun, also a Central Student Government presidential candidate, said there is a larger problem of vaccine inequity amongst Black, Indigenous and people of color communities that is rooted in historical systemic medical racism.
“There are hurdles: public health and medicine haven’t been the most conscious fields in terms of ethicality,” Arun said, referencing the Tuskegee syphilis study. “There’s this history in medicine and public health of exploitation, and that builds medical and public health distress. Like, (if) that’s what the medical community did to you, then how could you ever bring yourself to trust them?”
The Tuskegee syphilis study — one of the most infamous U.S. medical studies for its racism — followed the lives of Black men who had syphilis for decades to see if the illness affected Black men differently. The men were not offered penicillin when it became the standard syphilis treatment.
Arun said public health entities need to be connecting with these vulnerable populations and ensuring equitable vaccine distribution.
“The onus is on us, the onus is on public health professionals to bridge this gap and ensure that (BIPOC) communities are protected from COVID,” Arun said. “We need to be doing better.”
To help educate vulnerable communities on the vaccine, the U-M NAACP held a roundtable discussion via Zoom in January. The talk also helped clarify information about COVID-19 and discussed racial disparities in health care.
Zelner wrote health and income disparities affect COVID-19 vaccination and recovery in various communities. He wrote the static pattern of inequity perpetuated throughout history should be recognized.
“I think if we look at historical examples, whether it’s the 1918 flu or tuberculosis in the early 20th century, we see the same patterns of disparity over and over again,” Zelner said. “Poorer and otherwise less-advantaged individuals are pushed to the front of the line for exposure and have to wait the longest for some kind of relief, whether that’s in the form of treatment for acute disease or preventative measures like vaccination.”
Zelner wrote it is important to remember that the goal is achieving population-level protection and rolling the vaccines out to various communities is a good way to get there faster. Once the percentage of the population that is immune exceeds the percentage of the population who can contract the disease, the population has reached herd immunity and spread of the disease from person to person will decline.
“Ultimately, all of them are excellent at preventing severe disease and death, which should be our primary focus,” Zelner wrote. “And since the trials for the Pfizer and Moderna vaccines happened at a different time and in a different epidemiologic context in terms of variants, etc. you could just be rolling the dice on a non-existent or trivially small difference by holding out for a different vaccine.”
Daily Staff Reporter Justine Ra can be reached at rjustine@umich.edu.
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