Which COVID-19 Vaccine Is Best? 'The One You Can Get': Doctor

EVANSTON, IL — With the emergency authorization of the first single-dose coronavirus vaccine, health experts in Illinois and around the country are encouraging the public to take whichever type is available, whenever it becomes available.

Four million doses of one-shot Johnson & Johnson vaccine are due to begin arriving around the country Tuesday, and company officials have announced plans to deliver 20 million doses to the U.S. by the end of the month and 100 million by this summer.

The green light from regulators for the Johnson & Johnson vaccine follows the U.S. Food and Drug Administration's emergency use authorization of two-dose vaccines made by Pfizer-BioNTech and Moderna in mid-December. Unlike those previously authorized, the J&J vaccine does not need to be kept at extremely cold temperatures and can last up to three months with routine refrigeration.

Dr. Ben Singer, assistant professor of medicine in pulmonary and critical care at Northwestern University's Feinberg School of Medicine, said people should not be concerned with receiving one vaccine versus another.

"The best vaccine is the one that you can get, as soon as you can," said Singer, who treats coronavirus patients at the intensive care unit at Northwestern Memorial Hospital. He said all three have shown to be extremely effective at preventing severe cases of COVID-19.

"I don't think it makes a lot of sense to try to shop around for the vaccine," Singer said. "Because remember — the efficacy of not getting the vaccine is zero. So if you wait, and you get COVID, that means that you didn't receive the benefit of whatever vaccine you would have been able to get."

According to the results of its clinical trial, which included participants in eight countries including Brazil, South Africa and five Latin American counties, the vaccine was 85 percent effective in preventing severe cases of the disease across all regions within 28 days. Zero severe cases were reported 50 or more days after vaccination, and there were zero cases of COVID-19-related hospitalizations or deaths after 28 days.

"If you can take a disease that has killed 500-some-thousand people in the United States, and turn that same disease into something that feels more like a cold, even for those that do get it, that's a remarkable thing," Singer said.

While the Pfizer and Moderna vaccines have shown 95 percent efficacy against all symptomatic cases, their trials concluded last fall — before the emergence of new strains in the United Kingdom, Brazil, South Africa and elsewhere, which have shown signs of being more contagious or vaccine-resistant. The Moderna vaccine Phase 3 trial was only conducted in the U.S., while the Pfizer trial included participants in Argentina, Brazil, Germany, Turkey and the U.S.

Singer said there will never be a head-to-head randomized trial to compare the vaccines — since their efficacy has already been demonstrated, it would not be ethical.

With their trials conducted at different times, in different places, with different variants and infection rates, it is impossible to make an apples-to-apples comparison between the three types of vaccine authorized so far.

"The important thing from even those trials is, even in places where you had these emerging variants circulating, there was incredible efficacy in preventing bad outcomes," Singer said.

The differences are more important for the public health authorities responsible for distribution and scheduling of three different vaccines, each with different storage requirements and dosing schedules, than they are for the public. State and local health officials will be tasked with allocating where and when each company's doses are distributed.

"It's going to be determined based on where they think they can run the logistics best. If you have to set up a remote site that doesn't have the right freezer capability when you need prolonged refrigeration, then the Johnson & Johnson's probably what you'd put there," Singer said. "These are all things that are being considered when the supply chain logistics people roll out the distribution plans."

According to an unpublished Centers for Disease Control and Prevention survey conducted Feb. 11-15 presenting the efficacy data to the public, 58 percent of people would choose a two-dose vaccine, 7 percent would choose a one-dose vaccine and 21 percent would take either one.

But when those who said they would prefer the two-dose vaccine were asked if they wanted to wait an extra month, 28 percent would elect for the one-dose rather than waiting for a two-dose vaccine to become available.

In an ongoing survey of COVID-19 attributes by researchers from Northwestern and Ohio State universities, 45 percent of respondents last month said they were "likely" or "extremely likely" to take a COVID-19 vaccine when offered, while 23 percent described themselves as "somewhat likely" or "somewhat unlikely" and were classified together as "vaccine hesitant." The remaining 32 percent of respondents said they were "unlikely" or "extremely" unlikely.

According to preliminary results from the survey, the "hesitant" group was more likely to be female, Black, more religious, less interested in the news and less trusting of health care providers and public health experts.

A separate poll conducted last month by the Associated Press and NORC Center for Public Affairs Research found 68 percent of white people, 65 percent of Hispanic people and 57 percent of Black people reported they were "definitely," "probably" or "somewhat likely" to get vaccinated.

According to the CDC vaccine data tracker, 20.7 percent of Illinois' adult population had received at least one dose of a vaccine as of Monday — none of the vaccines are yet approved for children under age 16. Among its neighboring states, Illinois' vaccination rate was above that of Indiana, Missouri and Kentucky but below that of Wisconsin and Iowa.

Demand for COVID-19 vaccinations varies among regions. According to a U.S. Census Bureau survey from the first two weeks of February, about 60 percent of people in Illinois who had not yet received the vaccine would want one — almost 20 percentage points more than most Southern states.

The seven-day rolling average number of doses administered in Illinois stood at about 78,000 Monday, with 835,597 people — or 6.56 percent of the state's total population — fully vaccinated.