Line Up For 3rd Coronavirus Vaccine Just Like The Others: Expert

WESTCHESTER COUNTY, NY — The Johnson & Johnson one-shot vaccine is the latest to get an emergency go-ahead from the U.S. Food and Drug Administration, after two-dose vaccines made by Pfizer-BioNTech and Moderna were approved in mid-December. Unlike those, the J&J vaccine does not need to be kept at extremely cold temperatures and can last up to three months with routine refrigeration — and while it's slighly less effective overall, it's equal to the other two in terms of preventing serious illness and hospitalization.

So Patch again sought commonsense advice from an expert. The first time we talked with Dr. Robert W. Amler, a dean at New York Medical College who was once chief medical officer at the federal Centers for Disease Control and Prevention's Agency for Toxic Substances and Disease Registry, there were just 22 cases of the new coronavirus confirmed in New York.

Patch: A year ago, you talked about four things that needed to happen: better testing, more widely available testing, antiviral medication, and a vaccine. Now the Johnson & Johnson vaccine has been given emergency authorization, the third vaccine to be approved by the FDA.

Amler: We have a new sharp arrow in our quiver, and people should line up for it just like for the others.

Patch: But this Johnson & Johnson vaccine is only one dose — and it’s said to be less effective. Should people be concerned?

Amler: For today’s world, these vaccines are equivalent. I know it was less effective in trials, but those are carefully controlled settings. In the real world, people miss their appointment and don’t get a second dose! There are many things that can happen that don’t happen in a trial. I would say for a one-dose vaccine that only needs to be refrigerated, that’s a huge difference.

Patch: Why are there stigmas over vaccines?

Amler: If I came up to you in the street with a syringe and said, "Lanning, take this shot, it’s good for you," you’d say, "Get away from me." Vaccine hesitancy is a very natural thing. If you are offered a shot of penicillin, it’s because you are sick and need that medication to feel better. But by definition, a vaccine is something you give to people who are healthy.

The whole benefit-to-risk ratio has to be obvious. The way we show it’s obvious that the risk is minimal and the benefit is huge — well, in the United States, 500,000 people have died this past year from COVID-19. For a while, 3,000 people were dying a day.

That’s like nine or 10 jumbo jets crashing every day, killing everyone on board. The coronavirus is a real risk, so the benefit is that vaccination sharply reduces that risk.

Some people will not recognize that unless you spend a little time with them and understand and own their concerns.

Patch: Does the anti-vax movement worry you?

Amler: It's a free country, people are entitled to their beliefs, but your right to your belief ends when it begins to harm others. It’s very important for those who believe strongly against vaccines to temper their rhetoric and make clear what they’re speaking about does not have reliable evidence to support it. Because if you’re going to make recommendations to the public about their health, you have to make sure you have reliable and reproducible information.

Patch: These coronavirus vaccines don’t use a weakened or inactivated element of the virus to get our cells to build an immune response but instead use gene technology to do the same thing — why are they still defined as vaccines?

Amler: Basically, a vaccine is an agent that, when it is introduced into you, it produces a result. These are different from other vaccines, but on the other hand this is not a new technology. This has been developed since at least 2002 when the SARS outbreak occurred.

Coronaviruses in general are very common. It’s a very large pool of different species including the common cold viruses and the flu viruses. Viruses like that mutate constantly. That’s why we get different strains of flu showing up.

Patch: Given the demographics of COVID-19 fatalities, isn’t it only the elderly who need to be worried about catching the coronavirus?

Amler: This virus is full of surprises. Some of the earlier responses turned out to be wrong. We thought masks weren’t needed because there wasn’t airborne spread, and we were wrong. We thought it would tend to wane and disappear in the summer. That did not happen.

Even though you’re reading "young people don’t get really sick with this," there is evidence there could be some long-term problems. You’re still better off getting vaccinated and not getting the virus.

Patch: A year ago, you wanted people to know that hand-washing, sanitation and keeping away from other people — which you called "non-pharmaceutical intervention" — all would have a demonstrable impact. Do you think that proved true?

Amler: I think that it did. In situations where people have been careful, we have generally observed lower rates of transmission. We particularly observed health care personnel have the lowest transmission rates. They were the most careful.

Families that had gatherings transmitted the virus. No blame on your beloved aunt, but it appears that in many ways the living room has been one of the riskiest areas.

I’ve told people: Don’t beat yourself up, do the best you can. Be all the more careful next time around. Get vaccinated.

Patch: We thought stress levels were high a year ago — now aren’t you seeing added stress over vaccinations?

Amler: I’ve heard so many testimonials from people calling me and saying they just got their second shot and they’re so happy, they feel so relieved. Stress is a natural reaction to a terrible crisis. Getting the vaccine gives peace of mind.

Patch: But?

Amler: The vaccine is not a bulletproof vest, and we still have to keep up our guard. The virus is a killer, and it is out there.