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Johnson & Johnson vaccine pause makes it tougher to immunize hard-to-reach populations against Covid

A homeless individual carrying gloves and a protecting masks sits with an indication that reads, “Seeking Human Kindness” amid the coronavirus pandemic on April 19, 2020 in New York City, United States.

Alexi Rosenfeld | Getty Images Entertainment | Getty Images

The Johnson & Johnson Covid vaccine pause could not considerably gradual the general tempo of the U.S. vaccine rollout, however is making it tougher for hard-to-reach populations to get a shot.

Following the Food and Drug Administration’s request on Tuesday that states quickly halt utilizing the J&J vaccine “out of an abundance of caution” after six girls developed a blood-clotting dysfunction, White House Covid czar Jeff Zients stated that the announcement wouldn’t have a major influence on the U.S. vaccination program.

“We have more than enough supply of Pfizer and Moderna vaccines to continue the current pace of about 3 million shots per day,” Zients instructed reporters at a press briefing.

So far, this has held true. The nation is averaging 3.3 million each day vaccine doses reported administered over the previous week, and three million when counting solely Pfizer and Moderna. Only about 7.8 million of the 202 million whole pictures given within the U.S. have been from J&J, in accordance to Centers for Disease Control and Prevention knowledge.

But the single-shot Johnson & Johnson vaccine does symbolize about 10% of all totally vaccinated individuals within the U.S., a proportion that was on the rise for weeks, and it has confirmed beneficial for sure conditions and communities.

“Because of the characteristics of the J&J vaccine, it is being used in many cases for particular circumstances and populations for which it has been harder to get vaccines for,” stated Josh Michaud, affiliate director for international well being coverage on the Kaiser Family Foundation. 

Mass vaccination websites and cellular vans that drive doses to be administered on the go doubtless have a better time with the Johnson & Johnson storage necessities, Michaud stated. That vaccine solely wants to be saved in a typical fridge whereas the wants for Pfizer and Moderna are extra strict.

And for sure populations, equivalent to prisoners who’re altering services or homeless individuals who don’t have a everlasting residence, administering a two-dose routine could be a problem. Many states have been utilizing the J&J vaccine with these teams as a result of it’s onerous to discover individuals to administer a second dose, in accordance to Michaud. 

The one-shot choice can also be extra interesting to those that are extra hesitant to get a vaccine. A March Kaiser Family Foundation survey confirmed that amongst those that say they need to wait and see how the vaccines are working earlier than getting vaccinated themselves, a bigger share would get the J&J one-dose vaccine in contrast to both of the two-dose choices.

One in six individuals within the “wait and see” group stated they might “definitely get” the J&J vaccine, whereas roughly one in ten stated the identical concerning the Pfizer or Moderna vaccines.

“We know there is a significant portion of people on the fence about vaccines in general,” Michaud stated, “And I think the J&J vaccine is actually a plus for that group. It’s a big selling point for people on the fence.”

Add all of those components up and the J&J pause might have “an important negative impact on the U.S. vaccination rate,” he stated.

It isn’t but clear how lengthy the halt on utilizing the Johnson & Johnson vaccine will final. White House chief medical advisor Dr. Anthony Fauci has stated that the pause might final from a matter of days to just a few weeks. 

Vaccinating the homeless

Shelly Nortz, deputy govt director for coverage with the New York City-based advocacy group Coalition for the Homeless, stated the Johnson & Johnson vaccine pause will make it tougher to get pictures for the inhabitants she works with.

The coronavirus has hit New York City’s homeless onerous, significantly these in communal dwelling services. A Coalition for the Homeless and New York University evaluation confirmed that as of February, the age-adjusted mortality charge for sheltered homeless New Yorkers was 49% increased than the citywide charge.

And whereas the vaccination marketing campaign amongst New York homeless is off to a strong begin — Nortz stated the town’s most up-to-date announcement confirmed about 4,500 totally vaccinated single homeless adults out of some 21,000 in whole, a tempo not far behind the nationwide charge — the J&J halt goes to be a hurdle.

“Everybody was really eager to have the one-and-done situation with J&J,” she stated, “especially for people who are unsheltered and therefore not in the same place predictably.”

The Coalition for the Homeless not too long ago launched a partnership with the Center for Urban Community Services, which affords cellular medical care throughout New York, to present the Johnson & Johnson vaccine at considered one of its emergency meals websites. That program is now on maintain, as are discussions about providing the J&J vaccine on the group’s headquarters the place many purchasers come to choose up their mail.

Dr. Van Yu, chief medical officer at CUCS, agrees {that a} two-dose Pfizer or Moderna vaccine routine makes issues way more sophisticated.

“If you’re living outside, how am I going to find you in four weeks?” he stated.

Yu stated the shelter system could make it simpler to hold monitor of individuals, however there’s nonetheless quite a lot of churn as individuals come and go or are reassigned to considered one of New York City’s a whole lot of shelter websites.

The ease of storing the J&J pictures is one other benefit when vaccinating the homeless, in accordance to Nortz. 

“The fact that the other two approved vaccines require, in one case, deep refrigeration storage makes it very challenging to do anything mobile or pop-up or with an unknown number of people showing up,” she stated.

Zients stated Tuesday that every one vaccine supply channels, together with cellular supply models, are outfitted to ship all three vaccines. Yu stated the Moderna vaccine is straightforward sufficient to deal with at his group’s cellular websites, however that the Pfizer vaccine’s ultra-cold refrigeration requirement means it’s not an choice.

He is at the moment sitting on 185 unused J&J doses, and doesn’t have entry to any Moderna vaccines.

Some homeless individuals within the South Bronx, the place Noel Concepcion works because the division director of grownup homeless providers for the nonprofit group BronxWorks, have most popular the J&J vaccine as a result of it solely requires one dose. But the pause and surrounding misinformation is making it tougher to talk the significance of vaccinations to a bunch that’s already skeptical of the federal government, Concepcion stated, and it could gasoline some hesitancy towards all three vaccine choices.

BronxWorks had to cancel a vaccination occasion to use current provide of J&J pictures due to the pause, in accordance to Concepcion.

J&J extra handy for a lot of working individuals

Other limitations to getting a Covid vaccine, equivalent to an rigid work schedule or childcare tasks, have made the single-shot Johnson & Johnson vaccine a necessary choice for some.

Liz Schwandt, who runs a volunteer group known as Get Out the Shot aimed toward serving to individuals e book vaccine appointments in Los Angeles, stated that lots of the callers into her crew’s helpline haven’t got conventional job advantages or protections equivalent to day without work from work. Many of them are home employees equivalent to home cleaners, non-public nannies, or gardeners who receives a commission in money off the books. Some are workers who don’t work a 9-to-5 job, just like the group of night time shift custodians that Get Out the Shot not too long ago booked appointments for.

Elizabeth Raygoza will get her Pfizer vaccine shot, March 17, 2021, from Physician Assistant-Certified Alyssa Hernandez as the town of Vernon Health Department workers used the town’s new cellular well being unit clinic to administer COVID-19 vaccinations to practically 250 important meals processing employees at Rose & Shore, a significant, locally-based ready meals merchandise producer that serves supermarkets, faculties, eating places, airways and others.

Al Seib | Los Angeles Times | Getty Images

“We hear stories all the time like hey, my employer is making me get the vaccine, but won’t give me time off,” she stated, including that “for a working family, missing four hours of a shift [for a vaccination appointment] can be a big wage loss.” 

Childcare tasks and reliance on public transportation additionally make going to a number of appointments extra tedious, in accordance to Schwandt.

While Get Out the Shot books appointments for all three vaccines, Schwandt stated the FDA’s preliminary approval of the J&J vaccine again in February was welcome news.

“We were so thrilled with it,” she stated. “We loved having the one and done option for people.”

A CDC panel on Wednesday postponed a choice on Johnson & Johnson’s Covid vaccine whereas the investigation into the blood-clotting dysfunction continues. The panel is anticipated to reconvene subsequent week, when it will resolve what it will suggest to the CDC.

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