Post #827: Yeah, this really is the vaccine I want

Posted on September 27, 2020

Source: Safety and immunogenicity of the Ad26.COV2.S COVID-19 vaccine candidate: interim results of a phase 1/2a, double-blind, randomized, placebo-controlled trial.  Jerry Sadoff, Mathieu Le Gars, Georgi Shukarev, et al.,

Four days ago, in Post #824 , I stated that the Johnson and Johnson (J and J) COVID-19 vaccine is the one I want to get.  That was based on my reading of the initial research findings on monkeys, and some oblique hints dropped by US public health officials.

Friday’s news strongly reinforces that conclusion.  J and J tested the vaccine on hundreds of healthy people, and 98% of them developed “neutralizing antibodies” four weeks after vaccination. You can see popular press reporting of this at these links (The Independent, Reuters), and can read the original research at this link (medRxiv, hit “download pdf” to see full research paper.)

The term of art for that is immunogenicity.  The 98% immunogenicity of the J and J vaccine should be contrasted against 70% immunogenicity of the US vaccine, indirectly described by the head of the US CDC, less than two weeks ago (Post #815, What if this is as good as it gets?).

That was the incident where the head of the CDC sat at the microphone, waved around a mask, and said that  mask was going to provide you with more protection than the US vaccine.  Almost undoubtedly, the vaccine he was referring to was the Moderna vaccine.  There were good reasons to suspect that the Moderna vaccine wouldn’t be very good, starting with the fact that Moderna has never successfully produced a vaccine.  You can see the “baggage” that vaccine carries laid in full in Post #780.

If you read the details of the reporting, there are only a couple of issues.  One, this vaccine can make you noticeably ill for a few days.  About 20% of those vaccinated then ran a fever for a couple of days.  Many people reported soreness at the injection site.  But, in a sense, that goes hand-in-hand with the high immunogenicity.  You are trying to provoke an intense immune system reaction from the body.  Two, unfortunately, it may not make old people ill enough.  There were only 15 study participants age 65 and older, and they showed a much weaker reaction to the vaccine.  (Which is common, and that’s why many vaccines come in an “extra strength” dosage for the elderly.)

The final word of caution is that immunogenicity is not the same as effectiveness.  I laid that out in Post #815.  So the fact that this provokes a high titer of the right antibodies in 98% of people doesn’t mean that it prevents COVID-19 infection 98% of the time.

But at this point, it’s reasonable to guess that this is going to be a fairly effective vaccine. 

As a final footnote, I noticed similar research published for Pfizer’s vaccine (again at medRxiv).  To my eye, that looks every bit as promising as the J and J vaccine.  Below, the dots show the level of antibodies up to 28 days after vaccination.  There aren’t many dots, but all of them are way above zero four weeks after vaccination.

Source: Phase 1/2 Study to Describe the Safety and Immunogenicity of a COVID-19 RNA Vaccine Candidate (BNT162b1) in Adults 18 to 55 Years of Age: Interim Report.  Mark J. Mulligan, Kirsten E. Lyke, Nicholas Kitchin, et al,

The big drawback of the Pfizer vaccine is that it has to be stored at -94F, which is not achievable with standard refrigeration equipment.  (See this excellent discussion at fiercepharma).  (For those of you who have been following this, I also note that Moderna’s (US vaccine) claim of -4F storage for its vaccine has some significant caveats, and that for emergency-use authorization they are requiring the same ultra-cold storage temperatures as Pfizer.  Which is no surprise (see Post #789)).

The bottom line to all of this is that many competent drug companies appear to be capable of producing an effective and timely COVID-19 vaccine.  Just not the one that the our current administration chose, in a classic act of crony capitalism, backed with billions of your tax dollars (Moderna). (Read between the lines of the last two paragraphs of the fiercepharma article cited above, and you’ll get the drift.)

Given this administration, you really need to fear that much of the vaccine effort is geared toward making sure Moderna cashes in, rather than making sure Americans get the best.  In hindsight, I now wonder if much of the shilly-shallying over not distributing vaccines before they are fully tested is really aimed at helping Moderna.  If only 70% of the vaccinations with the Moderna product generate an immune response (i.e., 30% are duds from the get-go), the overall effectiveness of it could be close to, or perhaps below, 50%.  At that point, the only time they’ll be able to sell it in the US, per the stated FDA standard of minimum 50% effectiveness, is before the clinical trials finish, on an “emergency” basis. 

So we’ll eventually have an effective protection against this disease, despite our Federal government.  To me, that pretty much sums up the entire US response to coronavirus.