Johnson & Johnson’s Covid-19 vaccine could protect millions more Americans from contracting the coronavirus. The key will be assuring people that the single-shot vaccine is worth taking, as its overall efficacy appears lower than the two-dose ones already on the market in the U.S.

J&J’s shot, which U.S. regulators authorized Saturday, is more convenient than the vaccines cleared by the Food and Drug Administration last year. It requires one injection and can be stored for months in a refrigerator. State health officials and the Biden administration see it as a way to quickly host mass clinics as more transmissible virus variants continue to spread. Yet the ease of distributing the vaccine will need to be balanced with the risk of creating the perception that J&J’s shot is an inferior option.

At first blush, J&J’s formula looks less effective than the vaccines from Pfizer Inc.-BioNTech SE and Moderna Inc. It was found to be 72% effective in preventing moderate-to-severe Covid-19 cases in the U.S., and 66% effective globally. Pfizer-BioNTech and Moderna respectively touted 95% and 94% efficacy in preventing symptoms of the disease.

“I can certainly understand [people’s] confusion because there was a lot of data,” J&J’s Chief Executive Officer Alex Gorsky said in a phone interview Monday. “There’s a lot of facts, there’s a lot of figures.”

Yet it’s impossible to directly compare results. J&J conducted the largest Covid-19 vaccine trial to date, including at dozens of sites in South Africa and Brazil, pitting its vaccine against mutant strains of the virus that the earlier vaccines weren’t tested against. The 43,000-plus participant study began enrollment in September and reported results in late January. Cases were accrued at the pandemic’s peak globally.

“This is not the time to be quibbling over decimal places or the levels of efficacy that we’re seeing,” said Michelle Williams, an epidemiologist and dean of the Harvard T.H. Chan School of Public Health. Her message is clear: Vaccines are a public health tool meant to keep people from getting sick, becoming hospitalized, and overwhelming the health-care system.

Simple Messaging
That’s precisely what J&J’s vaccine does. Across all regions, including places where more transmissible variants have spread, the single shot was 85% effective in preventing severe disease after 28 days. Further, it demonstrated complete protection against all Covid-related hospitalizations and deaths.

Also, J&J’s refrigerated one-dose vaccine will be easier to distribute across the U.S. and globally, Gorsky said.

“We think that’s particularly true in the United States when you think about rural areas but equally as important when you get outside to you know, the developing world where it’s going to be so important,” Gorsky said.

H. Cody Meissner, a pediatric infectious disease specialist at the Tufts Medical Center in Boston and an independent adviser to the FDA, said public health authorities shouldn’t prefer one vaccine over another.

“It’s important that people do not think that one vaccine is better than others,” he said Friday during a public meeting after which the panel unanimously recommended that the FDA authorize the J&J shot. “All vaccines work with what appears to be equal efficacy and equal safety as of this time.”

Simplicity in messaging will be essential, said Glen Nowak, director of the Center for Health and Risk Communication at the University of Georgia. Health officials should stick to the main talking point: All three vaccines protect people against the strains of the virus currently circulating and causing illness and death in the U.S.

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