Covid Vaccine

[Budd77]

I heard that the Moderna and Pfizer vaccine will be ok for us Cllers, but has anyone heard anything about the Johnson & Johnson , being that it is not a MRNA vaccine.

[Smith123456]

can you actually pick a vaccine?. most places can only get one

[Jonquiljo]

See medscape.com/viewarticle/94...

The J&J vaccine is supposedly to be one of the best. I think Phase 3 trials will finish February and FDA approval in USA is expected March. I expect that J&J has large production capacity - but again it matters which country purchased how much.

But as Smith123456 just mentioned, choice is not likely an option.

I have personally decided that unless I am forced to - the Astrazeneca vaccine at 70% effectiveness is really terribly inferior to the others available. Then again, it may not be approved in the US. It's unfortunate, but I certainly wouldn't feel safe with CLL with only 70% potential protection.

[G1llHa1n in reply to Jonquiljo]

But with the second dose it is supposed to take protection up to the 90+ effectiveness same as the others.

[Jonquiljo in reply to G1llHa1n]

No, actually. The two doses combined are supposed to give 60+% coverage at the doses specified in the clinical trial. Unfortunately/fortunately — the clinicians in the trial made a mistake and gave some people a 50% dose on the first shot and 100% dose on the 2nd shot. Subjects injected this way got 90% coverage.

So AZ roughly states 70% for both methods combined. Since the 90% coverage was a fortunate mistake, it is unclear what doses can or will be approved for final approval.

This is the problem. I believe AZ would have filed in the US for approval a long time ago if its clinical trial data was in order. Its hard to approve a vaccine when the best result achieved was through a mistake, not trial protocol. Perhaps AZ has continued the trial at different doses to get the better results. Frankly it seems a real mess.

I certainly would not want a vaccine touted as 90% based on a mistake — and guess that regulatory agencies would agree. If used in the original protocol, it may not be much over 60%. Seeing the data upon which the UK approved the vaccine would be helpful. The US has not yet approved it and Until they do — its not clear how AZ will fix the problem. .

[G1llHa1n in reply to Jonquiljo]

I believe there have been different levels of investigations/testing and information released in the follow ups in the US and the UK especially since the US has not chosen to clear it for use whereas it has been approved for UK use.

Personally I'll take 90% by whichever means.

[Jonquiljo in reply to G1llHa1n]

I'll take 90% by whatever means also. I would want to see AZ's data that shows 90% - when done by any means other than by mistake.

That's one big mistake to make - and if they had any sense, they'd have done the trial all over again.

[G1llHa1n in reply to Jonquiljo]

I think the desperate need for vaccines meant they redid some aspects of the studies and supplemented some areas of study. They have done work on efficacy again - the UK regulator has required that of them and dosage regimen has been adjusted.

[AussieNeil Partner Administrator]

There are some advantages to J & J's entry, primarily for distribution and storage, but effectiveness is also good: mdedge.com/internalmedicine...

Neil