With both Pfizer and Moderna vaccines finally being delivered around the nation at a rate of 10 million doses a week, and Johnson & Johnson’s single shot vaccine likely to have its own hearing before the FDA’s panel of outside experts within the next two weeks, it’s worth reviewing the data from this chart again.
One thing that immediately stands out is how the vaccine is not just effective, it’s effective on dose one. Though both Pfizer and Moderna have insisted that theirs is a two-dose regime, it seems to take only about 10 days after the first dose for the vaccine to be powerfully effective. However, before any branch of federal or state government starts to think about delivering these vaccines “one and done,” there are a couple of caveats.
First, there’s duration. Early testing showed that people who had gotten ill with COVID-19 saw a drop-off in some signs of an immune response within a matter of weeks following the end of their infection. This was especially true of those who had a very mild or asymptomatic case of the disease. At the time, that raised concerns about potential for reinfection and made some experts worry that vaccines for the SARS-CoV-2 virus would not be long-lasting enough for the population to ever obtain herd immunity. Thankfully, neither of these things seems to be the case. Re-infection with the coronavirus appears to have remained rare even many months into the pandemic, and the vaccines so far distributed result in an immune response several times greater than what’s normally seen in a mild to moderate case. But data from both Pfizer and Moderna makes it clear that the second dose lifts that immune response even higher, which almost certainly means that it will be long-lasting. Immunity from the two-dose regime may last for a period of years.
Second, there are those frightening variants. The version of COVID-19 that has been dominant across the United States for most of the last year is one similar to the variant that was seen in Italy and France in the initial European outbreak. But that version is now being displaced by several new variants. The B.1.1.7 version, identified first with the U.K., appears to be more contagious, possibly more virulent, and also a bit more resistant to existing vaccines. In the Johnson & Johnson data, there was about a 10% drop off in efficacy when comparing the B.1.1.7 variant to earlier versions. The change is even more apparent when comparing to the South African B.1.351 variant, or the Brazil P.1 variant. Both of these have changes to the spike protein that make them less susceptible to being halted by current vaccines. But in all cases, a higher level of immune response is better. Most people who have received both doses of the Pfizer or Moderna vaccine should be having an immune response great enough that it overwhelms even the differences present in these dangerous new variants.
The way Johnson & Johnson’s vaccine works is a bit different. The 72% efficacy reported for the United States (66% in Latin America, 57% in South Africa) is really a kind of a point-in-time result generated from data 29 days after the injection. Before that date, the vaccine is less effective. After that date, it’s more effective. In fact, no vaccinated volunteer in any of the three studies came down with COVID-19 after Day 49. That doesn’t mean that the immune response of Johnson & Johnson’s vaccine keeps growing to the point where it provides 100% protection … but then again, it might.
What the results show with all three vaccines is this: Time is your friend. None of them provide immediate protection. Getting a jab and then heading for the the nearest bar to make up for a missing year’s worth of socializing is a truly terrible idea. Everyone should get their shot … then, for as long as possible, pretend that they didn’t. Keep social distancing. Keep following guidelines. And absolutely keep wearing a mask. These things will help make an already effective vaccine even more effective, reduce the chances of getting sick before the vaccine’s immunity takes hold, and minimize the risk of spreading some new variant you weren’t even aware was going around. It’s also not clear that a vaccine is going to prevent you from spreading the disease, even if it keeps you from getting ill. This is particularly true of the Johnson & Johnson vaccine, which rates its efficacy only in preventing moderate to severe disease, not in halting all infections.
As Dr. Anthony Fauci indicated on CNN on Wednesday, somewhere between 70% and 85% of the U.S. population will need to be fully vaccinated—that’s both doses of Moderna or Pfizer, or 30 days after an injection from Johnson & Johnson—before things start to look more normal. Then, if that masks really bothers you, you can take it off.
Then again, how many colds have you had this year?