Johnson & Johnson: What’s different about the Corona vaccine?

Johnson & Johnson: What's different about the Corona vaccine?

With the vaccine from the US pharmaceutical company Johnson & Johnson (Janssen-Cilag), a fourth vaccine against the coronavirus has been approved in the European Union (EU). The vector vaccine was initially able to score with an essential unique selling point: only one dose should be necessary to ensure adequate protection against infection. However, studies now suggest that a booster with an mRNA vaccine is advisable. How effective is the Johnson & Johnson vaccine, how does it work, what side effects are possible, and what are the advantages and disadvantages of other vaccines?

Johnson & Johnson – what is this vaccine?

The vaccine from Johnson & Johnson, which bears the official name Ad26.COV2.S, also called COVID-19 Vaccine Janssen ®, is a vector vaccine. This means that certain information from the “blueprint” of the coronavirus is transported into the cells in the form of DNA via the envelope of a harmless virus, the so-called vector. The vaccine from Johnson & Johnson uses the envelope of the adenovirus Ad26.

Like the other approved vaccines, this shell contains the blueprint for the so-called spike protein, which is harmless but with which the coronavirus docks to human cells. It is this protein against which the body builds immune protection with the vaccination. In the event of later infection with SARS-CoV-2, the immune system recognizes the spike protein and can fight it in a targeted manner.

 

How effective is the coronavirus vaccine?

The approval study on the effectiveness of the Johnson & Johnson vaccine included almost 40,000 people. These came from the USA, Latin America and South Africa. Half of the participants received the coronavirus vaccine, and the other half received a placebo.

The study showed the vaccine was 67% effective against moderate to severe courses and 77 to 85% against life-threatening courses. Complete protection was given 28 days after vaccination. There were no deaths from COVID-19 in the test group that received the vaccine, so the vaccine looks pretty protective.

The Robert Koch Institute states that the vaccine protects against infection with COVID-19 at 65 per centThe vaccine protects 100 per cent from a severe course that requires treatment in the hospital. However, these figures do not apply to infections with the delta or omicron variant of the coronavirus.

Vaccination significantly reduces the likelihood of infection, but not 100 per cent. In rare cases, vaccinated people can also become infected with the coronavirus and pass it on. In the event of an infection, the course of the disease is usually mild or asymptomatic despite vaccination.

How effective is it in older people?

19.5 per cent of those who participated in the efficacy study were at least 65 years old, and 3.7 per cent were 75 years old or older. Efficacy in these older people was the same as in the rest of the group. Only in the group of over 60-year-olds with additional diseases (comorbidity) was a slightly reduced effectiveness. However, severe courses of COVID-19 were not observed in these participants either.

However, due to the low number of participants over 75, the corresponding data were only classified as of limited significance according to the American drug agency FDA.

According to current knowledge, the same effectiveness is assumed for all age groups.

 

Does Johnson & Johnson’s vaccine work on mutations?

Regarding the alpha, beta, and gamma variants, the effectiveness of the Johnson & Johnson vaccine is only slightly reduced according to the current state of knowledge.

Data on the effectiveness of the Delta variant were initially inconsistent: According to the results of studies by Janssen-Cilag, vaccination with the vaccine also protects 77 to 85 per cent of infections with the Delta mutation from severe courses. However, a study by the Grossman School of Medicine in New York found that the delta variant had a significantly lower antibody titer and was, therefore, less effective. However, both studies had a low informative value since only a few test persons* (eight and ten participants, respectively) were examined in their context.

In the meantime, however, the protective effect against the Delta variant is assumed to be reduced. If infection with this mutation occurs, the protective effect against a severe course after vaccination with the vaccine from Johnson & Johnson is 70 per cent, according to the Robert Koch Institute. In addition, so-called vaccination breakthroughs occur more frequently after a single vaccination. Therefore, a booster vaccination with an mRNA vaccine is recommended promptly (from four weeks after the vaccination).

About the highly contagious omicron variant, a one-off vaccination with the Johnson & Johnson vaccine hardly offers any protection against COVID-19, according to the first study results. When 169 plasma samples from individuals who had received the vaccine were tested, no neutralizing antibodies to Omicron could be detected. A second and third vaccination with an mRNA vaccine is therefore currently recommended.

 

Differences and similarities to other vaccines

Compared to the vaccines from BioNTech/Pfizer, Moderna and AstraZeneca, the Corona vaccine from Johnson & Johnson has some similarities and differences.

functionality

The Johnson & Johnson vaccine is a vector vaccine. Like the AstraZeneca vaccine, it uses an adenovirus as the transport envelope for the spike protein’s blueprint. Johnson & Johnson uses the Ad26 adenovirus, also part of the first dose of the Russian vaccine Sputnik V. AstraZeneca. On the other hand, it uses the adenovirus ChAdOx1.

The mRNA vaccines from BioNTech/Pfizer do not use a virus to transport but a shell made of fats (lipids). The blueprint for the spike protein is not in the form of DNA but in the form of mRNA (“messenger ribonucleic acid”).

 

administration

This is the most significant difference to all previously approved vaccines: the vaccine from Johnson & Johnson does not have to be injected twice, but only once. Before the start of the study phase, the AstraZeneca vaccine was also considered to be tested for single administration. Still, the company hoped that the two-dose vaccine would be more effective.

The one-off vaccination offers both the advantage that the vaccination process can be completed more quickly and that no vaccine doses must be kept available for a second vaccination. All stored vaccine doses can be used up, and the logistical and organizational effort is significantly reduced. Like the other vaccines, the Johnson & Johnson vaccine is injected into the muscle of the upper arm.

storage

Like AstraZeneca’s vaccine, Johnson & Johnson’s vaccine can be stored at average refrigerator temperatures. In contrast, mRNA vaccines can only be stored in pharmaceutical refrigerators at a significantly lower temperature for longer.

effectiveness

The effectiveness of the Johnson & Johnson vaccine is given as 67 per cent for moderate to severe courses and 85 per cent for life-threatening courses. The average efficacy of the BioNTech/Pfizer and Moderna mRNA vaccines is 95 and 94.5 per cent, respectively. According to the manufacturer, the vector vaccine from AstraZeneca has an effectiveness of 70 per cent, which the European Medicines Agency (EMA) calls 60 per cent. However, recent studies indicate a higher effectiveness of this vaccine.

The effectiveness of protecting against life-threatening courses is, therefore, slightly lower for the vaccine from Johnson & Johnson than for the other vaccines. According to studies, the vaccines from BioNTech/Pfizer, Moderna and AstraZeneca are 100% effective here.

The effectiveness against the delta and omicron variants of the coronavirus is also reduced compared to mRNA vaccines.

Johnson & Johnson: What are the side effects?

Similar to the previously approved vaccines, moderate side effects have been observed with the coronavirus vaccine from Johnson & Johnson. The most common side effects were:

These side effects were usually mild or moderate. Side effects were less common among participants over 60 years of age. Severe allergic reactions after vaccination have occurred in sporadic cases.

After some cases of thrombosis became known after vaccination with the Johnson & Johnson vaccine in the USA, the EMA re-examined the vaccine. After testing, the vaccine was cleared for use in the EU. According to the EMA experts, sinus vein thrombosis can occur as an infrequent side effect of the vaccine, but the benefits of the vaccination outweigh the risks. However, the Standing Committee on Vaccination recommends vaccination with Johnson & Johnson for those over 60 years of age, similar to the AstraZeneca vaccine.

Since the vaccination may be linked to Guillain-Barré syndrome, the nerve disease has been included in the list of rare side effects. Symptoms of neurological disorders include paralysis and numbness. According to current knowledge, the syndrome occurred due to the vaccination in less than 0.01% of vaccinated people.

In January 2022, the EMA also reported on transverse myelitis (TM) cases, which can occur as an infrequent side effect after vaccination with the Johnson & Johnson vaccine. The neurological disease can cause symptoms such as tingling, numbness or bladder and bowel dysfunction.

Who is Johnson & Johnson’s vaccine approved for?

On March 11, 2021, the EMA Committee for Medicinal Products for Human Use recommended conditional approval of the vaccine in the EU. The EU Commission followed this recommendation. Admission applies to persons over the age of 18. In Germany, the vaccine is recommended for people over 60. Anyone under 60 who is interested can also be vaccinated with the vaccine after consulting a doctor. A booster vaccination with an mRNA vaccine is possible four weeks after vaccination.

Second and third vaccination

Recent studies show that a booster vaccination with an mRNA vaccine can help to improve vaccination protection significantly. Since October 2021, the Ministry of Health has recommended a booster vaccination for optimized primary immunization no earlier than four weeks after the one-off vaccination with the Johnson & Johnson vaccine. This should be done with the BioNTech/Pfizer or Moderna mRNA vaccines.

With the appearance of the omicron variant, this recommendation has become even more urgent because, according to the first study results, the single vaccination from Johnson & Johnson does not offer any significant protection against COVID-19 with the omicron variant. On January 15, 2022, the federal government adjusted the criteria for the vaccination statute accordingly as part of the protective measures exception ordinance. A person is now considered fully vaccinated only if they have received a second vaccination. mRNA vaccines are recommended for this. A third vaccination with an mRNA vaccine should occur three months after the second vaccination – only then is it considered boosted.

Transitional periods apply in some federal states. According to this, one is treated as a boosted person if the second vaccination was over two weeks but less than 90 days ago.

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