With a one-dose immunization now a part of Maryland’s COVID-19 vaccine rollout, eligible residents have started to wonder for the first time whether they have a choice to make.
Some Maryland residents are insistent about getting the two-dose vaccines produced by Moderna and Pfizer-BioNTech, concerned with the efficacy ratings for the latest approved product. Others just want the ease of the single-shot immunization made by Johnson & Johnson, about 50,000 doses of which arrived in the state in early March.
Considering that the supply of vaccines is still strained, public health experts and government officials say it’s no time for people to shop around for specific shots. With more contagious variants of the virus spreading, infections remaining relatively high and governments lifting restrictions, they say it’s about getting the vaccines — all of which are effective in preventing hospitalization and death — into arms.
“Putting off getting your vaccines while waiting to get the one you want in a setting where there are still a lot of infections going on, that’s what we’re trying to avoid,” said Dr. William Moss, executive director of the International Vaccine Access Center at the Johns Hopkins Bloomberg School of Public Health.
But now that there are three options, the latest of which features significant differences compared with the first two, it’s no surprise people have preferences, Moss said.
When it came to immunizations by Pfizer-BioNTech and Moderna, there was hardly a choice to make.
Both require two doses. Known as mRNA vaccines, they function by teaching cells in the body to make a protein that triggers an immune response to produce antibodies for the virus. In clinical trials, they were more than 94% effective at preventing symptomatic COVID-19 illness, according to the U.S. Centers for Disease Control and Prevention.
The Johnson & Johnson vaccine requires just one shot. It’s what’s known as a viral vector vaccine, which use a modified, harmless version of the virus to teach cells to produce a similarly harmless piece of the coronavirus in the body and triggers the immune system to produce antibodies. The single-dose immunization was 85% effective at preventing severe illness and 66% effective against moderate sickness.
“The Johnson & Johnson vaccine was still highly efficacious against severe disease, especially hospitalization and death,” Moss said. He added that it was tested later in the pandemic, when more contagious virus variants had become prevalent.
“It was almost tested with a different virus, more of the transmissible variants. That too is another factor that perhaps mitigates the lower overall efficacy,” he said.
But still, the Johnson & Johnson vaccine was on the mind of Leonard Foster, 66, as the West Baltimore resident inched Tuesday toward the vaccination clinic at the Baltimore Convention Center.
Foster had been waiting for his appointment for several days, eager for a dose of the Pfizer-BioNTech or Moderna vaccines to be shot into his shoulder. Foster said a close friend had been infected with COVID-19 and spent more than a month in the hospital. An immunization was his ticket to avoid getting sick.
But he was adamant about avoiding the new one-dose vaccine. He felt there was just too much uncertainty about Johnson & Johnson’s product, authorized for emergency use Feb. 27 by the U.S. Food and Drug Administration.
“If I get inside and they only are offering Johnson & Johnson, I will have to rain check,” Foster said. “The vaccine just came out, so this is still trial and error.”
Maryland vaccinators have discretion about whether to tell people which vaccine will be administered before they show up for their appointments, said Charles Gischlar, a spokesman for the Maryland Department of Health. The agency recommends “eligible individuals get any vaccine that is available as soon as possible.”
In the early stages of the Johnson & Johnson vaccine’s rollout, Maryland has been among states that paced the nation in providing the single-dose inoculation to its residents.
As of Monday, just four states had administered a greater percentage of their Johnson & Johnson vaccines, according to CDC data. Maryland has utilized 50,258 of the 65,100 doses allocated to the state by the federal government.
The state has spread out its Johnson & Johnson supply to health departments, hospitals and mass vaccination clinics, like the one at M&T Bank Stadium in Baltimore.
But fodder about which vaccine to get has come up already on the Facebook page Maryland Vaccine Hunters, which has become the de facto authority for many residents struggling to navigate the complex maze of online registrations. Some commenters wrote about elderly relatives or neighbors who wanted one type of vaccine and asked the group’s 65,000-plus members where they could find it.
Among them was Carroll County resident Diana Holland, 50.
Holland has been helping elderly neighbors and members of her church community register for the vaccine, which has proved to be challenging for many seniors. She said one neighbor wanted only the Johnson & Johnson vaccine. Her husband preferred the same option.
She said their logic was one appointment is easier than two, but they kept it in perspective: “We would prefer the one, but we’ll take what we can get.”
Public health officials agree with that sentiment. They point to the threat of more transmissible strains of the virus first detected in the U.K., Brazil and South Africa — the last of which the Johnson & Johnson vaccine factored in. As of Thursday, there were 147 total cases of the various variants identified in Maryland, about two months after the first case was discovered.
“Right now, to the best of our knowledge, the best vaccine is the one you can get,” said Gigi Gronvall, an immunologist and senior scholar at the Johns Hopkins Center for Health Security.
That’s now, while the supply is limited. By summer or fall, Moss can envision providers being stocked with multiple brands of the vaccine.
“I have no doubt we’ll get in the coming months to a point where people will have more of an opportunity to get the vaccine of their choice,” Moss said.
In the meantime, Baltimore County Health Officer Dr. Gregory Wm. Branch continues to urge residents to practice the “three W’s” of coronavirus safety: Wear masks, watch physical distancing and wash hands.
Speaking to the news media Wednesday at his agency’s vaccination clinic in at the state fairgrounds Timonium, he added a fourth: “Welcome whatever brand of vaccine you are offered.”
Baltimore Sun reporter Nathan Ruiz contributed to this article.
