I’m posting this partly out of guilt, as my reaction to this morning’s news was similar to Ed’s: Meh. Yeah, great, it’s nice to have another vaccine on the market, but who’d want to get J&J’s 72 percent effective vaccine when Pfizer’s and Moderna’s 95 percent nuclear weapon is available?

That’s a clown vaccine, bro.

Doctors and scientists are pushing back hard on that on social media, though. From a consumer’s perspective, J&J’s data is disappointing. If you’re looking forward to getting the shot, obviously you’d prefer the superior mRNA vaccines to the new guy. But 72 percent is still a solid degree of efficacy, experts are reminding people today, tantamount to the immunity provided by a flu shot. We’ve been spoiled by Moderna’s and Pfizer’s freakishly strong results. What we should focus on with any vaccine is not how many people get infected and develop symptoms after being immunized but how many people end up in the hospital or the morgue. Quote: “In the [Johnson & Johnson] clinical trial, all cases of covid-related hospitalization and death — the outcomes that most people would like to avoid — were among participants who had received placebo shots.”

Ideally, no one gets the jab would get sick at all. But if, at the end of the day, everyone who gets it ends up simply surviving COVID, that’s a hell of a lot better than 425,000 people dead.

The other reason for the disconnect between consumers and experts is that they’re looking at the pandemic from a macro perspective whereas you and I are looking at it from the micro view. Micro asks, “Which shot is best for me?” Macro asks, “Can this vaccine help us douse this global inferno before it burns through more uninfected people?” The answer to that question is clearly yes in J&J’s case and so scientists are popping the champagne:

2/2 This one shot vaccine was highly effective at preventing severe disease, even with new variants. The milieu of disease now is more complex; even in U.S. – trials done today are running into more mutated cases. Make no mistake: this is an important and wonderful development.

— Scott Gottlieb, MD (@ScottGottliebMD) January 29, 2021

I want to sum up the last two days in vaccine news: We got two more vaccines that work. I know, the variants complicate things, but this is still EXCELLENT news. Looking forward to J&Js prime-boost data.

— Florian Krammer (@florian_krammer) January 29, 2021

A single dose, easily transportable vaccine with 66% overall efficacy and 85% against severe disease is *absolutely phenomenally* good news – particularly for lower resourced settings https://t.co/Ho3mDmUIK0

— Alasdair Munro (@apsmunro) January 29, 2021

So while this may seem disappointing on the surface because it’s not as efficacious against all symptomatic disease as Pfizer or Moderna, it’s still great news. High efficacy against severe disease + one shot + less cold chain = more vaccines for all.

— Dr. Angela Rasmussen (@angie_rasmussen) January 29, 2021

Announcements by Novavax yesterday and JJ today should be cause for celebration. Yes, effectiveness is dampened against S. African Variants but 57%-72% efficacy still translates to millions of lives saved. 😷 will ⬆️ effectiveness until we #StampOutCOVID. https://t.co/MXq1Sd8PDO

— Prof. Dr. Benhur Lee, MD 🦠🧬🔬 (@VirusWhisperer) January 29, 2021

5. The J&J vaccine is fridge stable; it doesn’t have the same onerous shipping & storage requirements of the mRNA vaccines. It can be used with greater ease in more settings. It’s also inexpensive to make. “Frankly, simple is beautiful,” says Operation Warp Speed’s Matt Hepburn.

— Helen Branswell (@HelenBranswell) January 29, 2021

If you’re fighting a raging fire and another fire truck rolls up with a somewhat less powerful water cannon on the back, you don’t turn it away just because the trucks that are already on the scene can put more water on the flames. In fact, an interesting wrinkle in the data raises the possibility that J&J’s vaccine may be as powerful as Moderna’s and Pfizer’s over a slightly longer time horizon:

11. Thing to note about the J&J results: The immune response seemed to improve over time, with no cases in the vaccine arm after Day 49 post injection.
It’s possible maturation of the response may take longer with some vaxes than others. Durability an open Q for all the vaxes. pic.twitter.com/Rgr0X9WE8k

— Helen Branswell (@HelenBranswell) January 29, 2021

The story of common COVID in the United States has a reached a “boring” stage now in that we all know how it’s going to go over the next six months. More vaccines will be administered day by day, cases will decline, and life will gradually regain a degree of normalcy. The “interesting” story still to be told is what happens with the many variants circulating abroad that are starting to show up here. The J&J news this morning overtook an ominous report out of South Carolina that two separate cases of the dangerous South African strain of the virus have now been detected — in different regions of the state, in people who haven’t traveled recently. Community spread of that variant has clearly begun here, and that’s the variant that’s been most resistant to the current vaccines. J&J’s shot was only 57 percent effective against that strain. Novavax’s product was also less effective against it. So was Moderna’s, although Moderna believes that its vaccine will still produce enough antibodies to fend the virus off.

The war against common COVID has effectively been won. It’s a matter of continuing to advance and conquer enemy territory. The war against the variants is less certain. That’s what scientists are worried about now and why they’re eager for every weapon they can get, even if it’s not quite nuclear-scale like Pfizer’s and Moderna’s:

In a future where US is vaccinated but others are not

We could see rise of variants that can infect, cause outbreaks here and other vaccinated places

Requiring us to update our vaccines and vaccinate everyone again

It’s the nightmare scenario of a never-ending pandemic

6/7

— Ashish K. Jha, MD, MPH (@ashishkjha) January 29, 2021

Here’s a taste of what’s brewing in Brazil — and is already here:

More troubling may be the strain which has surfaced in Manaus, a Brazilian city of 2.2 million where an estimated 76 percent of the population has been infected and therefore should have enough naturally acquired immunity to constrain, if not suffocate, the spread of covid-19. That was the case for a while. But a new strain similar to the one in South Africa emerged, and infections caused by it are surging again in Manaus. This strongly suggests the virus has acquired the ability to evade naturally acquired immunity.

Both the Brazilian and South African strains have spread to other countries. On Monday, the strain from Manaus was identified in Minnesota.

Vaccinating the entire U.S. and letting the virus run wild elsewhere wouldn’t protect the U.S. long-term. Every outbreak abroad is a laboratory for the virus to mutate and become more efficient; potentially a super-contagious and/or super-lethal vaccine-resistant strain will emerge somewhere and eventually arrive here, rampaging through the population and placing us back in the nightmare of needing to vaccinate 300 million people immediately. You want to win the war, you need to make the world safe from COVID. And the only way to do it is to choke off as many vectors of transmission as possible, as quickly as possible, denying it opportunities to mutate. That’s what makes J&J a big win — not only does it do a solid-if-not-perfect job of immunizing people, its low-fuss storage/transportation requirements and its one-shot dosage make it a godsend for less wealthy countries. Combine that with J&J’s massive manufacturing capacity and we’re cooking:

3. J&J says it expects to be able to be able to produce 1 billion doses of vaccine a year — enough to protect 1 billion people. But Operation Warp Speed has previously warned that there won’t be lots of J&J vaccine supply for the US until April.

— Helen Branswell (@HelenBranswell) January 29, 2021

The way I’m imagining J&J’s vaccine, then, isn’t as a single fire truck rolling up on the burning building but a fleet of them. Their cannons are less powerful but collectively they may be able to put more water on the fire around the world than Moderna and Pfizer can. Especially in less developed countries.

As for its usage here, I’ll leave you with an idea from the head of the CDC’s advisory committee on vaccines: “I’d want to use the vaccine with higher efficacy in my most vulnerable population… I’d think about 60 to 70 percent efficacy in a younger population where we know that the secondary morbidity and mortality is much lower.” Give the mRNA nuclear weapon to the olds, whose immune systems need more help, and save J&J for the kids and younger adults who only need conventional weapons to win.