How seriously should we take the new, pessimistic J&J vaccine study?

Well, I’m certainly taking it seriously — as I got the Johnson & Johnson vaccine in March. Since then, the follow-up studies on their COVID-19 vaccine have been sparse, almost to the point of non-existence. The new study published yesterday and reported by the New York Times certainly gives those of us who received this vaccine reason for some pause in relation to the surge in the Delta variant:

The coronavirus vaccine made by Johnson & Johnson is much less effective against the Delta and Lambda variants than against the original virus, according to a new study posted online on Tuesday.

Although troubling, the findings result from experiments conducted with blood samples in a laboratory, and may not reflect the vaccine’s performance in the real world. But the conclusions add to evidence that the 13 million people inoculated with the J.&J. vaccine may need to receive a second dose — ideally of one of the mRNA vaccines made by Pfizer-BioNTech or Moderna, the authors said.

The conclusions are at odds with those from smaller studies published by Johnson & Johnson earlier this month suggesting that a single dose of the vaccine is effective against the variant even eight months after inoculation.

The new study has not yet been peer reviewed nor published in a scientific journal. But it is consistent with observations that a single dose of the AstraZeneca vaccine — which has a similar architecture to the J.&J. vaccine — shows only about 33 percent efficacy against symptomatic disease caused by the Delta variant.

“The message that we wanted to give was not that people shouldn’t get the J.&J. vaccine, but we hope that in the future, it will be boosted with either another dose of J.&J. or a boost with Pfizer or Moderna,” said Nathaniel Landau, a virologist at N.Y.U.’s Grossman School of Medicine, who led the study.

This contradicts the J&J studies last month about which Allahpundit wrote two weeks ago. Or does it? Like Allahpundit, this goes above my pay grade too, but it’s not clear that the two studies focused on quite the same thing. This study used blood samples in the lab on a one-time basis, where the J&J-funded studies appear to be more longitudinal with inoculated subjects and their outcomes. The earlier studies have gone through some peer review as part of their publication process, although accelerated due to “intense interest from the public,” as the NYT noted at that time.

Besides, we already have some real-world data on a larger scale on which we can rely. Yesterday, New Jersey Governor Phil Murphy announced the number of breakthrough cases in the state thus far among the 4.4 million people fully vaccinated in the Garden State: fewer than 4,000 cases, 84 hospitalizations, and only 31 deaths. Even if all of those cases came from those who received the J&J (Janssen) vaccine (which is impossible to know based on public data but seems highly unlikely), that would be out of 388,800 recipients. That figures out to an effectiveness rating of 99.04% against symptomatic disease for the J&J vaccine, 99.98% against hospitalization, and 99.991% against death — even in an environment where the Delta variant has eclipsed all others as dominant. The sequencing of variants in the past four weeks in New Jersey shows Delta accounting for 51.4% of detected cases in the population as a whole, so these numbers reflect real-world performance in that sense.

So what’s the difference here between these studies and the real-world performance of the vaccines? It might be that they’re not measuring all of the components of immunity. Antibody production is important in the first phase as a measure of efficacy, but other parts of the immune response are harder to measure. T-cell response is part of the long-term immunity, and these studies (as well as those on Pfizer and Moderna’s vaccines) may not measure that, either fully or at all. It might also miss other components of immune response, too. Thus far, it appears that every study — even the Phase 3 testing of the vaccines — have actually managed to undersell the immunity conferred by the vaccines in real-world application.

Petri-dish studies have their value, but we should focus on the real-world, holistic performance of the J&J and the two mRNA vaccines now. It may still pay to get a cross-platform booster; I’ve considered doing that myself at some point, but want to wait for some data on how that will impact my immune response before going cowboy on the idea. While J&J CFO Joseph Wolk has a clear interest in making this argument about skepticism over narrow lab studies at this point, it doesn’t make him wrong about it, either.