Thousands of Granite Staters have received the single-dose Johnson & Johnson shot as their primary COVID-19 vaccine series.
As reports of potential health complications and the new, highly contagious Omicron variant takes hold, many have questions on how they’re affected.
The Monitor spoke with with Dr. Jose Mercado, Dartmouth-Hitchcock Medical Center’s COVID-19 Response Leader, to address what recent scientific studies say on the topic.
Can you give an overview of whether someone who got the Johnson and Johnson shot has less protection than someone who got one of the other two mRNA shots?
I would not really focus on comparing mRNAs versus J&J. I think the way I would really view it is that we do know if you’re unvaccinated, you’re still at least 14 times more likely of dying than if you were vaccinated. And you know, that’s in broader terms. They don’t distinguish between mRNA versus a J&J.
There are some preliminary studies done in countries where Omicron was predominant that showed that J&J was still pretty good as far as preventing severe disease. They were quoting up to about 85%, so I think that is still a good number.
The CDC had changed their recommendations, where they now say, mRNA vaccines are preferred over J&J but that is really more because of additional data around adverse effects.
Can you tell me more about that recommendation?
There is additional data that shows that certain individuals or populations may be at risk for TTS (Thrombosis with thrombocytopenia syndrome) which is that you might have a tendency to form clots.
So for those who have risk factors for that, they just need to be aware that that’s a potential adverse effect. And that’s where the recommendation was coming from.
So just to clarify: someone who hasn’t been vaccinated should opt for Pfizer or Moderna as opposed to J&J.
Yeah, that is a reasonable way to think about it.
For someone who has already received a dose of J&J, are there any recommendations in terms of what booster will give them the most protection?
Really the data is still out because if you’re thinking about Omicron, it’s relatively new.
The idea now is that we have mixing and matching, that you would have a more robust immune response if you boosted with an mRNA vaccine.
I think that’s consistent with the messaging about their concerns around the adverse effects.
If you had some sort of contraindication or preference against mRNA vaccines, then it may still be reasonable to think about J&J as a booster. You just need to have that risk and benefit discussion with your primary care doctor.
People who had the J&J shot were approved to get a booster earlier than people who got an mRNA series. Should we expect that this group of people is going to be approved for an additional booster sometime soon?
I’m not aware of any studies or real-world data that would necessarily support that. There are studies that we may expect in the future, but unfortunately, nothing to really share at this time.
I want to ask you about Omicron a little bit more broadly. I think many people are seeing that this new variant is mild and think maybe it’s time to just accept that getting this virus is inevitable and start going out again. What are your thoughts on that, both in terms of an individual health level and the state of broader health care?
I wouldn’t recommend trying to catch Omicron.
There is a concern for immune escape or reinfection. I also think when you start thinking along those lines, you should start thinking about who you may be exposing because you know, it’s not just about you. Once you’re infected, you may be putting others at risk. And that other individual might be someone who has risk factors for severe disease or someone who is not vaccinated and is younger than five years old.
So the goal is not to catch the disease to have immunity. The goal is to stop the spread of infection and get vaccinated so that you protect yourself and you protect others.
What do we know about the long-term impacts of catching a virus like this?
The short answer to your question is that we don’t really know.
Anecdotally, fatigue is one of those symptoms that tend to linger after other symptoms have improved. We are aware of “long-COVID” which is not influenced by the severity of your disease. So regardless of you experiencing a mild disease or severe disease, you have that chance of developing long-term symptoms.
So again, it’s just another reason as to why you would need to get vaccinated and avoid catching the infection, rather than letting your guard down because of preliminary data that it is milder than the previous variants.
Do we know anything about whether vaccines help prevent the impacts of long-COVID?
There is some preliminary data around that and it’s really still hard to explain why some people who have been experiencing long-term symptoms felt better after they got vaccinated.