J&J COVID vaccine researcher: US 'can't be safe' until entire world is vaccinated
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So long as COVID-19 continues to spread and develop variants around the world, no one — even those in areas with high vaccine coverage — can be safe, according to Dan Barouch, MD, PhD, whose lab helped develop the Johnson & Johnson vaccine.
Barouch, who is director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center, the Boston-based laboratory that led the development of the Johnson & Johnson Ad26.COV2.S vaccine, addressed his comments to the 2021 Association of Women in Rheumatology Annual Conference. Speaking before conference attendees, he stated that the specter of more, and more dangerous, COVID-19 variants will continue to threaten the United States until “the entire world” is immunized against the virus.
“We feel strongly that multiple vaccines need to be implemented in parallel to accelerate rollout in the U.S. and particularly in the world, because we can’t be safe in the United States until everyone in the entire world is vaccinated, or at least there is a high level of vaccine coverage in all parts of the world,” Barouch said. “Because as long as any region of the world remains unvaccinated, there can and will be large surges there, and it’s in the context of the surges where progressively new and dangerous variants emerge.
“According to my phylogenetics colleagues, this virus has not yet fully sampled its sequence space, and so there is a very real possibility that, in the context of the next surge, or the next surge after that, there could be the emergence of variants that are even more concerning than the beta and delta variants that we have today,” he added. “And then those can then come and reinfect the U.S. population.”
According to Barouch, Johnson & Johnson has made a “substantial commitment” this year to supply the world with at least 1 billion doses of the vaccine — one that is “particularly well-suited for the developing world,” he added. The Ad26.COV2.S vaccine’s single-dose delivery and ability to be stored above subzero freezing temperatures will make it possible to expand mass vaccination campaigns to remote and hard-to-reach regions of the world, Barouch said.
He added that the company will be producing and deploying the doses on a “nonprofit basis,” with the goal of making the vaccine “affordable and accessible to the developing world.”
The vaccine rollout has reached new levels of urgency now with the emergence of the B.1.617.2, or “delta” variant, according to Barouch. He cited the recent Morbidity and Mortality Weekly Report paper published in late July 2021 on the “Provincetown cluster” of COVID-19 cases in Massachusetts, which suggested that the delta variant remains potentially highly contagious even in fully vaccinated individuals.
“The other piece of data from this study, which I think really caught the attention of the CDC public health authorities, is that fully vaccinated people who do get infected have similar viral loads in nasal swabs compared with unvaccinated people; it’s not lower at all,” Barouch said.
“The concern is that fully vaccinated people who then get infected are likely still protected from severe disease — that’s the key thing that I think has been missing in some of the media reports — but you still might get infected with a highly infectious delta variant, and, if you do get infected, then viral loads are going to be quite similar to if you were not vaccinated at all,” he added. “Which means that you probably can transmit the infection. I think this has led to a lot of the resurgent cases we are seeing in the United States, as well as additional mask mandates, including for fully vaccinated people indoors, from the CDC.”
Fortunately, however, the currently available vaccines appear to be effective at preventing severe COVID-19 and death. Regarding the Johnson & Johnson vaccine specifically, Barouch cited a study published last week by the South Africa Ministry of Health, which found that the Ad26.COV2.S vaccine provided 92% to 96% protection against death, and 71% protection against severe disease and hospitalization. The real-world study was conducted among 480,000 health care workers in the context of a massive delta variant surge within the country, according to Barouch.
“So, it really is important on many levels both for global humanitarian and global health purposes, but also even in terms of United States health, to make sure that we have a global vaccination strategy and that we can reach every corner of the planet,” he said. “I’m often asked when this pandemic will end, and of course I can’t predict that better than anyone else, but I do think that it really is a race between vaccinating the world — the global vaccination program — and the emergence of variants. That’s really going to determine how long we’ll be with COVID-19.”
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Barouch D. COVID-19: Developing a Vaccine During a Pandemic. Presented at: Association of Women in Rheumatology Annual Conference; August 12-15, 2021, Hilton Head Island, South Carolina (hybrid meeting).
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