Covid vaccines: Why some Americans are choosy about their jab - BBC News
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By Cache McClay
BBC News, Washington
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America has three vaccines approved for distribution, and now people are getting choosy about which they want.
All three have been shown to be effective at preventing Covid-19 disease and, crucially, hospital admissions and death - and health officials have said the best vaccine is the one you're offered.
Still, there appears to be a preference growing for the Pfizer and Moderna jabs over the Johnson & Johnson option.
In early March, Detroit mayor Mike Duggan rejected the Johnson & Johnson vaccine for city residents, suggesting that the other two jabs available in the US were superior.
"I am going to do everything I can to make sure the residents of the City of Detroit get the best," he said in a press conference.
After widespread outcry from the public health community, the mayor did an about-face, saying he had "full confidence" that the jab was safe and effective.
But like Mr Duggan, some Americans have also shown concerns about the Johnson & Johnson vaccine and its overall efficacy rates - even though health officials have cautioned those numbers don't tell the whole story.
Some say they'd rather delay their vaccination than take Johnson & Johnson at all, potentially throwing a wrench into the distribution plans of community health officials.
"I had an appointment for a vaccine this week, and I cancelled it because I heard they were giving out Johnson & Johnson. I'm not taking [that vaccine] at all," one Washington DC resident told the BBC.
Now, health officials like Dr Michele Andrasik are trying to reassure Americans that any authorised vaccine offered to them is a good one to take.
"On one hand, people are excited that there's just one shot [for Johnson & Johnson], and on the other, there's a lot of confusion with regard to what the efficacy results actually say and does this mean it's not as good," Dr Andrasik, senior staff scientist for the Vaccine and Infectious Disease Division at Fred Hutch, told the BBC.
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In February, US regulators formally approved the single-shot Johnson & Johnson coronavirus vaccine - the latest to get the green light.
Unlike Pfizer and Moderna vaccines, which use new mRNA vaccine technology and require two shots, the Johnson & Johnson vaccine uses a common cold virus that has been engineered to make it harmless.
media caption
It then safely carries part of the coronavirus's genetic code into the body. This is enough for the body to recognise the threat and then learn to fight coronavirus.
President Joe Biden has shown confidence in the vaccine. This month, he announced that the US will order 100 million more doses of Johnson & Johnson, doubling the amount available to Americans.
Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, has said that all the vaccines available in the US were good vaccines, and stressed that the Johnson & Johnson jab is "not the weaker vaccine".
The concern comes down varying to efficacy data released from clinical trials - but those figures aren't all they appear to be, say experts.
Health officials have stressed that the most important statistic in fighting the pandemic is that all three vaccines have 100% prevention of hospital admissions and death from the virus.
The Pfizer and Moderna drugs were also tested before newer, more contagious variants were widespread, making a difference in trials.
"They were not compared head-to-head. They were compared under different circumstances," Dr Fauci has said.
Additionally, the CDC explains that all the vaccines are more effective than the annual flu shot.
"The bottom line is that Johnson, Moderna and Pfizer are all incredibly effective at preventing severe disease progression, hospitalisation, winding up in the ICU or on ventilation, or death," says Dr Andrasik.
Another positive of the Johnson & Johnson vaccine, community health advocates say, is that it is the only single-shot vaccine available in the US.
It may also be more convenient when it comes to distribution - especially in harder-to-reach places like some poor or rural regions. But there is concern that sending just that vaccine to those areas might increase stigma.
"Equity involves choice," says Dr Andrasik.
"So, if you only have one choice and you are a disenfranchised population, I think that fuels the idea of inequity, uncertainty and questioning of why we only have this one choice."
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She adds: "I think that all the vaccines should be available for everyone. I think the rationale of sending Johnson & Johnson to rural [and poorer] communities is because of access to care."
Community leaders and health professionals like Dr Andrasik are making efforts to spread awareness about the vaccine and combat misinformation.
When over half a million people have died from Covid in the US, "as soon as it's my turn, I will take whatever vaccine is available to me at that time", she says.
What are other concerns?
The Johnson & Johnson vaccine was also recently in the news after the US Conference of Catholic Bishops - which represents the church in the US - and others expressed "moral concerns" with the jab.
The concern is over how it is produced with abortion-derived cell lines - cells taken in the 1980s "originally isolated from fetal tissue, some of which were originally derived from an aborted fetus" - like a number of other vaccines available today.
Johnson & Johnson used a similar method in developing its Ebola vaccine - and no Covid-19 vaccine contains human tissue of any kind.
The conference advised that, given a choice, Catholics should take an alternate vaccine.
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The advice given by the US conference seemed to contradict the Vatican's own stance, which is that such vaccines are "morally acceptable".
Other Catholic leaders have come out to reject the idea that church members should avoid this vaccine.
In Connecticut, the Archbishop of Hartford and other local clergy declared in a statement that all residents "should feel free in good conscience to receive any of the vaccines currently available ...for the sake of their own health and the common good".
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While many other vaccines, such as those used for chicken pox and rubella, were developed similarly, the latest concerns from Catholic leaders for the Johnson & Johnson vaccine has added to scepticism among some Americans.
Johnson & Johnson isn't the only vaccine facing concerns. Oxford-AstraZeneca - which the US is considering authorising - has been suspended in more than a dozen European countries over concerns with blood clots.
The EU's medicine regulator has since come out saying that the vaccine is "safe and effective" and Germany, France, Italy and Spain have said they would resume using the jab.
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Most people look at the published efficacy rates of vaccines and assume (not unreasonably) that those numbers mean one vaccine is better than another. But that is comparing apples and bananas. The vaccines were tested under different conditions.
Importantly, the Moderna and Pfizer vaccines were tested in America when infection numbers were low and there were less variants to consider.
The J&J vaccine was tested at a time of higher infection, in places around the world, and the South African and UK variants had developed.
The important thing is all the vaccines are 100% effective at keeping people from dying or out of intensive care.
The important thing is all the vaccines are 100% effective at keeping people from dying or out of intensive care.
Spot on!... If I had the option for the J&J as it is "one-n-done" that would be my choice. Right now I'm scheduled for the second part of the Pfizer in another week.
The only thing I'm choosy about is which arm gets stuck. Left arm, please.
All the vaccines are as safe as possible. And all the vaccines do what is needed. Flu vaccines don't prevent catching the flu, either. But flu vaccines will lessen the severity of the disease which is what they are intended to do. Unrealistic expectations can't be satisfied.
I can understand the concern over the J&J vaccine being developed with fetal tissue. IMO a moral objection is valid in that case and should be accommodated.
I chose what I was offered (Moderna). I am too old to be picky or proud when it comes to this.
That is the one I got, Moderna. If given a choice I would probably have chosen the Pfizer one. I am waiting on my second shot which will be 11 April.
I would take whatever was given though.
Mine is Pfizer and I'm getting my second shot tomorrow. I'm going home right after that because I anticipate the side effects. My first shot - my arm ached, I felt crappy, nauseous, headachey, just not well.
I heard that the second shot will be worse. I hope I'm wrong. But my co-worker - I don't know if she got Pfizer - I'll have to ask her at our Zoom office meeting tomorrow, but she said with the second shot - she got fever, chills, muscle aches, I think a headache, the whole shebang!
But like last time, if I do get the side effects, they'll be gone within about 12 hours or so.
With mine I never had any side effects except for my arm being a little sore.
I get my second shot on the 26th. I have already stocked up on cold packs for the sore arm I will get.
I got my second Pfizer shot on March 16th, and while my arm was a bit sore for a couple of days I didn't need any pain killer for it. Just when I raised my arm over my head did I feel any real pain, but, I don't do that often. The first shot I didn't have any reactions at all, just with the second one.
My arm was so sore the next day that I felt like the recipient in an arm punching contest.
Same here from Moderna along with the bride. The third day there was a knot, the 4th day nothing.
Wife had diarrhea day 2 & 3, may or not be connected.
TMI: So now ya Sleepin on the couch tonight ?
LOL
By the next day, the soreness was all but gone. I was fatigued but I don't know if it was the shot or the fact that I had been doing home improvements at the new place.
I got my second shot right at 11:00 this morning. I came home right after because of the potential side effects. I wanted to be home and comfy just in case. So far, so good. I can't remember though from the first shot, how long it took the side effects to show up. I took four Naproxen as soon as I got home. Hopefully that will help. Crossing my fingers.
Hope it turns out good. Hopefully you will just have a relaxing day.
Co-worker got the shot Monday, incapacitated on Tuesday with the Pfizer curse,
now he can barely speak through the coughing.
Sorry to her that. Hope they fell better soon.
I have heard of it happening with the Modera one. I also thought I read that it could be worse for people that have the virus yet are asymptomatic.
He's off sick today, meanwhile I have developed some unusual aches and a persistent cough.
Good news is I will be out of town when the County has me scheduled for the 2nd shot,
BUT CVS is now making appointments when they ( randomly ) get some doses
so I may be able to schedule with CVS and not spend hours in line with the County fiasco.
We got our first shots in January and our second shots 5 weeks ago Wednesday. We received the Pfizer vaccine. After the first shot my left shoulder was slightly sore for a day. After the second shot I noticed some minimal shoulder soreness only that afternoon I had no other side effects. My wife had no side effects at all.
We signed up for the first shots on the then new California state website. The vaccination site was a drive thru site at a local state university. We waited in line in our car for about an hour or so, then for a 15 minute monitoring period after the injection. We received text and email reminders about our second shot without having to sign up again. We only waited about 20-30 minutes for the second shots, also in the car. Waiting in the car was much better than standing in line, especially since the first day was fairly cool.
Overall, it was a good experience.
I got a first shot of Pfizer yesterday. No side effects at all other than a slight soreness in my arm muscle.
I also did not even feel the needle. I asked the vaccine lady if she was ready to give me the shot and she said "you're done".
Got the J&J shot 2 weeks ago and had no side effects, felt good after it. I was sick with the virus before they knew what it was and that may have made a difference.
Good luck to everybody getting shots and hope side effects are small
The sooner everyone who can be vaccinated actually is vaccinated, the sooner we can reach herd immunity and get back to life. This is not the time to be picky.
Got my first jab of Moderna . Will get my second one next week. Parents are fully vaccinated.
Scheduled to get my first shot at the local VA clinic on Saturday morning, the second in mid-April is also already scheduled. I don't know if it's the Pfizer or the Moderna... It could be either.