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Medicine

CDC Panel Recommends Moderna, Pfizer Vaccines Over J&J's (reuters.com) 139

An anonymous reader quotes a report from Reuters: A panel of outside advisers to the U.S. Centers for Disease Control and Prevention on Thursday voted to recommend Americans choose to receive one of the other two authorized COVID-19 vaccines over Johnson & Johnson's shot, due to rare but sometimes fatal cases of blood clotting. The CDC's Advisory Committee on Immunization voted unanimously to make the recommendation in favor of the vaccines made by Moderna and Pfizer/BioNTech over the J&J shot. The regulator still needs to sign off on the guidance.

Fewer Americans have received the J&J shot than the other two vaccines by a significant margin. Out of more than 200 million fully vaccinated people in the United States, around 16 million received J&J's vaccine, according to CDC data. [...] Members of the panel also said J&J's vaccine is less effective in preventing COVID-19 than the other two authorized vaccines. In a presentation to the committee, a leading J&J vaccine scientist said the vaccine generates a strong and long-lasting immune response with just a single shot.

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CDC Panel Recommends Moderna, Pfizer Vaccines Over J&J's

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  • by Anonymous Coward
    Of course, it's not going to stop me from getting Omicron. But, hopefully it'll just be a little time off of work, rather than a hospital bed and a ventilator.
  • by sabbede ( 2678435 ) on Friday December 17, 2021 @09:14AM (#62090017)
    Okay, I heard about this on the radio this morning, and it was mentioned that most of the 50-something people who died from clotting were young women. That's weird. So I thought about it for a minute, and remembered there is something that pretty much only young women do that has a known association with clotting - taking birth control pills.

    That said, fifty something deaths out of the millions of doses given doesn't really sound like something that calls for much concern.

    • by olsmeister ( 1488789 ) on Friday December 17, 2021 @09:19AM (#62090033)
      They didn't tell people not to get the vaccine or express a high level of concern. They simply said, if you have a choice, they recommend the mRNA ones.
      • Well duh, the J&J was only like 68% effective against the original strain. The recent titers test showed 2dose moderna/pfizer antibodies dropped from 1500+ against the original strain, down to just 80 against omicron. J&J fell all the way to zero. As effective as tits on a bull.
    • by gweihir ( 88907 )

      Indeed.

      a) Really low numbers, too low for actual concern. 50 of 16M is 0.000'031%
      Just as a comparison, the fatality rate for driving a car in the US is around 1 in 100M vehicle miles. So driving 300 Miles is about as deadly as getting the J&J shot.
      If you assume about 10% are young women in the risky age range, for them it is still less than the risk of dying while driving 3000 Miles.
      b) Hard to find out what is actually happening as the numbers ar

      • Really low numbers (Score:2, Insightful)

        by gillbates ( 106458 )

        Really low numbers

        This is what the conservatives have been saying about the pandemic in general. A three or even four percent fatality rate wasn't enough to justify the lockdowns and mask mandates, but perhaps enough to mandate isolation of the vulnerable population.

        Yes, there are portions of the population with higher risk factors, but accommodating those people by allowing them to quarantine/work from home, etc... would have had far less impact on the rest of the population than insisting that every

        • by drinkypoo ( 153816 ) <drink@hyperlogos.org> on Friday December 17, 2021 @11:09AM (#62090407) Homepage Journal

          Really low numbers

          This is what the conservatives have been saying about the pandemic in general.

          And yet, they are wrong.

          A three or even four percent fatality rate wasn't enough to justify the lockdowns and mask mandates, but perhaps enough to mandate isolation of the vulnerable population.

          We already know that doesn't work, because you can't isolate them well enough given the transmission rates.

          Yes, there are portions of the population with higher risk factors, but accommodating those people by allowing them to quarantine/work from home, etc... would have had far less impact on the rest of the population than insisting that everyone perform these measures, which in retrospect had only the smallest effect on the pandemic

          Actually, they had a rather huge effect, because they have reduced the time hospitals spent overtaxed and not only unable to handle the influx of covid hospitalizations but also unable to handle any OTHER health care while this has been going on. Tons of "elective" but ultimately necessary (lest they progress, or cause other problems) procedures have had to be postponed indefinitely because of covid hospitalizations.

          If we had unlimited hospital capacity then it might be reasonable to just let covid run its course, but since we don't, it definitely isn't.

          but created rather serious financial and mental health issues for those involved.

          You know what else does that? When hospitals don't have any free capacity. When corpses are being stacked up like cordwood and stored in refrigerated trucks because the morgue system can't handle the load, and would-be patients are being told they have to die because there's no facilities to care for them.

          • by SvnLyrBrto ( 62138 ) on Friday December 17, 2021 @02:44PM (#62091221)

            And in the here and now, there's a very easy solution for the hospital capacity: triage.

            If the hospital is at capacity and a cancer patient needs a round of chemo, an old person needs a new hip, or someone stumbles into the ER with a stubbed toe, and there are anti-vaxxers taking up space; roll one of them out, kick them to the curb, and give the space to someone who gives at least the smallest damn about his own health.

            We keep hearing that COVID is now "a pandemic of the unvaccinated" or delta is "a surge of the unvaccinated" and "the only way to get through this is for everyone to be vaccinated." Well, that is not going to happen. The anti-vaxxers have never been reasonable or rational, even when it was just measles they were trying to bring back. And there's no excuse for them. They... we... have all had since April to do the sane and responsible thing and get our damn shots. There needs to be an endgame now where those of us who've been vaccinated move on, take back our normal lives, and leave the unvaccinated behind.

            • That's not how triage works. Triage is applied at the beginning of care. If you're already taking up an ICU bed, they can not kick you out of that bed.

            • by gweihir ( 88907 )

              However satisfying that would be, it cannot be done unless you want your country to burn. In civilized countries (and the US qualifies, even if barely), removing somebody from an ICU bed they need to survive is called "murder". There are some rare exceptions for hopeless cases, but that is basically it.

          • The problem was that the lockdowns didn't actually flatten the curve enough. I know former cancer patients who could have been treated except they lived in a lockdown state, their hospitals filled up, and they died because they couldn't receive treatment.

            It's hard to make the case that lockdowns save lives when we've all seen people die because of them. I have been made aware by more than one physician that mental health affects physical health, and poor mental health can compromise a person's immune s

        • That's because they 1) don't grasp that death is not the only bad outcome, and 2) can't grasp that "isolating the vulnerable" as they describe isn't possible. When it's spreading that far and wide, the vulnerable will get it unless you seal them in biosafety level 4 labs.

          But it does fit nicely with their belief that money is way more important than lives.

          You are describing the "Sweden model", which failed so badly Sweden itself abandoned it after a few months.

          which in retrospect had only the smallest effect on the pandemic

          [Citation Required]

          Also, you know what has had

        • I think some pretty stringent measures are important to not only save the 1% who will die (where'd you get 3 or 4 percent?), but to save a substantial 30%-ish minority of everyone else from long term damage.

          I have friends who have lost their sense of smell. Some apparently permanently. "Covid brain" is no joke either. Are you so smart that you can afford to functionally lose 10-20 IQ points? And then there is the chronic fatigue, the blood clots, from COVID, all quite a lot more common than the limited

          • not every nation is as selfish. Portugal, for example, has a 89% vaccination rate (two doses or more) (according to our world in data as of today), compared to 61% in the USA. And the USA started vaccinating kids 5-11 years old before.

          • A lot of us who *are* vaccinated are fed up and done with the bullshit though. There is no more reason or excuse for anyone... except for a vanishingly small minority who have allergies or autoimmune disorders that legitimately preclude vaccination... to have, catch, or suffer in any way from COVID. And that's been the case since April. Yeah... masks and isolation and travel resrictions made sense... last year and for the first half of this year. Now? Anyone with COVID has it because they chose to get

            • And you know what had a higher death rate than either COVID or polio? AIDS. But because AIDS affected mostly gay people; there were no masks, or isolations, or lockdowns, no travel restrictions,

              You know what isn't transmitted through the air? AIDS.

              It's almost like different viruses need different mitigation strategies.

            • But because AIDS affected mostly gay people; there were no masks

              I'm curious to hear how you believe AIDS is transmitted.

          • Are you so smart that you can afford to functionally lose 10-20 IQ points?

            The anti-vaccine mob is clearly a ploy by Republicans to swell their ranks.

            Sorry, couldn't resist the easy joke...

        • by sinij ( 911942 )
          When we get old I fully expect school age generation that we locked away during their crucial formative years will repay us by locking us up in old age coffin motels and telling us to suck up and just use Zoom.
        • by gweihir ( 88907 )

          Really low numbers

          This is what the conservatives have been saying about the pandemic in general. A three or even four percent fatality rate wasn't enough to justify the lockdowns and mask mandates, but perhaps enough to mandate isolation of the vulnerable population.

          Even a 0.4-0.8 percent fatality rate (what is actually happening) is in no way "really low numbers". It is pretty high.

          No idea what you are trying to insinuate here.

  • by GlennC ( 96879 ) on Friday December 17, 2021 @09:16AM (#62090019)

    It will be interesting to see how the amateur infectious disease "researchers" respond to this.

  • by CastrTroy ( 595695 ) on Friday December 17, 2021 @09:25AM (#62090049)

    Wasn't the J&J vaccine always considered worse than mRNA or even the AZ vaccine? I don't even think we used it up here in Canada. From what I heard it was really only recommended for situations where tracking people down for a second shot might be difficult such as in homeless populations. I'm aware that other people got it, but it always seemed like the least good option.

    • sounds like Canada finally got a couple shots (only 20k) https://www.canada.ca/en/publi... [canada.ca]

      This is out of a firm order of 10 million doses, with options to go up to 38 millions. Those doses were to be delivered by the end of September 2021, by the way, so I hope Canada didn't pay or got a refund.
      I know Canada is supposed to give them to poor countries, but even this didn't seem to happen yet.

    • Wasn't the J&J vaccine always considered worse than mRNA or even the AZ vaccine?

      Not always, South Africa sold/swapped its AZ doses to get J&J ones instead.
      Also, AZ is still not approved in the USA, for some reasons.

      But yes, from the data we have, mRNA vaccines have better efficacy. Getting an mRNA shot 2 months after J&J is likely very effective as well.

      • With a 2 month "booster" it seems roughly equal to two shot mRNA, the 6 month booster seems to work roughly as well as a third mRNA booster too.

        Seems to me they were a bit too optimistic about only needing one shot, but shot for shot efficacy is roughly equal.

        • Seems to me they were a bit too optimistic about only needing one shot, but shot for shot efficacy is roughly equal.

          I've heard the same, that a second shot of the J&J vaccine brought the effectiveness close to the mRNA vaccines.

          Because there was a rush to get vaccines that worked well enough, there wasn't time to determine the optimal course of treatment. I've also seen it mentioned that it looks like getting a second dose of an mRNA vaccine 2-3 months after the first dose is more effective than getting the second dose after 3-4 weeks. Hopefully there will be opportunities in the next year to optimize.

    • As far as I know, the immediate protection of J&J is comparable to AZ, while having fewer side effects. Here in the Netherlands, AZ was restricted to higher age brackets after reports of side effects in young women in particular, while J&J was in general use until mid-summer, after which mRNA became the norm and J&J was only used for special cases.

      If it indeed provides better long term protection, there might be a role for it in the future.

    • by skam240 ( 789197 )

      Here in the US the push has been to get people vaccinated with anything they'll take so Moderns, Pfizer, and J&J have all been pushed.

      I know I heard from a number of people that they preferred one shot J&J over the other 2 two shot mRNA vaccines. I don't know if they were aware that J&J is rated significantly less effective than the other two but I didn't really want to push on the issue with any of them. I'm just happy they were getting vaccinated.

      • Here in the US the push has been to get people vaccinated with anything they'll take so Moderns, Pfizer, and J&J have all been pushed.

        I know I heard from a number of people that they preferred one shot J&J over the other 2 two shot mRNA vaccines. I don't know if they were aware that J&J is rated significantly less effective than the other two but I didn't really want to push on the issue with any of them. I'm just happy they were getting vaccinated.

        Beyond the initial studies leading to authorization and approval, how has effectiveness compared between the three in dealing with the variants?

        • by skam240 ( 789197 )

          Sorry but you've gotta learn to use google. I'm a random on the internet not a vaccination expert, why would you ask me this question?

    • Wasn't the J&J vaccine always considered worse than mRNA or even the AZ vaccine?

      For sure not over AZ, where protection was about the same and side effects less.

      However if you consider the larger picture, J&J was always the best vaccine:

      1) Room temperature storage instead of temperatures that require special refrigeration.

      2) A single shot means people are more likely to complete full course of vaccination.

      3) Based on older vaccine technology and therefore risks much more likely to be known based on

      • mRNA vaccines are about 20 years old now. Many have been developed before the COVID vaccines.

        They did not go into widespread use because initial studies showed they were no more effective than traditional vaccines. With the extra difficulty of storage and transport, there was no reason to commercialize them.

        So first, there's been plenty of time for some sort of long-term harm to appear.

        Second, that's not how vaccines work. After about 2-4 days, the vaccine is no longer in your body. It's in the local wa

    • by tlhIngan ( 30335 )

      Wasn't the J&J vaccine always considered worse than mRNA or even the AZ vaccine? I don't even think we used it up here in Canada. From what I heard it was really only recommended for situations where tracking people down for a second shot might be difficult such as in homeless populations. I'm aware that other people got it, but it always seemed like the least good option./blockquote

      Yeah, J&J was always considered as a last resort. Though Canada did also start using them for those afraid of needles

  • TTS for J&J has about the same prevalence of anaphylactic shock with Pfizer, except that one hits my gender equally whereas TTS is not a risk for me at all.

    I hope they still make the J&J vaccine by the time government gets too obnoxious with booster mandates.

    • TTS for J&J has about the same prevalence of anaphylactic shock with Pfizer, except that one hits my gender equally whereas TTS is not a risk for me at all.

      I hope they still make the J&J vaccine by the time government gets too obnoxious with booster mandates.

      But what is the percentage of cases where the Pfizer vax has caused anaphylactic shock? Moreover, and just like in any medical establishment that provides treatment with penicillin, all COVID vaccination locations carry epinephrine injections, so the risk (on top of being statistically negligible, it is also manageable.

      I'm not being nonchalant about the risk. I am myself allergic to Bactrim, which I found out when my tongue and face got swollen after taking Bactrim to fight a staph infection. But we must

  • by sinij ( 911942 ) on Friday December 17, 2021 @10:09AM (#62090155)
    Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infection [nature.com]

    Although myocarditis and pericarditis were not observed as adverse events in coronavirus disease 2019 (COVID-19) vaccine trials, there have been numerous reports of suspected cases following vaccination in the general population. We undertook a self-controlled case series study of people aged 16 or older vaccinated for COVID-19 in England between 1 December 2020 and 24 August 2021 to investigate hospital admission or death from myocarditis, pericarditis and cardiac arrhythmias in the 1–28days following adenovirus (ChAdOx1, n=20,615,911) or messenger RNA-based (BNT162b2, n=16,993,389; mRNA-1273, n=1,006,191) vaccines or a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive test (n=3,028,867). We found increased risks of myocarditis associated with the first dose of ChAdOx1 and BNT162b2 vaccines and the first and second doses of the mRNA-1273 vaccine over the 1–28 days postvaccination period, and after a SARS-CoV-2 positive test.

    This is peer-reviewed study published in tier-1 journal.

    • by burtosis ( 1124179 ) on Friday December 17, 2021 @10:31AM (#62090237)
      From the exact same paper:

      Whilst myocarditis can be life-threatening, most vaccine-associated myocarditis events have been mild and self-limiting22. The risk observed here is small and confined to the 7-day period following vaccination, whereas the lifetime risk of morbidity and mortality following SARS-CoV-2 infection is substantial. Indeed, myocardial injury is very common in persons admitted to hospital with SARS-CoV-2 infection26, when evaluated systematically using high-sensitivity cardiac troponin tests27. Moreover, evidence of myocardial injury, irrespective of whether due to myocarditis or myocardial ischemia, is associated with a higher risk of in-hospital death28. We estimate that the absolute number of excess myocarditis events in the 28days following a first dose of adenovirus or mRNA vaccine is between one and six per million persons vaccinated, and the excess risk following the second dose of the mRNA-1283 vaccine is ten per million. By contrast, we estimate 40 excess myocarditis events per million in the 28days following SARS-CoV-2 infection. The risks are more evenly balanced in younger persons aged up to 40years, where we estimated the excess in myocarditis events following SARS-CoV-2 infection to be 10 per million with the excess following a second dose of mRNA-1273 vaccine being 15 per million. Further research is required to understand why the risk of myocarditis seems to be higher following mRNA-1273 vaccine. Although the wider societal benefits of controlling the spread of virus to those who are more vulnerable are substantial, these data may help inform public health policy and the choice of vaccine offered to younger adults.

      So not only were the findings of myocarditis extremely rare and mild, they were AN ORDER OF MAGNITUDE less than actually contracting covid unvaccinated and that’s ONLY myocarditis not any other symptoms, or death. All in all this paper is a mountain of evidence how the issue is overblown in the media and general public and the only real concern is switching out a vaccine for another vaccine that has a couple of less cases PER MILLION. If any of these vaccines were the only one available it would be several orders of magnitude safer to simply take it because the infection is far worse. Fuck getting polio of the lungs, I have no sympathy for the dying breaths of ignoramuses who still disbelieve reality and try to fight medical staff clogging the hospitals and wearing down the medical providers and generally making the world worse off for everyone.

      • by sinij ( 911942 )
        My conclusions from reading the paper is that Pfizer vaccines is safer than Moderna and separating vaccination shots by only 30 days is likely too short. Another conclusion is that if you experience cardio symptoms after a shot, go to a hospital right away. Most people don't even realize that such side-effects are possible, as the enforced point of view is that vaccines do not have any side effects.
        • My conclusions from reading the paper is that Pfizer vaccines is safer than Moderna and separating vaccination shots by only 30 days is likely too short. Another conclusion is that if you experience cardio symptoms after a shot, go to a hospital right away. Most people don't even realize that such side-effects are possible, as the enforced point of view is that vaccines do not have any side effects.

          False, at least in all of America. Every person given a vaccine of any type for covid is required to wait for any side effects to develop for at least 15 minutes, 30 if you have underlying conditions that could increase thus chance. People are given this verbally, it’s on the literature that’s handed out, and it’s posted on the walls.

          Second, safer when it means 2-3 mild adverse reactions per million but does a good job of preventing death that’s about a 3% chance is not safer, i

        • The myocarditis seems to be due to the mRNA getting into the bloodstream and thus producing spike proteins throughout the cardiovascular system, instead of in localized muscle tissue. The way to prevent it is to draw back the syringe slightly first to check to see if blood comes out easily or not. If blood comes out, then don't inject, because you hit a blood vessel of some sort.

          • Yea, there is some evidence for this but it’s also well known to any who are supposed to be administering covid vaccines. Even so when it’s about millions of vaccine shots given it’s guaranteed there will be some human error.
      • From what you quote at the beginning (presumably for all ages together?), it says myocarditis can be up to 6 in a million (it says 1- 6, I am picking the high one) from a first shot, and 10 in a million from a second shot, which adds up to 16 in a million for a two dose series. The risk is 40 in a million for contracting covid (presumably without early treatment which one can debate the effectiveness). So, 16 compared to 40 is not an order of magnitude (10x) difference, it is about 2.5x.

        Further, not everyon

        • From what you quote at the beginning (presumably for all ages together?), it says myocarditis can be up to 6 in a million (it says 1- 6, I am picking the high one) from a first shot, and 10 in a million from a second shot, which adds up to 16 in a million for a two dose series. The risk is 40 in a million for contracting covid (presumably without early treatment which one can debate the effectiveness). So, 16 compared to 40 is not an order of magnitude (10x) difference, it is about 2.5x.

          Further, not everyone actually would get Covid even if no one was vaccinated because typical infectious diseases spread to about 60-70% before transmission gets difficult for the disease. So, when you consider that (perhaps a 30% reduction, so maybe 40 becomes an actual risk of 28 or so), it seems to me the numbers are actually about the same (16 versus 28) when considering how noisy all the data may be. Reasons the data is noisy include that adverse reactions tend to be underreported significantly and trial results tend to be spun as best as possible and trials also generally involve only very healthy people and so may not always be generalizable to the entire population.

          Even worse, the quoted bit says later on that for people under 40 years of age, the rate of myocarditis from the second dose is 16 per million (it does not say the rate for the first) but the rate from getting Covid is 10 per million. So, the study seems to show that for people under 40, they have about a 50% greater risk of heart damage from the vaccine than from the disease. If you again add in the fact that not everyone would get the disease, then the risk of getting myocarditis from the vaccine is probably about 2x that of the disease for people under 40. So for that one concern, it seems like a negative risk/benefit ratio for people under 40 years old.

          That is what the part you quoted seems to say (to me). Yet you concluded "So not only were the findings of myocarditis extremely rare and mild, they were AN ORDER OF MAGNITUDE less than actually contracting covid unvaccinated".

          Can you please explain how you reached that conclusion? For example, am I making a basic math error here myself in analyzing the quoted text? Did I misread something perhaps?

          You never read the source article. From the abstract:

          We estimated an extra two (95% confidence interval (CI) 0, 3), one (95% CI 0, 2) and six (95% CI 2, 8) myocarditis events per 1million people vaccinated with ChAdOx1, BNT162b2 and mRNA-1273, respectively, in the 28days following a first dose and an extra ten (95% CI 7, 11) myocarditis events per 1million vaccinated in the 28days after a second dose of mRNA-1273. This compares with an extra 40 (95% CI 38, 41) myocarditis events per 1million patients in the 28days following a SARS-CoV-2 positive test.

          Collectively if you look at all groups it’s an order of magnitude. Yes for young adults the risk of only myocarditis is completely irrelevant because already we have approaching 200k hospital admissions [cdc.gov] or already 300 per million if you assume every single person has already been infected, realistically we are perhaps a third at best. There have been 4761 deaths [statista.com] or 87 per million already, with 1/3 that’s more like 260 deaths per million.

  • The advisory's board failure to even discuss side effect mitigation through the use of traditional aspiration prior to injection amounts to criminal negligence.
    • What (and I cannot emphasize this enough) the fuck are you talking about?

      • There's a theory that some of the side effects from vaccination are caused by the vaccine being injected into a blood vessel instead of muscle tissue, and that aspirating the needle (inserting it and pulling back on the plunger before injecting) to see if it's in a blood vessel (pulling in blood shows that), then the vaccine shouldn't be given. Some countries have this in their protocols and supposedly have fewer overall adverse events. However, it wouldn't explain why many of the heart events happen to you
    • Do you believe that words with more syllables will help hide that you have no idea what you're talking about?

  • The only reason why I would get it is to avoid job loss. I don't care about effectiveness or side effects. To that end, if I have to get it, I will get the J&J one because it's less shit going into my body under duress.

  • Another reason to not bother with J&J is that Omicron is becoming the dominant strain in the next few weeks, and J&J being not effective against it [reuters.com], there is no point in continuing to roll it out.

    Pfizer and Moderna have higher efficacy, and less severe side effects too.

    As far as clots, they are indeed rare (1:250,000 or so), but still ...

    This paper [science.org] is about how Astra Zeneca's ChadOx1 (Chimpanzee Adenovirus) causes rare clots. It starts with enough of the vaccine particles seeping into the blood, and

  • ... whet the general public has known for at least a year. Get pfizer or moderna, not J&J.

Get hold of portable property. -- Charles Dickens, "Great Expectations"

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