BISMARCK — With a single-dose vaccine newly authorized for use around the country, North Dakota's COVID-19 Vaccine Ethics Advisory Committee on Monday, March 1, mulled distribution plans for the latest product.
The Johnson & Johnson vaccine, which received federal regulatory clearance over the weekend, begins shipments to states immediately and is expected to complement the inoculation process already underway with Pfizer and Moderna's vaccines.
But the newly approved vaccine comes with a few differences. Unlike the vaccines already in distribution, the Johnson & Johnson vaccine is a single dose, meaning that it doesn't require a booster shot to provide its full inoculation. It also has a lower rate of efficacy than the historically effective Pfizer and Moderna vaccines.
To help promote equitable distribution, North Dakota immunization program manager Molly Howell told ethics committee members that the state Department of Health is leaning toward distributing most of the Johnson & Johnson vaccine through a single provider across the state. The state would send doses of the latest vaccine to pharmacies in each county, with many of them focusing on workplace and essential worker vaccinations.
"We would like people to have an option of Johnson & Johnson in every community," she said.
By contrast, Moderna and Pfizer vaccines have been implemented through a variety of channels, including health care providers, state agencies and a federal pharmacy partnership. Howell said if a county doesn't have a pharmacy registered with the state health department, the state would provide the Johnson & Johnson vaccines directly to the counties.
The logistics discussed by the ethics committee Monday are tentative, and the health department is still finalizing distribution plans for the Johnson & Johnson vaccine.
In addition to being one dose, Johnson & Johnson's vaccine has a longer shelf life than the previously approved vaccines, lasting up to three months in refrigerated storage, without the need for freezer or ultra-cold holding like the Pfizer and Moderna vials. In clinical trials, Johnson & Johnson's vaccine was 66% effective against moderate to severe cases, 85% effective against severe illness and 100% effective at preventing death from the virus, compared to the 95% immunity granted by the Pfizer and Moderna shots.
These differences in the Johnson & Johnson vaccine have driven some talk among officials around the country that it could pose challenges to a fair and equitable distribution system. But in approving the new vaccine on Sunday, the U.S. Centers for Disease Control and Prevention and its Advisory Committee on Immunization Practice (ACIP) said they do not consider the new vaccine an inferior product, a voucher that North Dakota's ethics committee members said alleviated previous concerns about how to balance distribution of the new vaccine with those already in circulation.
"To me, hearing ACIP's words were music to my ears," said Interim Chief Health Officer Dirk Wilke. "It clearly does what vaccines are supposed to do. If this had been the first vaccine, we would have been giddy with joy."
Contributors to the ethics committee meeting on Monday also said that several groups around the state have expressed specific interest in the Johnson & Johnson vaccine as a way to more efficiently inoculate vulnerable populations. The North Dakota Department of Corrections and Rehabilitation is interested in the new vaccine as a simpler way of vaccinating inmates in the state prison system, Howell said, while one local public health coordinator noted that the one-shot vaccine would be helpful for reaching a demographic that may have a harder time lining up their second dose.
"In our county, transportation is such an issue," said Barbara Frydenlund, a public health administrator in Rolette County, a rural area in north-central North Dakota, who pointed to homeless and homebound residents who may have higher barriers to getting the second dose. "People might get to us once, or we might get to them once, but there isn't necessarily that opportunity for the second dose and I don't want that to be a barrier. So I'm just excited that there might be some options."
Johnson & Johnson has committed to delivering 20 million doses of its vaccine to the United States by the end of March, and 100 million by the end of June. Pfizer and Moderna have each said they intend to deliver more than 100 million doses for the country by the end of this month.
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