I handled this past pandemic year worse than most people I know. Not because I had it harder, obviously; my family was insulated by all sorts of privilege. But emotionally, I more or less fell apart.
Unlike my friends and acquaintances, I developed no new domestic skills or hobbies. If there were silver linings, I was too mired in hysterical grief for my old life to appreciate them. Knowing how little I’d lost compared to others didn’t lessen my misery, it just added a slimy coating of shame to it.
Frantic for an escape hatch, I started applying to vaccine trials last year, and was accepted into the Johnson & Johnson one. Sometimes when I mention this, people have thanked me, but there was nothing really altruistic about it. I’m delighted to have played a minuscule part in the development of a vaccine, but to me, any risk involved paled beside the possibility of getting immunity early.
When I got a shot at my first appointment in December, I felt something close to ecstasy, but the next day it curdled into despair. In a sort of reverse hypochondria, I scanned my body hoping to feel any ghostly twinge of a side effect, but there was nothing. I was pretty sure I’d gotten a placebo.
Since then, of course, Johnson & Johnson’s single-shot vaccine has received emergency authorization. Like the two-dose Pfizer and Moderna vaccines, it appears to be highly protective against hospitalization and death from COVID-19. But because the Johnson & Johnson trial showed lower efficacy in preventing symptomatic COVID, there’s a fairly widespread perception that it’s inferior to the other vaccines.
In its trial, the Pfizer vaccine’s efficacy was about 95 percent. Moderna’s was more than 94 percent. Johnson & Johnson measured its results differently, but its efficacy was 85 percent against severe disease and 66 percent when factoring in more moderate cases. Public health experts are telling most people to take whatever shot is offered, but the vaccines are clearly not all the same.
Detroit’s mayor initially rejected a shipment of the Johnson & Johnson vaccine, saying residents of his city deserve “the best.” (He later reversed course.) In February survey data cited by the Centers for Disease Control, 58 percent of respondents said they wanted one of the two-dose vaccines, and only 7 percent the one-dose. Of the 58 percent, only a little more than a quarter would take a one-dose vaccine now rather than wait a month for a two-dose version.
Thanks to the vaccine trial, I had a similar choice. This month, in a process known as unblinding, the researchers told me that, as I suspected, I’d gotten the placebo. Then I was offered the real thing. For me, it was an easy call. Not knowing when I’ll be eligible in New York, I begged the people conducting the study to let me come in as soon as possible, and got my Johnson & Johnson shot last week.
I’m thrilled and grateful, but I still couldn’t help wondering if I’ll be more vulnerable than those who got two-shot inoculations. Dr. Ashish Jha, dean of the Brown University School of Public Health, convinced me I shouldn’t be anxious about the vaccine’s effectiveness. “If there is a difference, it’s so trivial and irrelevant that I certainly wouldn’t worry about it,” he said.
The gap between 95 percent and 66 percent doesn’t sound that trivial to me, but Jha argued it’s partly an artifact of where and when the vaccines were tested. The Johnson & Johnson trial had arms in South Africa and Brazil, each beset by variants of the virus that can decrease vaccine efficacy. It took place later than the other trials, when more variants were circulating. Even so, there were no hospitalizations or deaths among any vaccinated trial participant.
“If you actually want to say where do we have the best evidence about the South African variant, and which vaccines do we have the best evidence that it protects you from severe outcomes against the South African variant, it’s J&J,” he said.
Jha expects that Moderna and Pfizer would also perform well against the coronavirus mutations — he’s not arguing that Johnson & Johnson is better than the others, only that each has advantages. I’d read Jha saying that, thanks to the vaccines, he hopes to have around 20 people over for a July 4 barbecue. I asked him whether he’d consider what vaccines they got. He insisted he wouldn’t.
“If you show up with any of those three vaccines, and a little bit of time to let the vaccines work, I’d be comfortable sitting down inside my house and having a meal with you,” he said.
It’s something I’ve been aching for: dinner with friends, our kids playing in the background. As people around me get vaccinated, that vision is finally in sight.
My small personal hell has an expiration date. According to the CDC, you’re fully vaccinated two weeks after the Johnson & Johnson shot. Jha said it’s really more like four.
It already feels as if it’s saving my life.