Johnson & Johnson’s Single-Dose COVID-19 Vaccine a ‘Tremendous Asset’ for Patients With Cancer

EDITOR’S NOTE: On April 23, Members of the CDC's Advisory Committee for Immunization Practices agreed the benefits of the Johnson & Johnson single-dose COVID-19 vaccine outweigh the risks from rare blood clots linked with the vaccine. The Food and Drug Administration will update the vaccine's label indicating women under 50 years old should be aware of blood clot risks associated with the vaccine.

The Food and Drug Administration’s recent emergency use authorization of Johnson & Johnson’s single-dose COVID-19 vaccine will likely open many doors for patients with cancer to get vaccinated, according to Dr. Katherine Mullin.

For instance, if the vaccination rate in a certain state has been 10% with either the two-dose Pfizer-BioNTech or Moderna vaccine, that rate would have doubled with a single-dose vaccine available to the public.

“So if we think about it in that way, it's going to be a game changer,” Mullin, director of infection control and prevention and medical director of antimicrobial stewardship at Roswell Park Comprehensive Cancer Center in Buffalo, New York, said in an interview with CURE®.

An initial analysis of an ongoing phase 3 trial of the Johnson & Johnson single-dose vaccine demonstrated that as of Jan. 22, 2021, it was 66.9% effective in the prevention of moderate to severe/critical infection at least 14 days following vaccination and 66.1% effective at least 28 days after vaccination. The vaccine was also approximately 77% effective in preventing severe/critical infection at least 14 days after vaccination and 85% effective in preventing severe/critical infection at least 28 days after vaccination.

Benefits of a Single-Dose Vaccine

Many people, according to Mullin, will call into question the varying efficacy data between the three vaccines, and claim the Johnson & Johnson vaccine to be ineffective.

“I would love to take this opportunity to sort of re-message that because I think that people are going to say, ‘Oh, the Moderna and Pfizer vaccines are 95% effective and the J&J vaccine is somewhere between 60% and 70% effective,’” she said. “And while I think 95% is better than 66% or 70%, The J&J efficacy rates are extremely good. And honestly, if you had told me that all the vaccines that we'd have for COVID-19 were (going to be this good) last March, I would have been thrilled and thought it was a miracle.”

The fact that this vaccine is also a single-dose, instead of a two-dose, regimen is of tremendous benefit to patients, Mullin said. Not only can it be a pain for patients to have to schedule a time to get their booster shot weeks after their first dose, but a two-dose regimen can cause operational challenges when trying to roll out the vaccine to the public.

“I think there are people in the public health world who would argue that a one-shot vaccine that was 70% effective is better than a two-shot vaccine that's a little more effective than that because we can get it to people faster, we don't need to wait another three to four weeks (for the booster shot) and then a couple weeks beyond that (for the person) to have immunity.”

Tremendous Asset for Patients With Cancer

Mullin recommends that patients with cancer get whichever vaccine is available at the time they go to get vaccinated.

“I think that (the authorization of this single-dose vaccine) will be a tremendous asset to our cancer patients who also don't need to worry about (whether they can) get a follow up (because they’re) scheduled for treatment the week before,” she said.

Although there’s no data available to speak to how the vaccines affect cancer treatment, it’s clear that patients with cancer are at a higher risk for contracting COVID-19 and any vaccine provides patients with a significant benefit.

“(The single-dose vaccine) has implications not just on their COVID-19-related illness, but also treatment going down the road,” Mullin said. “The fact that someone would have 70% less likelihood of coming up against something that could delay chemo or delay a surgery in the future is a really big deal and should provide a lot of peace of mind.”

Suppressing anxiety

In conversations with patients, Mullin said the primary cause of anxiety around the vaccine has been a possibility of hyper inflammatory reactions to the second dose of either the Pfizer-BioNTech or Moderna vaccine.

One of the benefits to a single-dose vaccine, according to Mullin, is there isn’t that looming fear for patients.

“It is still a small percentage of people that do have the fevers and chills and whatnot from the second shot, but not having to worry about that, and not having that on your mental plate is a big deal,” she concluded.

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