Editor's note: Joseph R. Betancourt, MD, MPH, contributed to this post.
When the Johnson & Johnson single-dose COVID-19 vaccine joined the ranks of the Moderna and Pfizer/BioNTech two-dose vaccines, many Indigenous Peoples were excited about its potential.
American Indians and Alaska Natives (AI/ANs) have the highest COVID-19 hospitalization and death rates in the US. And given that 46% of adult Natives lack access to a vehicle, a single-dose vaccine looked like an especially appealing option to protect Indigenous communities. Yet even before the recent pause on the Johnson & Johnson vaccine raised concerns about safety that have since been resolved, its effectiveness for AI/AN peoples was in the spotlight.
Efficacy is the measure of how well a vaccine protects against illness under the ideal conditions of a scientific study. In March, a physician wrote an opinion challenging the efficacy of this vaccine in protecting Indigenous recipients. This appeared in Indian Country Today, the most prominent Indigenous-centered news source in the US.
After analyzing data from the FDA briefing document on the Johnson & Johnson vaccine, the author claimed that the risk of getting COVID-19 after being vaccinated was over two times higher in Indigenous people compared with people from all other racial groups. He strongly encouraged Natives to choose the Moderna or Pfizer/BioNTech vaccines instead.
A group of Indigenous health scholars including Abigail Echo Hawk, director of the Urban Indian Health Institute, penned a response in Indian Country Today. They expressed confidence in the efficacy of all three available vaccines, and encouraged Native people to take the first one available to them.
The chief medical officer of the Indian Health Services (IHS), Dr. Michael Toedt, also disagreed. No data support the claim that the Johnson & Johnson vaccine is less effective for Natives, he stated.
Even in large, well-powered studies, its not possible to interpret results for small subgroups, such as people over age 75 or racial subgroups represented only in small numbers as participants in a trial. And in fact, the FDA report also makes this point. Subgroup results are provided for completeness, although their interpretability is limited.
So, how well does the Johnson & Johnson vaccine protect AI/AN peoples from COVID-19? Lets tease apart the available numbers.
In the trial, about 19,300 participants received the Johnson & Johnson vaccine. Only 1,628 of those participants were Indigenous. Just 95 were AI/AN from US tribes (the rest were from Latin American countries). Only 18 of all the Indigenous participants got COVID 19 after being vaccinated and just one of them was AI/AN from the US. Not a single hospitalization or death occurred among the Indigenous participants. Its worth adding that no genetic or scientific factors explain why this vaccine would offer less protection against COVID-19 for AI/ANs compared with all other racial groups.
What about the two-dose COVID-19 vaccines? No cases of COVID-19 were recorded among AI/AN study participants who received these vaccines: thats zero out of 107 (Moderna) and 104 (Pfizer/BioNTech).
All three vaccines were rigorously studied in tens of thousands of clinical trial volunteer participants. Given the reassuring results of those studies, the FDA deemed them safe and effective in protecting people from hospitalizations and deaths due to COVID-19 infection. By late April, more than 230 million doses of COVID-19 vaccines had been given to people across the US.
Some people have no side effects after getting the vaccine. Others have common, temporary side effects, such as pain at the injection site, muscle aches, fever, and feeling tired.
Two extremely rare side effects have been noted:
Because COVID-19 is a danger to every racial and ethnic group, free and accessible vaccination is important for everyone. American Indian and Alaskan Native communities face some of the highest rates of diabetes, cardiovascular diseases, and cancer, making COVID-19 deadlier to them. They are exposed to pollution, have less access to health care, are less wealthy, live without clean water, and experience food insecurity at levels greater than non-Indigenous people. As a result of centuries of neglect, many Native Americans also have well-earned mistrust of the US medical system.
This is a time when trust could save lives. Claims that the Johnson & Johnson vaccine fails to protect Native Americans may needlessly work against community trust. Currently, no evidence shows that the Johnson & Johnson vaccine is less effective or less safe for AI/AN communities than the Moderna and Pfizer/BioNTech vaccines.
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
A vial labelled "Johnson&Johnson coronavirus disease (COVID-19) vaccine" is seen in this illustration picture taken May 2, 2021. REUTERS/Dado Ruvic/Illustration
Johnson & Johnson (JNJ.N) said on Friday that it has been in talks with Taiwan about providing its COVID-19 vaccine to the island since last year.
"Johnson & Johnson has been in confidential discussions with the Taiwan Government regarding supply of the Johnson & Johnson COVID-19 vaccine since last year," it said in an emailed statement to Reuters, without giving details.
Our Standards: The Thomson Reuters Trust Principles.
Leigh Appleby, the CSCU spokesperson, told The Courant Friday in a statement that the system is strongly considering a vaccine requirement and is undertaking a review, with input from faculty, staff, and students, to examine the most effective ways to ensure all members of our communities are vaccinated against COVID-19 before stepping on campus for the fall semester.
More than 1.5 million Utahns have received at least one dose of COVID-19 vaccine Salt Lake Tribune
The European Union is pushing back hard against U.S.-backed calls to temporarily waive intellectual property rights for Covid-19 vaccines, preparing a rival plan that officials said would better safeguard drug companies patents and look for other ways to boost supplies for developing countries.
As the gap between vaccine haves and have-nots has widened, Washington and China have endorsed a proposal by developing countries at the World Trade Organization to suspend patent protections for the immunizations.
Brussels alternative plan would liftexport restrictions on vaccines and their raw materials, expand manufacturing capacity around the world, and make it easier for countries to use existing rules to override patents in some cases, according to documents reviewed by The Wall Street Journal.
The EUs stance makes a quick deal on the waiver proposal less likely, and could sink it altogether, trade experts say.
EU officials said they would present the proposal at the WTO next week, when members are also set to debate the waiver. They argue that removing patents wont do much to help increase production in the short term and would remove incentives for pharmaceutical companies to do further work, such as updating vaccines for virus mutations.
About 1.4 million new doses of Covid-19 vaccines have been administered since Thursday, boosting the seven-day average of doses administered back to just over 1 million doses per day. It had fallen to under a million a day on average earlier in the week.
These figures, however, are down from an early April average high of 3.3 million per day.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said Friday that the best way for the country to avoid another Covid-19 surge -- and another shut down -- is to get vaccinated.
"It ain't over 'til it's over -- and it is not over yet," Fauci said at an event hosted by US Health and Human Services, urging people to be wary of believing the pandemic is over.
At present, 12 states have already met Biden's one-dose goal: California, Connecticut, Hawaii, Massachusetts, Maryland, Maine, New Hampshire, New Jersey, New Mexico, Pennsylvania, Rhode Island and Vermont.
The push to increase vaccinations is highlighted by further evidence that the mass vaccination programs this year have contributed greatly in the fight against Covid-19.
In the last month, the number of deaths from Covid-19 have noticeably dropped, and confirmed cases continue to plummet when compared to earlier highs, according to CDC data.
Nearly 170 million people -- just over half of the total US population -- have received at least one dose of vaccine, and about 137.5 million people -- 41.4% of the population -- are fully vaccinated.
Incentives for vaccines continue
The latest is Hawaii, which is offering a variety of donated prizes, including vacation packages and airline miles, to help reach vaccination milestones as soon as possible.
"The last 15 or 16 months have been a very difficult time for our tourism sector," said Hawaiian Airlines president and CEO Peter Ingram.
Hawaii, which has maintained some of the toughest travel restrictions throughout the pandemic, is beginning to loosen rules on air travel, dropping its testing and quarantine requirements for people flying between the Hawaiian islands starting June 15. All pandemic restrictions will be lifted once the full vaccination rate reaches 70%, the state announced.
In Kentucky, Gov. Andy Beshear announced the state's new Covid-19 vaccine incentive which will give vaccinated adults "a shot at a million dollars," he said.
"In the coming weeks, three vaccinated Kentuckians, 18 years or older, will become millionaires," Beshear said Friday, adding that 15 Kentuckians ages 12 to 17 will win full scholarships to a state public college, university, or technical or trade school.
More than 2 million Kentuckians have already been vaccinated, but Beshear anticipates "a significant increase" following Friday's announcement, he said.
In Colorado, Gov. Jared Polis presented Sally Sliger with a super-sized check for $1 million as the winner of the first drawing in the state's 'Comeback Cash' initiative.
Sliger said she is a lifelong resident of Colorado and currently lives in the town of Mead with her husband and two children.
"The odds of me and my family being given one million dollars overnight seemed impossibly small," Sliger said, encouraging everyone to get vaccinated for the freedom provided. "It was surreal, of course."
Protecting children remains a focus
As vaccines continue to go into the arms of eligible teens and adults, health officials remain concerned over the safety of children. Only those ages 12 years and older are currently eligible to receive a Covid-19 vaccine in the US.
"It tells you children can still suffer and be hospitalized by this virus," Offit told CNN's Jake Tapper. "We had this notion, initially, that this was just a disease of older people. It's not true. This virus can also hurt children."
As a result, bans on school mask mandates in states like Texas are irresponsible and could result in more children getting sick, Offit said.
"To have those kinds of rules which only promote the spread of this virus which only promote more children getting sick -- is just nonsensical," he said.
The CDC says vaccinated people may stop wearing masks in most cases, but unvaccinated people should continue to use them.
The FDA's Vaccines and Related Biological Products Advisory Committee (VRBPAC), on which Offit sits, is set to meet on June 10 to discuss what the FDA should consider in either authorizing or approving the use of coronavirus vaccines in children under 12.
Both Moderna and Pfizer are running trials for their vaccines in children ages 11 and under.
CNN's Deidre McPhillips, Lauren Mascarenhas, Michael Nedelman, Andy Rose, Melissa Alonso, Naomi Thomas and Hannah Sarisohn contributed to this report.
A general view shows an empty street during a lockdown due to the spread of the coronavirus disease (COVID-19), next to a residential building in Gombe district of Kinshasa, Democratic Republic of Congo April 19, 2020. REUTERS/Kenny Katombe/File Photo
Democratic Republic of Congo is facing a third wave of coronavirus infections, with its epicentre in the capital, Kinshasa, one of Africa's most-populous cities, Health Minister Jean-Jacques Mbungani said on Thursday.
Like many other African countries, Congo has officially reported relatively few cases and deaths, but health authorities are concerned about a recent spike in infections that saw 243 new cases recorded on Wednesday, the highest daily figure since March.
"I officially announce the onset of the third wave of the COVID-10 pandemic in our country, with Kinshasa as its epicentre," Mbungani told reporters.
A low vaccination rate and haphazard observance of recommended hygiene practices were among the reasons for the rising infection rate, he said.
On Wednesday, the World Health Organization said it was concerned about the spread in Kinshasa of the Delta variant first identified in India, which is thought to be more transmissible.
The week ended May 30 saw an exponential increase in the rate of infections in Kinshasa, the WHO said.
Congo's vaccination campaign has stuttered after it delayed the rollout because of safety concerns about the AstraZeneca (AZN.L) shot. As a result, about 75% of the 1.7 million doses it received in March were reallocated the following month to make sure they were used before they expired.
In total, Congo has reported over 31,900 infections and 786 coronavirus-related deaths since the pandemic began.
Among the victims were 32 members of parliament, or about 5% of the total killed by the virus, the authorities said last week. read more
Our Standards: The Thomson Reuters Trust Principles.
A man takes a selfie while getting the COVID-19 vaccine during a vaccination day in Mexico City. Hector Vivas/Getty Images hide caption
A man takes a selfie while getting the COVID-19 vaccine during a vaccination day in Mexico City.
One million Johnson & Johnson COVID-19 vaccines are heading to Mexico from the U.S. with most of the shots set to service resort areas and spots along the border.
The batch of vaccines is part of the 25 million excess doses the White House announced on Thursday would be shipped to other countries around the world. Much of the vaccine distribution will be through COVAX, an international system aimed at helping to vaccinate people in the world's poorest countries.
In a bid to boost the country's economy, Assistant Health Secretary Hugo Lpez-Gatell said much of those 1 million vaccines will be sent to Caribbean resort hotspots such as Cancn, Pacific coast resorts like Los Cabos, and cities along the U.S. border.
Mexico, a country of roughly 130 million, has been hard hit by the coronavirus and has struggled to control its spread.
According to government data, Mexico has given more than 23.2 million adults in the country at least one shot of a COVID-19 vaccine. As of Thursday night, Johns Hopkins University's Coronavirus Tracker reports more than 2.4 million confirmed coronavirus cases in Mexico with more than 228,000 deaths.
Government officials have indicated that the actual death toll from the pandemic is likely far higher, according to The Associated Press., with a preliminary assessment suggesting more than 350,000 excess deaths 54% above the official toll.
Canada's National Advisory Committee on Immunization is recommending allowing people to mix COVID-19 vaccine doses. Here, people walk past a vaccination clinic this week in Toronto. Zou Zheng/Xinhua News Agency via Getty Images hide caption
Canada's National Advisory Committee on Immunization is recommending allowing people to mix COVID-19 vaccine doses. Here, people walk past a vaccination clinic this week in Toronto.
Canada's public health agency says people can mix COVID-19 vaccines if they want to, citing cases where local supply shortages or health concerns might otherwise prevent some from completing their two-dose vaccination regimen.
The new recommendations come after safety concerns were raised linking the AstraZeneca vaccine to the potential for dangerous blood clots a condition the health agency calls "rare but serious." That vaccine is not authorized for use in the U.S., but the Johnson & Johnson vaccine, which has faced similar scrutiny, is. Both of them are viral vector vaccines.
Several Canadian provinces have recently moved to mix vaccines, the CBC reported, because of supply issues, when the vaccine used for a first dose isn't available for the second.
Public confidence is also an issue: Health officials cite a study from late April that found more than 90% of participants said they were comfortable with either the Pfizer or Moderna vaccines, but only 52% of participants said they were comfortable with the AstraZeneca vaccine. Both Pfizer and Moderna are mRNA vaccines.
Based on the available evidence, "we are recommending that someone who received a first dose of the AstraZeneca ... vaccine may receive an mRNA vaccine for their second dose," said Dr. Caroline Quach-Thanh, who chairs Canada's National Advisory Committee on Immunization.
The agency cites the results of a study in Germany and clinical trials in the U.K. and Spain as supporting the safety of vaccine interchangeability. It says it expects further data from ongoing studies in Canada and elsewhere in the coming months and will update its recommendations if warranted.
Nationwide, the Pfizer-BioNTech and Moderna vaccines have increasingly become the primary vaccines administered in Canada, according to the latest government data.
The Pfizer-BioNTech and Moderna vaccines "can be considered interchangeable" between the first and second doses, Canada's advisory committee on immunization says in its recommendations that were updated this week.
Canadian officials are hoping the new guidance will help bridge a wide gap in their vaccination program. As of late May, 50.6% of Canada's population had received at least one vaccination shot but only 4.6% of the population was fully vaccinated.
"This is not a new concept," the advisory group said of the practice known as heterologous vaccination. In the past, the group added, "Different vaccine products have been used to complete a vaccine series for influenza, hepatitis A, and others to complete a vaccine series for influenza, hepatitis A, and others."
Several European countries have already been encouraging people who've received a first shot of the AstraZeneca vaccine to make either the Pfizer or Moderna vaccines their second shot, including France, Spain and Germany.
In addition to potentially easing vaccine reluctance, mixing vaccines could also bring other benefits.
As NPR's Joe Palca reported last month: "Basically, all vaccines work by showing people's immune systems something that looks like an invading virus but really isn't. If the real virus ever comes along, their immune systems will recognize it and be prepared to fight it off.
"Using two different vaccines is a bit like giving the immune system two pictures of the virus, maybe one face-on and one in profile."
As other countries authorize mixing vaccines, the U.S. is not following suit in part because the Food and Drug Administration hasn't authorized the AstraZeneca vaccine. And unlike that vaccine, the Johnson & Johnson vaccine requires only a single dose.
When asked for comment about the strategy of mixing vaccines, an FDA spokesperson cited a lack of data about the interchangeability of the vaccine with other COVID-19 vaccines.
"Individuals who have received one dose of the Pfizer-BioNTech or Moderna COVID-19 vaccine should receive a second dose of the same vaccine to complete the vaccination series," the spokesperson added.
The familiar displays, re-enactments and other features are back for the Mid-Atlantic Air Museums 30th World War II Weekend.
The three-day event on the grounds of the Reading Regional Airport in Bern Township was canceled last year due to the coronavirus pandemic.
Whats new is the fact that we are having it this year, said Jim Swope, event coordinator and founder. And from the looks of it, we havent skipped a beat. There is full participation from the living-history groups and everywhere you look, someone is walking around.
The air museum planned to hold the exhibition this June even before restrictions in the state were eased, Swope said, noting there would have space on 36-acre grounds to accommodate 50,000 under the safety guidelines.
Swope of Mount Penn, a retired history teacher, said his goal is for the exhibition to faithfully recreate the sights, sounds and smells of the World War II era.
Hopefully, not the smell of wet canvas, he said referring Friday morning to the gathering clouds that brought an afternoon thunderstorm.
The event, which runs through Sunday, draws aviation enthusiasts and history buffs from around the world to commemorate the war and honor those who served.
Many of the attendees had fathers, grandfathers or great-grandfathers who served in the European or Pacific theaters during World War II.
They can relate intergenerationally to their relatives who were in World War II, he said.
About two dozen World War II veterans will share accounts of their war experiences and will be available for autographs throughout the weekend.
Although the emphasis is always on those who served, features include displays of authentic World War II aircraft in the air and on the ground.
Themed A Gathering of Warbirds, the 30th event hosts 10 total bombers: heavy, medium, dive and torpedo.
We have big aircraft, including a B-17 and B-29, participate with flight demonstrations and rides, Swope said. There is nothing more famous than a B-17, the plane that led the bombing campaign against the Nazis, or a B-29, the plane that led the bombing campaign against the Japanese.
The planes are brought in from all over the country, he said. Some are privately owned and others are owned by museums and foundations.
Other highlights include living-history exhibits of American, Allied and Axis equipment, a glimpse of life on the homefront and period entertainment.
My ultimate goal is to provide visitors with a good three-minute stretch, during which they wont know if it is 1943 or 2021, Swope said.
