Can Trust in the Johnson & Johnson Vaccine Recover?
A damaged reputation is an awfully hard thing to fix. As my colleague Tara Law reports, that's the hard truth facing the Johnson & Johnson/Janssen vaccine after U.S. regulators recommended pausing its use on April 13, following reports of clotting events in six women out of more than 6.8 million recipients.
The U.S. Food and Drug Administration and Centers for Disease Control and Prevention have not said when or if they will lift the pause. Use of the J&J vaccine could resume as soon as this week, though the agencies might recommend that it only be given to older people, since the six affected women ranged in age from 18 to 48. The question is: If and when the J&J shots come back, will people take them?
Tara helps answer that question by comparing what's currently happening in the U.S. with what happened in the U.K., Germany and France after similar clotting problems were tied to the AstraZeneca-Oxford University vaccine, which is used across Europe. If two of those countries are any indication, the outlook may not be good for J&J here.
Trust in the AstraZeneca vaccine has suffered the least in the U.K., where it enjoyed numerous advantages. For one, the shot was developed there, giving it what Tara calls "home field advantage." The U.K. was also extremely aggressive in rolling out the shots, and as millions of people were vaccinated without major side effects, at least some skeptics were convinced to get the jab themselves. Moreover, after the clotting reports emerged, the British government did not pause AstraZeneca's use entirely, but rather restricted it to people over 30, since the clotting happened in younger people. The result of all these factors: in an April poll, only 13% of people in the U.K. called the AstraZeneca vaccine unsafe, about the same as before the clotting reports.
In Germany and France, however, things have been more complicated. Both countries began using the AstraZeneca shot six weeks after the Pizer vaccine rolled out, giving it less time to build up a positive reputation before reports of blood clotting surfaced. Both also completely paused use of the vaccine in mid-March—the way the U.S. has with the J&J shot—rather than simply restricting who can receive it.
Germany lifted its AstraZeneca pause after just three days, but later decided to limit its use to people over 65—mixed messaging that did not help uptake. In Germany, 55% of people now consider the AstraZeneca vaccine unsafe, up from 30% in December. France also resumed use of the AstraZeneca shot after just a few days, but it was already a tough place to promote any vaccine; a survey in The Lancet rated it the most vaccine-hesitant country out of 67 polled. In France, 61% of people now say the AstraZeneca vaccine is unsafe, up from 48% in December.
None of that bodes well for the J&J vaccine in the U.S., especially in a climate in which vaccine use has become increasingly politicized. It also isn't helping that the current pause is going on as long as it has, with no certain date for its end.
"I truly and deeply hope that a pause is genuinely a pause, and it doesn't get into weeks and a month, because it will really undermine public confidence," Heidi Larson, the founding director of the Vaccine Confidence Project at the London School of Hygiene & Tropical Medicine, told Tara. "If there's one message to the U.S. out of all this, it's: don't let the ambiguity drag on."
More than 264.5 million doses of the COVID-19 vaccine have been shipped to various U.S. states as of yesterday afternoon, of which some 211.5 million doses have been administered, according to TIME's vaccine tracker. About 25.7% of Americans have been completely vaccinated.
Up to 6,000 fully vaccinated Americans have contracted COVID-19, U.S. CDC Director Dr. Rochelle Walensky reported at a press conference yesterday. Walnsky added that since the numbers are from only 43 states and territories, they are likely an undercount. Still, she assured the public that some "breakthrough" infections are inevitable with any vaccine, that the 6,000 cases represent only 0.007% of the 84 million fully vaccinated Americans, and that in 30% of the cases, the infected individuals had no symptoms.
China is seeking to improve the efficacy of its five domestically-made vaccines by experimenting with mixing two of them, The New York Times reports. In a new trial of 120 subjects over age 18, researchers are first administering a dose of a shot made by CannSinoBIO, followed weeks later by one made by Anhui Zhifei Longcom Biopharmaceutical. The move comes after Brazilian officials complained that China's Sinovac vaccine was only 50% effective and the United Arab Emirates began administering a third dose of Beijing's Sinopharm shot after finding the first two left some people with insufficient antibody levels.
Despite the increasing availability of vaccines in sub-Saharan Africa, only 5.2 million people out of a regional population of 1 billion have received their shots so far, Bloomberg reports. The extreme vaccine hesitancy is caused by a raft of local rumors. In Ivory Coast, for example, there is widespread belief that the pandemic was planned by foreign actors, while in Somalia, the militant group Al-Shabaab is warning the public that they are vaccine "guinea pigs." Local leaders are pushing back by publicly taking the vaccines themselves.
TODAY'S CORONAVIRUS OUTLOOK
The Global Situation
More than 142 million people around the world had been diagnosed with COVID-19 as of 1 a.m. E.T. today, and more than 3 million people have died. On April 19, there were 692,805 new cases and 10,481 new deaths confirmed globally.
Here's how the world as a whole is currently trending:
Here's where daily cases have risen or fallen over the last 14 days, shown in confirmed cases per 100,000 residents:
And here is every country with over 2 million confirmed cases:
The U.S. continues to lead the world in absolute COVID-19 cases and deaths, but Brazil just passed a troubling milestone, becoming the leading country in the Americas in terms of cumulative deaths per capita, the Rio Times reports. Brazil is currently recording 1,756 deaths per million inhabitants, compared to 1,722 for Peru, 1,713 for the U.S. and 1,646 for Mexico. The P1 variant is a major driver of the rising death rate across Brazil.
There is a downside to the steady reopening of the global economy as the world crawls out from beneath the pandemic: carbon emissions are set to rise by 5% in 2021, the second highest year-to-year increase on record, my colleague Ciara Nugent reports. The prediction comes from the Paris-based International Energy Association.
India's 180,000-plus COVID-19 deaths place it fourth in the world in overall pandemic mortality, but in the midst of the country's most recent surge, the figure may be an undercount—for one very grim reason. According to Reuters, India's rate of cremations is soaring under COVID-19 protocols that call for rapid disposal of remains if patients die of unknown causes before they can be tested for the virus. One state official told Reuters that fast cremations take place "even if there is 0.1% probability of the person being positive." Yesterday alone, India officially registered a record 273,810 new daily infections and 1,619 deaths.
The Situation in the U.S.
The U.S. had recorded more than 31.7 million coronavirus cases as of 1 a.m. E.T. today. Nearly 568,000 people have died. On April 19, there were 67,316 new cases and 473 new deaths confirmed in the U.S.
Here's how the country as a whole is currently trending:
Here's where daily cases have risen or fallen over the last 14 days, shown in confirmed cases per 100,000 residents:
Even as air travel within the U.S. picks back up, the U.S. State Department is warning against many trips overseas, the Washington Post reports. Currently, 16% of foreign countries carry the State Department's highest "Level 4: Do Not Travel" designation, but that number will jump to a whopping 80% this week amid ongoing COVID-19 concerns. The warning is just that—a warning, not a prohibition—but the State Department urges Americans who choose to travel to countries on the no-go list to first read its guidance about the dangers they may face.
More woes for Emergent BioSolutions, the Baltimore contractor now infamous for spoiling 15 million doses of the Johnson & Johnson/Janssen vaccine: According to the New York Times, a congressional panel plans to investigate whether Trump Administration officials improperly steered a $628 million contract to Emergent to make J&J doses despite the company's spotty history of quality control issues and questions over workers' training. Emergent announced yesterday that it had suspended operations at the plant in order to "restore confidence" in its work.
The situation remains grim in Michigan, where health officials yesterday reported a 9.5% increase in total known coronavirus outbreaks across the state compared to last week, according to local news outlet M Live. A single outbreak is defined as a situation in which two or more cases are linked by place and time; Michigan's Department of Health and Human Services is tracking 1,261 active outbreaks statewide. The manufacturing and construction industry led the state in such clusters last week with 47, followed by 43 in K-12 schools and 42 in retail establishments. Restaurants and bars accounted for 26.
All numbers unless otherwise specified are from the Johns Hopkins University Center for Systems Science and Engineering, and are accurate as of April 20, 1 a.m. E.T. To see larger, interactive versions of these maps and charts, click here.
WHAT ELSE YOU SHOULD KNOW
The Pandemic Didn't Change Where Americans Move
The betting had been that with work-from-home becoming a growing option across the country, Americans would be freer to choose where they want to live, changing home-buying patterns. But as The New York Times reports, with the exception of New York and San Francisco, not much has changed: places that were popular before remain popular now. Read more here.
The Crisis in India's Hospitals
"No place for you," is the phrase heard more and more by sick people in India in need of hospitalization. Here, the Associated Press has a troubling account of a country where hospitals are under siege by the pandemic. Read more here.
The Pandemic Leads to a New Emotional Disorder
The feeling that you're not quite depressed, but not quite happy either has a name, according to The New York Times. It's "languishing," and it just might be one of the dominant emotions of 2021. Read more here.
Can Our Economic Recovery Prioritize Women?
According to another report from my colleague Ciara Nugent, a growing number of governments worldwide are taking special care to ensure that women are not left out of the coming post-COVID economic recovery. That's good news, as women were often hardest hit by the pandemic slowdown. Read more here.
Thanks for reading. We hope you find the Coronavirus Brief newsletter to be a helpful tool to navigate this very complex situation, and welcome feedback at coronavirus.brief@time.com. If you have specific questions you'd like us to answer, please send them to covidquestions@time.com.
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Today's newsletter was written by Jeffrey Kluger and edited by Alex Fitzpatrick.
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