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5 March 2021

With a Third Vaccine, from Johnson & Johnson, Are We Finally Winning Against COVID-19?

By Amy Davidson Sorkin

Optimism is one of the things that the coronavirus pandemic has made it hard to hold on to, or even to measure. Going through the data can have a seesawing effect on a person’s state of mind. Last week, Johnson & Johnson announced that, in trials, its covid-19 vaccine had an efficacy rate of more than sixty-six per cent in preventing moderate to severe disease, and was eighty-five per cent effective at preventing severe to critical cases—and that no one who got the vaccine was hospitalized or died because of covid-19. On Friday, the Food and Drug Administration’s vaccine-advisory committee voted, unanimously, to recommend that it become the third vaccine to be given an emergency-use authorization in the United States. It could be deployed as soon as this week.

Should one’s mood be lowered by the knowledge that the two vaccines that were previously approved, from Pfizer-BioNTech and Moderna, have higher efficacy rates—around ninety-five per cent? (Not really; the J. & J. numbers are still very good.) Alternatively, should one’s mood get an upswing from the knowledge that, unlike with the Moderna and Pfizer vaccines, only one J. & J. shot is required, and that the vaccine can be stored in a normal refrigerator? (Definitely.) Is there a sign that vaccinations, along with the end of the holiday season and a growing willingness to wear masks, are, finally, altering the trajectory of the pandemic? (Yes: since the beginning of the year, the average daily number of new cases in the United States has fallen by three-quarters; worldwide, the number is half of what it was.) Thankfully, the ups seem to be beating the downs.

Yet joy can be hard to come by, because of the weight of what the country is still going through. The average daily number of deaths is about two thousand—a sharp drop from mid-January, when it was well above three thousand, but quadruple what it was last July. And, as February ended, there seemed to be something of a wavering in the progress—perhaps because extreme weather caused disruptions or, more ominously, because of the spread of what appear to be more infectious variants.

The biggest brake on optimism concerns those variants: the British, the Brazilian, and the South African. The J. & J. vaccine held up well in large-scale trials in South Africa. There is evidence that other vaccines will not work quite as well against that variant or, apparently, against the Brazilian one, though vaccine makers are working on boosters to address that issue. The vaccines do appear to be effective against the quickly spreading British variant. But the fear is that variants may yet outpace vaccinations. The race is still on: a new variant with worrisome mutations seems to be gaining ground in New York City.

Two White House commemorations last week embodied the lurch between pain and progress. The first, on Monday evening, was held on the South Portico, to mark half a million recorded U.S. covid-19 deaths. Before calling for a moment of silence, President Biden urged Americans not to become “numb to sorrow.” Just three days later, Biden, with Vice-President Kamala Harris and Dr. Anthony Fauci, watched four frontline workers get their first shots at an event billed as “50 Million covid Vaccinations.” The “50 Million,” as Biden made clear, referred only to the number of doses administered since he was inaugurated. The total is approaching seventy million doses, with twenty million people fully vaccinated. Biden offered a stream of banter about how the shot doesn’t really hurt, then cautioned, “This is not a victory lap.” But, he added, “we’re getting close.”

It is hard to cheer unabashedly when the distribution of vaccines has been such a mess. Donald Trump had no real plan, and left matters such as eligibility to the states. The Biden Administration has been far more involved, but the system remains fragmented. Just because you are eligible to get a vaccine in New York, it doesn’t mean that you are eligible in Massachusetts or Georgia. A contentious issue is whether prioritizing K-12 teachers should be a requirement for reopening schools; they are eligible for vaccines in about thirty states, and only in certain counties in some others. If you are eligible, you still often need a lot of spare time and technical access to secure an appointment. Racial and class inequities abound, along with a certain arbitrariness. Yet, looking only at the raw numbers, people in the U.S. are being vaccinated at almost twice the rate of those in Germany. (And both the U.S. and Germany are in a better position, in terms of supplies, than much of the developing world.)

One measure of how tricky it can be to think about the pandemic’s next chapter is the discussion around “vaccine passports.” The idea is that a person’s vaccine status—perhaps documented by an app—could open doors that would otherwise be closed. But which doors? Showing proof of vaccination before travelling to another country is a familiar practice. Difficulties arise over access to jobs and whether vaccinated people should be encouraged to act as if covid-19 is no longer a factor—to go to big indoor weddings, crowded theatres, busy restaurants—when vaccines are not universally available and vaccinated people may still spread the disease, albeit to a lesser extent.

Conversely, some worry that downplaying what vaccines can do might further people’s reluctance to get one. (Vaccine hesitancy is a concern; a third of the members of the military who have been offered a vaccine have turned it down.) In that sense, the vaccines highlight, rather than eliminate, a central dilemma of this brutal but unevenly experienced pandemic: how to balance rational risk-taking with community obligations and realism about what’s still ahead. It is reasonable, for example, to expect vaccinated people who gather at home with vaccinated friends and relatives to continue wearing masks in public settings.

The winter wave is ending, and there is every chance, with luck and vigilance, that we won’t soon see its like again, even if the coronavirus and its descendants linger. Recently, Fauci told CNN both that he thought life might return to its usual patterns by the end of this year and that Americans might still be wearing masks in 2022. As he put it, “It really depends on what you mean by normality.” One can, in the course of a long pandemic, begin to get used to too many intolerable things. But it would be disastrous to grow numb to hope. 

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