Wednesday, April 14, 2021

The Insane, Reckless "Pause" Of The Johnson & Johnson Vaccine Will Cost Lives

 The FDA and CDC have called for a "pause" of deliveries of the Johnson & Johnson (Janssen) COVID-19 vaccine. This is absolutely insane based on relative risk alone: one woman died among the six women affected (all 18-49 years old), versus over seven million vaccinated. Meantime, the CDC's own best-guess infection fatality ratio shows twenty deaths per million infected among the 0-17 years age group. So the FDA and CDC are stopping vaccinations that could save the lives of twenty times the number of people even in the best case scenario. The most likely case, the 18-49 age bracket, sees an IFR of 500, which means you are looking at two orders of magnitude more risk of death than without vaccination. The FDA has a history of safetyism overriding sense, and this will kill people, especially as it means fewer vaccines will be available.

 In a sense, the pause may not matter, because the vaccines wouldn't be available even if these thrombotic events hadn't happened. Johnson & Johnson took over production at contract manufacturer Emergent BioSolutions following production errors there that mixed up their vaccine with AstraZeneca's, and this caused the destruction of up to "15 million doses". Accordingly, the CDC announced it expects J&J to cut supply by 80%, putting the overall annual goals of 100 million doses in the US and one billion worldwide in jeopardy.

Lastly, for anyone who wants to get into the weeds on this subject, Derek Lowe has a good explainer on the subject. This seems to be a problem shared with the AstraZeneca ChAdOx1 vaccine as well, and while I recommend the whole post, I wanted to highlight this one section in particular:

Is this blood clotting happening with the mRNA vaccines, too?

No. That seems quite clear – to the best of my knowledge, there have been no reports like this at all with either the Moderna or the Pfizer/BioNTech vaccine. That’s good news, and it tells us a lot. For one thing, this blood clotting problem is not a general feature of trying to vaccinate people against the coronavirus. It also means that it apparently has nothing to do with inducing the coronavirus Spike protein in people, since that’s what both the adenovirus vectors and the mRNA vaccines are doing, in the end.

The version of that protein brought on by the AZ/Oxford vaccine is slightly different from the others (it doesn’t have a key set of protein-stabilizing mutations), and when the clotting problems showed up in Europe some people were wondering if that had anything to do with it. But the appearance of such side effects with the J&J vaccine would seem to rule that out. Instead, what those two have in common is that they’re both adenovirus vector vaccines [emboldening mine — RLM]. Oxford used a chimpanzee adenovirus, and J&J picked a less-common human one. Which means that if this is a side effect shared by adenovirus vectors, it’s shared at a pretty basic level, isn’t it? I’m not enough of an adenovirus jock to tell you in detail about the similarities between the proteins in the ChAdOx vector versus Ad26, and at any rate it’s probably more about the antibody response to these things (and why, in a small number of people, that goes awry with the PF4 protein).

It's becoming increasingly obvious that the vectored virus vaccines are a technological dead end: harder to manufacture at scale, more likely to generate weird side effects, and less effective than mRNA vaccines. But any of them are still better than getting COVID.

Update 2021-04-15: Alex Tabarrok has a useful thread detailing post-vaccination thrombotic events in the UK. The mRNA vaccines maybe have dodged a bullet on this?

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