Johnson & Johnson: The pause heard ’round the world
Tuesday’s recommendation from U.S. health authorities to pause distribution of the Johnson & Johnson COVID-19 vaccine has received a wave of reactions. The fallout for national vaccination campaigns varies widely, but – fairly or not – things are looking grim for the reputation of J&J’s once-hailed vaccine.
J&J itself delayed deliveries of the vaccine to the E.U. following the U.S. recommendation. The E.U. vaccination campaign is lagging, partly thanks to similar worries about the AstraZeneca vaccine, and European Commission officials responded with “urgent” concern to the prospect of a further supply shrinkage.
Meanwhile, South Africa also temporarily suspended J&J shots Tuesday. By Wednesday, sources told Italy’s La Stampa that the European Commission would not renew E.U. contracts with either J&J or AstraZeneca, and the E.U. simultaneously ordered 50 million more Pfizer/BioNTech doses. Fortune’s David Meyer sees this as Europe going “all-in” on mRNA-based vaccines, and abandoning the adenovirus-based J&J and AZ shots.
As if that weren’t enough, the CDC’s vaccine review board on Wednesday decided it needed more time to review and collect data, extending what might have been a two-day pause for at least another week.
All of this, it bears reiterating, comes in response to a risk that is still unproven and, at worst, appears slim. The six cases of dangerous blood clotting that triggered the U.S. pause arose out of 6.8 million doses delivered. Those cases may not have been caused by the vaccine at all, though similar cases among patients who received the AstraZeneca vaccine may suggest a common cause. But even if the vaccine is linked to clotting, it has been widely observed that the current incident rate suggests less risk than comes with taking oral contraceptives, which can trigger a different kind of clotting that is also potentially fatal.
This is not entirely doom and gloom for J&J. In a perfect world, the CDC and others would identify clear risk factors linked to negative outcomes with the J&J vaccine, and then direct doses into lower-risk arms. The six clotting cases at the center of the U.S. pause were all in adult women under 50, so discouraging or barring that group from taking the J&J vaccine may do the trick. And while it’s a grim calculus, any J&J doses the U.S. or E.U. decide they don’t want to distribute would probably be welcomed by some nations that still face serious vaccine shortages – the risk of COVID-19, after all, still appears much greater than any risk from the J&J vaccine.
The stock market has also had a measured reaction so far to J&J’s bad news. J&J stock climbed roughly 15% between October of 2020 and January of 2021, when the release of positive phase 3 trial results sent the stock to a peak of $170 before drifting closer to $160. The ‘pause’ announcement on Wednesday only knocked about 2.5% off that number, and today the price more than recovered.
Myself and others have wondered whether the pause would give ammunition to anti-vaxx conspiracists, but a small survey by Echelon Insights found that the J&J pause made 58% of Americans more confident in vaccines rather than less. A more robust YouGov poll found a major decline in trust of the J&J vaccine specifically, but little or no decline in faith in the Moderna and Pfizer vaccines.
It seems Americans may be interpreting the pause carefully and, I would argue, correctly: If health authorities are willing to hit pause on J&J over a handful of cases and a single death, it highlights just how safe the other options likely are.
David Z. Morris
david.morris@fortune.com
@davidzmorris
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