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What The Johnson & Johnson Pause May Mean For Vaccine Equity

AILSA CHANG, HOST:

The rollout of the Johnson & Johnson vaccine against COVID-19 will remain on pause for at least a week. The Centers for Disease Control and Prevention says it needs more time to study a link between the vaccine and extremely rare but severe blood clots. Meanwhile, this pause may affect the overall vaccination plan in the U.S., especially in communities already struggling with vaccine in equity. To talk more about this, we're joined now by Dr. Paul Adamson. He's an infectious diseases fellow at David Geffen School of Medicine at UCLA. Welcome back to ALL THINGS CONSIDERED.

PAUL ADAMSON: Hey. Thanks for having me.

CHANG: Thanks for being with us. Well, first, can you just explain why the Johnson & Johnson vaccine has been chosen in many cases to be the vaccine for underserved communities - I mean, compared to the Pfizer and Moderna vaccines?

ADAMSON: Yeah, I think the Johnson & Johnson vaccine was a really welcome addition to our vaccination efforts. And I think it was particularly useful in, you know, much harder to reach populations where it had specific benefits, where it was a single dose vaccine. It didn't require the same cold chain that the other vaccines Required. And so in those cases, it was beneficial to get out into more rural communities or remote settings. And then the one dose allowed it to be - able to be given to populations that have a harder time ensuring follow-up appointments. So those could be farm workers. Those could be people experiencing homelessness. Those could be people in our jail systems.

CHANG: And also, to add to the groups of people who might benefit from the one-dose regimen, homebound people, people who can't get out very easily.

ADAMSON: Exactly. Yeah. There is a lot of barriers for folks who are homebound, especially thinking about, you know, potentially more elderly folks who have a harder time getting out of the house, have a harder time with transportation. And the dose really kind of reduces the barriers for them to receive the vaccine.

CHANG: Well, we talked to you last month about vaccine inequity here in Los Angeles. Are you afraid this pause in the Johnson & Johnson vaccine will only make that inequity worse?

ADAMSON: Yeah. You know, it's a good question. And I'm not quite sure how it's going to play out. I think over the last month since I spoke with you last, state and local officials here have made, you know, really concerted efforts to improve vaccine equity. In early March, California devoted 40% of its vaccine commitments to communities in the lowest quartile for the California Healthy Places Index. And I really think those efforts are just starting to pay off. We're still seeing a bit of the narrowing the gap in terms of vaccine uptake in our most vulnerable communities. You know, and access to vaccines are improving, but we still know that gaps exist.

So I think that it's definitely a setback in terms of helping with vaccine equity. But, you know, we still - it's a good reminder that we still have lots of vaccines available from Moderna and Pfizer. And people are still eligible for vaccines. And so I think there's still work that can be done in terms of improving equity, in terms of access to those vaccines. But it is a bit of a setback to have this pause for Johnson & Johnson at the moment.

CHANG: How frustrating has this been for people like you who just want to make sure everyone gets vaccinated?

ADAMSON: Yeah. You know, on the one hand, I think that, you know, the pause is needed and it shows that, again, that the FDA and the CDC are reviewing and monitoring safety data. And I think for me, that's very reassuring, you know. But on the other hand, we've also had so many obstacles and hurdles throughout this vaccine rollout process. And I think this is frustrating because it's sort of another hurdle. And that so in that sense, it has been a bit frustrating. But again, I'm glad that they're reviewing the data. And I'm really hopeful that they're going to continue to endorse the vaccine after they're able to complete their review.

CHANG: Dr. Paul Adamson is an infectious diseases fellow at UCLA. Thank you very much for joining us today.

ADAMSON: Thank you so much for having me. Transcript provided by NPR, Copyright NPR.

Ailsa Chang is an award-winning journalist who hosts All Things Considered along with Ari Shapiro, Audie Cornish, and Mary Louise Kelly. She landed in public radio after practicing law for a few years.
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