J&J COVID Vaccine Thwarts Delta Breakthrough Infections In Large South African Trial. What It Means For NYC

The Johnson & Johnson COVID-19 vaccine showed substantial protection against two variants thought to threaten our immune system defenses, according to new results from a South African trial involving nearly 480,000 health care workers. The results arrive as worries of the delta variant surge grow in New York and nationwide—and as confidence remains low in the single-dose option from Johnson & Johnson despite a string of promising findings.

In a presentation live-streamed Friday, researchers behind the Sisonke study said that Johnson & Johnson’s single-shot provided 71% protection against hospitalization with the delta variant, meaning it reduces the odds of this serious outcome by that much.

This efficacy slightly outmatched what they recorded against the beta variant, which was initially detected in South Africa late last year. Together, these levels of protection also mirrored what was reported in clinical trials when the vaccine was authorized in the U.S. this past winter.

“The protection is good against both the beta and the delta variants,” Dr. Glenda Gray, a project co-leader and the president and CEO of the South African Medical Research Council. “We showed you that it’s about 67% protection when beta dominates and about 71% protection when a Delta dominates.”



Efficacy of the Johnson & Johnson COVID-19 vaccine against the beta and delta variants, through July 17th
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Efficacy of the Johnson & Johnson COVID-19 vaccine against the beta and delta variants, through July 17th Sisonke trial


Efficacy of the Johnson & Johnson COVID-19 vaccine against the beta and delta variants, through July 17th
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Efficacy of the Johnson & Johnson COVID-19 vaccine against the beta and delta variants, through July 17th Sisonke trial

Their current analysis ran from February, a period where beta was dominant in South Africa, to July 17th, when delta had risen to the top. When they looked at all the breakthrough infections—incidents where vaccinated people still catch the coronavirus—dating back to the start of the study, they found 96% of these cases were mild. Another 3% were moderate, while less than 0.05% of breakthroughs resulted in severe disease or death.

“So in conclusion, Linda-Gail and I and the Sisonke team provide the world’s first evidence that the [Johnson & Johnson] Ad26 COVID-19 vaccine is effective against the Delta variant of concern,” Gray said, referring to co-leader Dr. Linda-Gail Bekker of the Desmond Tutu HIV Foundation. “We show you that the vaccine works very well in South Africa and protects against severe disease and death.”

Delta variant now makes 92% of analyzed cases in New York City, as cases and hospitalizations begin to mount in certain neighborhoods. This uptick, along with new incentives and mandates, has motivated a swing in demand for the COVID-19 vaccines following months of a downslide. Daily new recipients of the life-saving doses have jumped from less than 8,200 on July 10th to around 11,000 on August 4th.

But city health department data show most new recipients are taking the Pfizer and Moderna two-shot vaccines. Interest in the Johnson & Johnson vaccine continues to decline, despite only requiring one dose.

The Johnson & Johnson vaccine has played a key role in Mayor Bill de Blasio’s initiatives, including the homebound seniors’ program and rollouts for unhoused communities. Governor Andrew Cuomo also used it for the subway-based vaccine drives run by the Metropolitan Transportation Authority.

This week, a nationwide survey released by KFF shows that faith remains lower in the Johnson & Johnson vaccine compared to its competitors, with only 47% of survey takers confident in the shot. This percentage drops even further among unvaccinated people, to 18%.



Perceptions of COVID-19 vaccines safety have not significantly changed since April, with J&J still lowest safety confidence
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Perceptions of COVID-19 vaccines safety have not significantly changed since April, with J&J still lowest safety confidence KFF


Despite solid safety data, majorities of unvaccinated Americans are not confident in COVID-19 vaccines.
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Despite solid safety data, majorities of unvaccinated Americans are not confident in COVID-19 vaccines. KFF

New York City data shows a huge drop in demand for the Johnson & Johnson vaccine after the federal regulators issued a temporary pause on its distribution on April 13th—due to concerns over rare and atypical blood clots. The city has dolled out 441,000 Johnson & Johnson single-shots, while by contrast, New Yorkers have taken 9.6 million combined first and second doses of Pfizer and Moderna.

As of July 26th, U.S. health officials have spotted only 39 confirmed reports of this condition out of 13 million doses delivered. Another adverse event associated with the shot—Guillain-Barré Syndrome—has only been documented 143 times.

Likewise, Gray said that the Sisonke trial had recorded only 2 cases of atypical blood clots after delivering hundreds of thousands of shots. She added that overall, the single-shot reduced the chances of death to near zero in the Sisonke trial, which involved 122 sites.

Their team is also seeing the vaccine responses retain their durability. Johnson & Johnson, based in New Brunswick, New Jersey, has also released recent data showing its shot can still neutralize the delta variant.



Sisonke trial on Johnson & Johnson vaccine durability
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Sisonke trial on Johnson & Johnson vaccine durability Sisonke trial

“Looking at the data set, we can report that the single jab J&J vaccine protected between 91 to 96.2% of healthcare workers against death,” Gray said. ”We do not believe that there’s a need for a booster at this stage…We see surprising durability in the immune response, for up to eight months.”

Due to manufacturing delays, the U.S. and global rollouts of the Johnson & Johnson vaccine have been slow. This week, the World Health Organization called for high-income nations to skip giving booster shots for all COVID vaccine brands until other countries could catch up.

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