The J&J Rescue Mission Starts With a Choice

Rehabilitating the Johnson & Johnson vaccine, experts told me, will require honest acknowledgments of its shortcomings, and validating, not combatting, people’s concerns. The rare blood clots that have been tied to the vaccine are serious, they said, but extraordinarily uncommon—a risk that’s far outweighed by the benefits of immunity.

The pause clearly did shake things up. Willie Bodrick II, a senior pastor of Twelfth Baptist Church in Boston, who’s heavily engaged in vaccine outreach to the city’s Black community, told me that, even before the pause, he had been fielding questions about the J&J shot for weeks. Some people who were unwilling to take a second dose, whether because of work constraints or wariness of side effects, saw the single injection as an ideal option; others “were really worried they would be receiving a subpar vaccine,” he said. Just days before the J&J halt, Bodrick felt he’d made progress. But news of the rare blood clots “resurfaced a hurdle I thought we were doing a good job moving beyond,” he said. Van Yu, a physician at the Center for Urban Community Services in New York City, where he is working to bring J&J vaccines to people experiencing homelessness, told me that, before the pause, many of his patients explicitly requested “the single-shot thing.” Now that J&J is available again, he and his colleagues have noticed that some people are citing the halt as a reason to turn it down.

The risk of clots has persuaded a few people to forgo vaccination entirely. Earl Potts, a 60-year-old IT-security specialist in Maryland, told me that he’s been skeptical of receiving any vaccines for decades. Although constant coaxing from family initially nudged him and his wife, Lori Renee Potts, toward getting J&J “because it was just one shot,” the pause reignited their fear that the vaccine-making process had been rushed. “I need more data; I need more time,” he said.

In many parts of the country, however, a simple message is still encouraging people to roll up their sleeves: Johnson & Johnson’s vaccine is “one of three excellent choices for protection against COVID-19,” as Hardeman puts it. In Columbus, Ohio, the health department’s on-site clinic vaccinates about 130 to 140 people each day, more than a third of whom are still queueing up for the one-and-done shot, Health Commissioner Mysheika Roberts told me. At another large site, where Pfizer and J&J doses are alternated throughout the week, “the J&J days are just as busy.”

Still, the pause prompted Roberts and her team to switch up their outreach tactics. Before the halt, city officials had brought only one brand at a time when inoculating off-site, prioritizing J&J allocations for the residents of homeless shelters and homebound individuals. When the vaccine returned with a warning label, “we thought it was appropriate to offer a choice,” Roberts told me, so no one felt cornered. Porting mRNA vaccines around requires a mobile freezer, which is “tedious to maintain,” she said, but removes a barrier. “Now when we go out to any location, it’s, ‘Which do you want, Pfizer or J&J?’”

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