Kevin Rosengran stared at the piece of paper in disbelief. No antibodies.
The 46-year-old resident of Richmond, Virginia, received theone-dose Johnson & Johnson vaccine in March. He was confident in the vaccine’s effectiveness and finally felt free to leave his house, travel and meet with friends.
But lately, news of the highly contagious delta variant driving a surge of COVID-19 cases worried him. He didn’t want to bring the virus home to his unvaccinated 11-year-old son.
Rosengran confided in his local pharmacist, who offered an antibody test to dispel his concerns. Unfortunately, the results only added to them.
“I had this coat of armor on before and now I feel completely naked in the world of COVID,” he said.
The Food and Drug Administration does not recommend antibody testing, because it's not yet clear what level of antibodies is protective enough and because different tests yield different results.
Rosengran knows the test may have been inaccurate, and he still has confidence in all the COVID-19 vaccines authorized by the agency. But he can’t help wondering if he’s one of the unlucky few whose body did not react properly to the J&J vaccine.
“You always have this little thing at the back of your mind no matter how much data you read like, ‘I’ve had one shot and other people have two shots,’” he said. “I don’t want to be worried anymore. I’m tired of getting worried.”
Rosengran is part of a growing group of healthy J&J vaccine recipients contemplating whether they should get a “booster” dose from one of the mRNA vaccines from Pfizer-BioNTech or Moderna, hoping to improve their chances against the delta variant.
As of Friday, the Centers for Disease Control and Prevention reportedmore than 13.7 million people have gotten the J&J jab,and about 1% of them have gotten additional shots. Health experts say real-world evidence shows it protects against the worst outcomes of COVID-19, and it’s too early to recommend additional doses to healthy recipients.
J&J's pivotal large-scale trial showed it was effective against COVID-19, preventing more than 70% of symptomatic infections and about 86% of serious ones. New data the company presented on July 22 to a federal advisory committee showed the protection lasts against all variants now circulating for at least eight months.
As long as the J&J vaccine continues to protect against the severest forms of COVID-19 disease, healthy people don’t need a booster shot, said Dr. Paul Offit, a vaccine expert at Children's Hospital of Philadelphia, who spoke Tuesday in a public conversation with Brown University School of Public Health.
“We will cross the line where we know we need a booster dose when people who are fully vaccinated nonetheless are hospitalized with (J&J) or dying of COVID,” he said. “We’re not there, yet.”
Although J&J studies show its vaccine offers continued protection against most of the known variants, a study posted online July 19 but not yet peer-reviewed suggested it was less effective against the delta variant. Researchers from New York University found that blood samples from people who had received the J&J vaccine were less able to neutralize the delta variant than blood from people who received the Pfizer-BioNTech or Moderna shots.
This form of lab testing offers hints of protection but is not as reliable as showing whether the vaccine works in people, experts said.
Dr. Angela Rasmussen, a virologist at Georgetown University, told CNBC she received a booster shot of Pfizer and BioNTech’s COVID-19 vaccine in late June, about two months after she got J&J’s single dose.
She told the news outlet she was concerned about her level of protection against the delta variant. Rasmussen has not replied to USA TODAY's request for comment.
The San Francisco Department of Public Health recently began allowing J&J vaccine recipients to get a “supplemental dose” of one of the mRNA vaccines. To qualify, residents must have had their single dose shot in San Francisco and attest that a health care provider discussed the risks and benefits with them.
The public health department emphasizes “supplemental vaccines are not required or recommended,” and those who have gotten a J&J COVID vaccine are considered fully vaccinated.
Mixing and matching mRNA vaccines with other vaccine technology is not a part of the FDA’s emergency use authorization, but there is some preliminary data that support it.
A June study led by researchers at the University of Oxford suggests mixing vaccines may protect better than the two-dose mRNA vaccine regimen. The Lancet preprint study not yet peer-reviewed, found people who received both the AstraZeneca and Pfizer-BioNTech vaccinesmay have had a better immune response than those vaccinated with just Pfizer.
In May, researchers at the Carlos III Health Institute in Madrid announced results from a study that found a strong immune response in people who received the same AstraZeneca-Pfizer combination. The AstraZeneca vaccine is a viral vector vaccine, the same technology used by the J&J vaccine.
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But health experts are waiting formore concrete evidence.
“More is not always better,” said Dr. Tammy Lundstrom, infectious diseases specialist and chief medical officer at Trinity Health in Livonia, Michigan. “It’s prudent to wait for the science to dictate who needs a booster, what’s the optimal spacing (between shots) and whether mixing and matching is safe.”
While they wait for the data, she urges concerned J&J vaccine recipients to wear masks and avoid crowded areas as an extra layer of protection against the virus.
Instead of debating “boosters” for healthy vaccinated people, Offit said the conversation should be redirected to vaccinating those who still haven’t gotten their shot, as the delta variant continues to thrive on the unvaccinated.
“This discussion of boosters is just off point,” he said. “The problem in this country is not boosting people who have already been vaccinated, the problem in this country is vaccinating people who haven’t been vaccinated.”
“That’s what we need to focus our efforts – all our efforts – on.”
Contributing: Karen Weintraub and Elizabeth Weise, USA TODAY. Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.
Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.
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