TWV Podcast Episode 454: J&J and AstraZeneca Covid-19 Vaccines

This week on The Whole View Podcast, Stacy and I dive deep into the two adenovirus-vector DNA vaccines for covid-19: Johnson & Johnson/Janssen and AstraZeneca/Oxford.

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Recommended Reading and Listening
Citations:

This episode follows up on our epic 4-part series on the covid-19 mRNA vaccines, where we examined the history of vaccines, the very real statistics on vaccine-induced injury, the advances that led to mRNA vaccine technology along with the inherent advantages of this platform, the safety and efficacy data from the phase 2/3 clinical trials for both the Pfizer/BioNTech and the Moderna covid-19 vaccines, and answered listener FAQ and addressed common myths circulating on the internet. If you haven’t listened to these episodes yet, know that they lay some important scientific groundwork for our discussion of the adenovirus vaccines this week.

This week, I explain how the adenovirus vector platform for vaccines works, its similarities to the mRNA vaccines (it also doesn’t need adjuvants and also has very clean ingredients!) and its differences. We examine the safety and efficacy data from the phase 2/3 trials, including discussing why the AstraZeneca/Oxford vaccine has not yet received Emergency Use Authorization in the USA. And finally, we dive deep into the rare adverse events that the media has reported as “blood clots” but which is actually immune thrombotic thrombocytopenia.

Once again, we took a data-driven approach, trying to present the science and facts with context, detail, nuance, integrity, compassion and as objectively as possible. As a reminder, I am always happy to engage in good-faith conversation regarding scientific evidence, and strive to create an informative, engaging, and supportive community. As such, I will not reply to messages that are not in good faith.

If you enjoy the show, please review it on iTunes!

Citations:

Folegatti PM, Ewer KJ, Aley PK, Angus B, Becker S, Belij-Rammerstorfer S, Bellamy D, Bibi S, Bittaye M, Clutterbuck EA, Dold C, Faust SN, Finn A, Flaxman AL, Hallis B, Heath P, Jenkin D, Lazarus R, Makinson R, Minassian AM, Pollock KM, Ramasamy M, Robinson H, Snape M, Tarrant R, Voysey M, Green C, Douglas AD, Hill AVS, Lambe T, Gilbert SC, Pollard AJ; Oxford COVID Vaccine Trial Group. Safety and immunogenicity of the ChAdOx1 nCoV-19 vaccine against SARS-CoV-2: a preliminary report of a phase 1/2, single-blind, randomised controlled trial. Lancet. 2020 Aug 15;396(10249):467-478. doi: 10.1016/S0140-6736(20)31604-4. Epub 2020 Jul 20. Erratum in: Lancet. 2020 Aug 15;396(10249):466. Erratum in: Lancet. 2020 Dec 12;396(10266):1884. PMID: 32702298; PMCID: PMC7445431.

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J&J Vaccine Fact Sheet

FDA Fact Sheet for J&J

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Safety and Efficacy of Single Dose

Voysey M, Clemens SAC, Madhi SA, Weckx LY, Folegatti PM, Aley PK, Angus B, Baillie VL, Barnabas SL, Bhorat QE, Bibi S, Briner C, Cicconi P, Collins AM, Colin-Jones R, Cutland CL, Darton TC, Dheda K, Duncan CJA, Emary KRW, Ewer KJ, Fairlie L, Faust SN, Feng S, Ferreira DM, Finn A, Goodman AL, Green CM, Green CA, Heath PT, Hill C, Hill H, Hirsch I, Hodgson SHC, Izu A, Jackson S, Jenkin D, Joe CCD, Kerridge S, Koen A, Kwatra G, Lazarus R, Lawrie AM, Lelliott A, Libri V, Lillie PJ, Mallory R, Mendes AVA, Milan EP, Minassian AM, McGregor A, Morrison H, Mujadidi YF, Nana A, O’Reilly PJ, Padayachee SD, Pittella A, Plested E, Pollock KM, Ramasamy MN, Rhead S, Schwarzbold AV, Singh N, Smith A, Song R, Snape MD, Sprinz E, Sutherland RK, Tarrant R, Thomson EC, Török ME, Toshner M, Turner DPJ, Vekemans J, Villafana TL, Watson MEE, Williams CJ, Douglas AD, Hill AVS, Lambe T, Gilbert SC, Pollard AJ; Oxford COVID Vaccine Trial Group. Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK. Lancet. 2021 Jan 9;397(10269):99-111. doi: 10.1016/S0140-6736(20)32661-1. Epub 2020 Dec 8. Erratum in: Lancet. 2021 Jan 9;397(10269):98. PMID: 33306989; PMCID: PMC7723445.

AZD1222 US Phase III trial met primary efficacy endpoint in preventing COVID-19 at interim analysis

Vaccine-induced Immune Thrombotic Thrombocytopenia

Mahase E. Covid-19: AstraZeneca vaccine is not linked to increased risk of blood clots, finds European Medicine Agency. BMJ. 2021 Mar 19;372:n774. doi: 10.1136/bmj.n774. PMID: 33741638.

Cerebral venous thrombosis and portal vein thrombosis risk is 10x higher after covid-19 than after AstraZeneca vaccine

Mahase E. AstraZeneca vaccine: Blood clots are “extremely rare” and benefits outweigh risks, regulators conclude. BMJ. 2021 Apr 8;373:n931. doi: 10.1136/bmj.n931. PMID: 33832929.

Brierley CK, Pavord S. Autoimmune cytopenias and thrombotic thrombocytopenic purpura. Clin Med (Lond). 2018 Aug;18(4):335-339. doi: 10.7861/clinmedicine.18-4-335. PMID: 30072561; PMCID: PMC6334040.

Cines DB, Bussel JB. SARS-CoV-2 Vaccine-Induced Immune Thrombotic Thrombocytopenia. N Engl J Med. 2021 Jun 10;384(23):2254-2256. doi: 10.1056/NEJMe2106315. Epub 2021 Apr 16. Erratum in: N Engl J Med. 2021 Jun 10;384(23):e92. PMID: 33861524; PMCID: PMC8063912.

Schultz NH, Sørvoll IH, Michelsen AE, Munthe LA, Lund-Johansen F, Ahlen MT, Wiedmann M, Aamodt AH, Skattør TH, Tjønnfjord GE, Holme PA. Thrombosis and Thrombocytopenia after ChAdOx1 nCoV-19 Vaccination. N Engl J Med. 2021 Jun 3;384(22):2124-2130. doi: 10.1056/NEJMoa2104882. Epub 2021 Apr 9. PMID: 33835768; PMCID: PMC8112568.

Watanabe Y, Mendonça L, Allen ER, Howe A, Lee M, Allen JD, Chawla H, Pulido D, Donnellan F, Davies H, Ulaszewska M, Belij-Rammerstorfer S, Morris S, Krebs AS, Dejnirattisai W, Mongkolsapaya J, Supasa P, Screaton GR, Green CM, Lambe T, Zhang P, Gilbert SC, Crispin M. Native-like SARS-CoV-2 Spike Glycoprotein Expressed by ChAdOx1 nCoV-19/AZD1222 Vaccine. ACS Cent Sci. 2021 Apr 28;7(4):594-602. doi: 10.1021/acscentsci.1c00080. Epub 2021 Apr 2. PMID: 34056089; PMCID: PMC8043200.