What Johnson & Johnson's 1-shot vaccine could mean for Ontario's most vulnerable

The first doses of Johnson & Johnson's COVID-19 vaccine are set to arrive this week in Ontario, where one expert says they could do a world of good for some of the province's most vulnerable.

Canada expecting 300,000 doses of the single-shot vaccine this week

A nurse fills a syringe with the Johnson & Johnson COVID-19 vaccine at a pop-up vaccination site in New York City on April 8. (Mary Altaffer/The Associated Press)

The first doses of Johnson & Johnson's COVID-19 vaccine are set to arrive this week in Ontario, where experts say they could do a world of good for some of the province's most vulnerable. 

J&J's one-shot vaccine, which does not need to be stored at ultra-cold temperatures, is perfect for populations like migrant workers, prison inmates and people experiencing homelessness, according to Dr. Isaac Bogoch, an infectious disease specialist at University Health Network in Toronto.

"Oh my God, we could do so much good with that in those places," Bogoch, who sits on Ontario's vaccine task force, told CBC News. "This single-shot vaccine makes it a lot easier."

Public health officials have had some trouble administering second doses to people in those groups, Bogoch says. They are also more likely to experience bad outcomes if they get COVID-19, because of barriers to health care.

1-dose vaccine better for certain populations 

The province is struggling to contain its third wave of the pandemic, which this month has routinely seen more than 4,000 new cases per day. 

According to Bogoch, a one-shot vaccine "makes it a lot easier to provide greater protection to a larger number of individuals in a shorter period of time. It's as simple as that." 

WATCH | 1-dose J&J vaccine helpful in settings with barriers to care, Bogoch says: 

Johnson & Johnson has 'fantastic' COVID-19 vaccine, specialist says

1 year ago
Duration 2:40
The Johnson & Johnson COVID-19 shot is a 'fantastic' vaccine with benefits that outweigh the risks, says Dr. Isaac Bogoch, an infectious diseases specialist in Toronto.

The J&J vaccine is also exciting because it's effective at preventing illness caused by variants of the coronavirus — including the B117 variant, Dr. Zain Chagla told CBC. That variant, first detected in the United Kingdom, is now driving a majority of cases in the province, according to data published by Public Health Ontario.

Chagla, who is an infectious disease physician at St. Joseph's Healthcare in Hamilton, Ont., agreed that it will be perfect for populations that are typically hard to reach. 

The key will be to get doses of J&J into jails, shelters and emergency rooms, he told CBC via email. Home-care providers could also use it to inoculate patients who are homebound.

"The storage requirements make this very favourable to put into places that are hard to reach with other vaccines."

Pharmacies could also be a good place to give out J&J's vaccine, since it's so easily administered, Bogoch said.

The province is already offering other vaccines through some pharmacies. 

300,000 doses expected this week

A spokesperson for Ontario's Ministry of Health told CBC via email late Tuesday that it was too early to say exactly how the J&J vaccine will be distributed but said the rollout would be informed by guidance from Canada's National Advisory Council on Immunization (NACI.)

Canada is expecting about 300,000 doses of the J&J vaccine to arrive at the end of this week, with 116,700 allocated for Ontario

Health Canada approved the J&J vaccine in March, but its use in the U.S. was paused last month amid reports of very rare blood clotting — in 15 of the roughly 6.8 million Americans who got the shot, according to the U.S. Centers for Disease Control and Prevention (CDC).

The J&J vaccine could be perfect for vulnerable populations because it only requires one dose, says infectious disease specialist Dr. Isaac Bogoch. (Dado Ruvic/Reuters)

The CDC on Sunday recommended resumption of the vaccine's use, but said women under the age of 50 should be aware of this "rare but increased risk."

Health Canada acknowledged the risk on Monday when it updated its label for the vaccine. 

In a tweet about the update, the agency said: "Cases of rare blood clotting events reported in the U.S. after immunization with the … vaccine are similar to those reported after the AstraZeneca vaccine."

Both Health Canada and the CDC say the benefits outweigh the risks. In a study of 43,000 participants, J&J's vaccine was found to be 66 per cent effective in preventing symptomatic COVID-19 infection starting two weeks after vaccination, according to Health Canada.

Benefits outweigh risk for 'much of the population'

Bogoch says he's heard concerns about giving the J&J vaccine to vulnerable populations because of the "tiny-but-not-zero" risk of blood clots.

"Some people are saying, 'Are you giving people a substandard vaccine?'

"And the answer is no, we're not. We're giving AstraZeneca to anyone who's 40 years and up, that also has small-but-not-zero-per-cent risk of blood clotting events with it. And it's flying off the shelves in all neighbourhoods," he said.

"These are vaccines that were approved in Canada. They work well. And you have an opportunity to provide significant protection to a group of people that, through no fault of their own, are just less likely to come back for a second dose."

Chagla said the benefits of J&J will outweigh the risks for "much of the population."

"This vaccine really does keep people from being hospitalized, dying and spreading COVID-19 with a single dose, and that really needs to be balanced against everything."

Ontario administered 94,819 doses of COVID-19 vaccines Monday, bringing the total number of shots given out to almost 4.8 million. There are now 362,563 Ontarians who are fully vaccinated, according to officials.

Health Canada says recipients should seek immediate medical attention if they notice any of these symptoms within a month of getting the J&J vaccine:

  • New severe headaches, worsening or persistent headaches, blurred vision, confusion or seizures.

  • Shortness of breath, chest pain, leg swelling, leg pain or persistent abdominal pain.

  • Unusual skin bruising or pinpoint round spots under the skin beyond the site of injection.

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