Last month, with the Delta variant tearing across America, the Biden administration began floating the idea that everyone who had gotten a COVID vaccine should eventually receive a booster shot.
Well, almost everyone.
The nearly 15 million Americans jabbed with the Johnson & Johnson dose — I count myself among those few and now not-so-proud — were left out of the White House plans, beyond a vague assurance that while we’d probably need another shot, we’d be given more guidance on the matter (of, you know, life and death) when more data had come in. The good news was that by this point, us J&Jers scarcely expected any kind of clarity on our plight anyway; we’d fully come to terms with a certain purgatorial status.
Thus far, the FDA appears to believe that boosters for anyone under 65 aren’t really necessary, so we won’t have to endure the spectacle of all our friends and country people gallivanting off to Walgreens while we sit at home watching our antibodies wane. But after months of confusion, there remains more or less radio silence on the J&J question from those famously effective communicators at the CDC and FDA.
Never mind that a growing body of evidence shows that we could use another dose more than the Pfizer Pfanatics or Moderna Mafia — that breakthrough infections are at least somewhat more common among one-dose recipients than our smugly double-dosed compatriots, even if hospitalizations remain exceedingly rare. The small size of our cohort, plus the timeline of U.S. vaccine approvals (J&J was last on that score, natch), meant that data was scarce for large swathes of this spring and summer. And despite being in real need of some direction, it has often felt as if we’ve been cast out of the pandemic narrative altogether — like we’re the Generation X of vaccine recipients. Even insentient systems treat us shabbily: A J&J-dosed co-worker reported that New York’s Excelsior app didn’t recognize his vaccination site as legitimate until he called a confused-but-ultimately-helpful human to complain.
Facing this continual snubbery, some of us have taken matters into our own hands and sought out bootleg boosters at pharmacies by pretending to be unvaccinated. (“Uh, yes, I’ve been hearing more about this coronavirus thing, and it sure sounds concerning! One of your finest Moderna shots, please!” ) Others are dutifully waiting until the glacial medical bureaucracy weighs in. A recent New York Times piece on the J&J dilemma — one of the few that has addressed the topic head-on — concluded by noting that “we understand why so many people are flummoxed.” Sing it, sister.
Perhaps the whole J&J deal was too good to be true. Even back in March, before it fully carried the stink of inferiority, there was some reason for caution: Results showed that the vaccine, an old-fashioned adenovirus concoction, was only 66 percent effective against COVID infection compared to the near-perfection shown by those mRNA hotshots Moderna and Pfizer. But it still provided full protection against the most severe outcomes, and anyway, doctors insisted the top-line number was misleading since J&J had been tested in harsher virus environments.
Besides, the one-and-done vaccine seemed perfect for underserved populations and shiftless loafers alike. And it was a godsend for inveterate needlephobes like me. I thought the cold, all-encompassing fear I experience when encountering any kind of syringe would dissipate in adulthood; I was mistaken. If anything, it has gotten worse. So when I spotted an appointment at Co-Op City in the Bronx, a mere 90 minutes from my apartment, I jumped at the chance. After psyching myself up, meekly informing the nurse of my phobia as per usual before any inoculation, experiencing a 257 percent drop in my blood pressure during the 15-minute cool-down period, and later experiencing flu-like side effects that appeared to confirm the vaccine’s potency, I thought I was home free.
Soon after, the CDC issued a pause on administering J&J shots because the vaccine was associated with an extremely rare blood-clot condition. Yet I still felt secure, even smug, about my decision. For a while there, as Slate’s Dan Kois winkingly wrote in May, J&J felt like the coolest vaccine.
The problem was that after the fateful hiatus — and a major factory-production screwup to boot — nobody in America really wanted J&J anymore. The hipster credibility that scarcity bestowed quickly became a liability, and an information brownout took hold.
When the Delta variant arrived, confirmation that Pfizer and Moderna’s vaccines worked pretty well against it arrived fairly quickly, but J&Jers were left in the lurch, leaving me to comb through Twitter for any morsel of information. (Hey, an admittedly small study out of Saskatoon shows positive results!) Occasionally, some positive-seeming news would slip through into the mainstream, and the company itself was sanguine about its product. Still, the pandemic chroniclers I trust most were clear in their opinions that one shot was not enough.
For me, there was a perverse dynamic at play as I followed these discussions. Such is the extent of my needle hatred that even as my brain became increasingly convinced that a second dose would be wise, my heart, or more accurately my shoulder, argued otherwise. I began making shoddy excuses: That data set out of Ulaanbaatar showed that one shot was probably good enough, didn’t it? (It did no such thing.) I didn’t really want to lie to obtain a second dose, did I? (Oh, please.)
Gradually, I have come to terms with the reality that another injection — God, just the word is deeply unpleasant — will very likely be in my future. And two developments this week have only furthered that notion. First, human interview machine Dr. Anthony Fauci said that “the actual data that we’ll get that third shot for the Moderna and second shot for the J&J is literally a couple to a few weeks away,” putting a timeline on what had felt like an interminable process. Second, Johnson & Johnson announced that an additional dose of its vaccine provided double plus extra good protection against Delta. Given the FDA’s seeming aversion to mixing and matching, the agency might sentence J&Jers to more of the same, even as we clamor for that sweet, sweet Moderna.
In the end, I will likely face the very outcome I was trying to avoid back in March. (Other than “not getting COVID,” so thank you for that, J&J.) True, the under-65 brigades of the Pfizer Pham and Moderna Mob may eventually need a third dose, but in the very near future, we’ll be tied at two apiece — and they didn’t have to experience the existential limbo that only me and my 15 million comrades now understand. As I psych myself up for that second shot, I have also adopted a slogan for the next global pandemic that rolls around: give me mRNA or give me … well, not death. Okay, it needs some work.