ORLANDO, Fla. — Lou Fischler thought he’d finally nailed down a deal with his 25-year-old son on the coronavirus vaccine. The dad would co-sign a loan — if the son would get the shot.
“I told him, ‘Look, you can get this Johnson & Johnson vaccine,” Fischler said. “It’s one shot and you’re done.’ I just really wanted to protect him.”
But when Fischler started searching Orlando clinics and pharmacies for the single-dose vaccine, it seemed almost no one had it.
In fact, what was once seen as the conquering hero of the COVID-19 battle — a one-and-done wonder that needed only standard refrigeration — has become increasingly scarce throughout the state.
Dr. Raul Pino, the state health officer for Orange County, said he hasn’t been able to order more J&J through the Florida Department of Health for weeks. Neither has Seminole County, nor Volusia, Lake or Osceola. Publix doesn’t carry it, nor does any Walmart from Melbourne to The Villages. Mobile clinics and homeless outreach workers, who once used it exclusively, report they can’t get it either.
“At this time, the Johnson & Johnson COVID-19 vaccine is unavailable nationally for ordering,” said Megan Moran, deputy communications director for the Florida Department of Health.
According to records from the federal Centers for Disease Control and Prevention, Florida isn’t alone. Few additional doses of J&J vaccine have made their way to the states since mid-June, despite reassurances from both public health authorities and the manufacturer that the vaccine is considered extremely safe and highly effective at keeping people from dying of COVID-19.
“It was a good option for us with our unsheltered folks,” said Dewey Wooden, director of behavioral health for the Health Care Center for the Homeless, which has been leading the vaccination effort at Central Florida shelters and homeless camps. “We didn’t have to worry about trying to track them down again for a second dose.”
The vaccine was also popular among busy working people and young adults, who figured it was an easier option. The Federal Emergency Management Agency, or FEMA, once offered up to 5,000 Johnson & Johnson shots a day at its Orlando site alone, no appointment needed. Some days they ran out.
“This is a vaccine that’s easy,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security and infectious disease physician. “You can put it in mobile units. You can grab it and take it to someone’s house (for homebound patients). And there are some people who want the Johnson and Johnson vaccine because it uses different technology and just needs that single dose. All of that’s important.”
But Florida’s FEMA sites closed three months ago, and soon after the J&J supply all but dried up. The CDC media relations office referred distribution questions to the U.S. Department of Health and Human Services. HHS hadn’t provided a response as of Friday afternoon — although federal distribution data show there has been a clear move away from the single-dose J&J to the two-dose Pfizer and Moderna vaccines.
A little over 14 million Americans have received the J&J vaccine to date. Meanwhile, 65 million people had gotten both doses of Moderna, and 85 million had received two doses of Pfizer, which has already been approved for a third dose for people who are immunocompromised.
To be sure, J&J has had more than its share of trouble since the vaccine’s debut in early March.
In April, the U.S. Food and Drug Administration issued what turned out to be a 12-day “pause” in the vaccine’s use after a rare blood-clotting disorder developed in six women who got the shots. Ultimately the agency discovered 17 cases, including three that resulted in death, but ruled the vaccine’s benefits outweighed the risk.
But the FDA also added a warning to doctors on how to treat the condition — and a warning to women under age 50, especially, that they should be aware of the possibility.
That matter had barely faded from headlines when news of vaccine contamination broke. Errors at a Baltimore contractor site led to the FDA ordering 60 million doses of the vaccine destroyed.
Then came concerns that the J&J vaccine had lower efficacy rates than its two-dose counterparts, although that turned out to be largely unfounded. Yes, the single-dose vaccine was less effective at protecting against mild COVID-19 infection, but it held up well when it counted.
Real-world data, including a recently reported study of 500,000 frontline healthcare workers in South Africa, found the J&J vaccine has been 95% effective in preventing death due to COVID-19 involving the highly contagious delta variant.
“it’s unfortunate that all the negative headlines, I think, decreased the demand,” Adalja said. “Particularly now, when we’re up against a wall of vaccine hesitancy, we should want every option available. The more convenient it is for people to get a vaccine, the better.”
Meanwhile, J&J is laying the groundwork for its own booster. On Aug. 25, the company reported that ongoing research found a second dose of its vaccine generated a “rapid and robust” increase in COVID-19 antibodies, nine-fold higher than those detected 28 days after a single dose.
“We are currently engaging with the U.S. Food and Drug Administration, CDC, European Medicines Agency and other health authorities regarding boosting with the Johnson & Johnson COVID-19 vaccine,” company spokesperson Richard Ferreira wrote in an email. But he did not have a timeline for seeking official FDA authorization.
Fischler isn’t waiting. He found his son an appointment for the J&J shot next week at an Orlando Costco.
“I know the odds of him getting seriously ill are low, but, still, for some people, the consequences can be serious,” he said. “And the long-term effects [of infection] are unknown. This was just about me being a dad and not wanting to see something bad happen to him.”