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Could Johnson & Johnson's Booster Opportunity Be Better Than Pfizer's and Moderna's?

By Keith Speights and Brian Orelli, PhD – Oct 15, 2021 at 6:05AM

Key Points

  • Johnson & Johnson's data supporting booster shots looks promising.
  • That vaccine's lower initial efficacy compared to the other FDA-approved COVID-19 jabs could increase the likelihood of it receiving authorization for booster shots.

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The bar could be lower for the FDA to authorize booster shots for J&J's COVID-19 vaccine.

Pfizer (PFE -0.67%) has already won authorization to inoculate people with boosters of its COVID-19 vaccine, albeit thus far, only those in certain higher-risk groups. Moderna (MRNA 0.24%) and Johnson & Johnson (JNJ -0.30%) will now have their first chance to join it with a Food and Drug Administration advisory committee reviewing data for their boosters. In this Motley Fool Live video recorded on Sept. 22, 2021, Motley Fool contributors Keith Speights and Brian Orelli discuss whether or not Johnson & Johnson's booster shot opportunity could be greater than Pfizer's or Moderna's.

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Keith Speights: There's another big story this week on the COVID-19 vaccine front, and this one is from Johnson & Johnson. On Tuesday, Johnson & Johnson announced real-world data, along with phase 3 results, for a single-shot COVID vaccine. However, the big story, I think, was that company also reported data from a booster shot of its vaccine.

Brian, what were the main takeaways you think from J&J's results? Do you think Johnson & Johnson could even have a better chance at winning FDA and CDC authorization for a booster than either Pfizer or Moderna?

Brian Orelli: Yeah, the booster data was both promising and a little confusing. It offered 100% protection against severe disease. That's obviously the big positive. But then, if you look at moderate-to-severe disease, the data gets a little confusing. It was 75% efficacy globally, and then, if you look just specifically at the United States, it was at 94%.

That obviously implies that outside the United States, the efficacy is a lot lower. It depends on how many people in the clinical trial were in the U.S. versus outside the U.S. to try to make that comparison. If it was a large number, let's say half of the people were outside the U.S. -- which might be extreme, but let's just go there -- then outside the U.S., [efficacy] would have to be 56% to balance out the 95% in the U.S. to get 75% [overall].

I don't know, we'll have to wait and see, look at the full data from Johnson & Johnson to see how many were in the U.S., how many were outside the U.S., to try to figure out that difference between 94% in the U.S. and then 75% globally, which includes the U.S.

Since the Johnson & Johnson efficacy started at a lower level than Pfizer and Moderna's vaccines, I think that means there's a lower barrier to get an approval for a second dose, assuming the data pans out and it justifies the higher efficacy. But yeah, I would agree that it's probably an easier road for Johnson & Johnson than for Pfizer and Moderna.

Speights: That's what I was thinking too, Brian, that just because of that bar being lower for J&J, that the company could have an easier path to getting authorization for boosters. Again, we'll have to wait and see what happens. But that seems to be a pretty good argument there, I thought it was. I thought Johnson & Johnson's data for its single-shot vaccine was still pretty good though. That will have a bearing as well.

Orelli: Yeah. What was it? It was in the 70% range, I think.

Speights: Yeah, that's not bad.

Orelli: I think the FDA was looking for 50% efficacy before we got any data, so 70% looks good on the range of "50% is acceptable." But in the range of 90% for Moderna and Pfizer, then 70% doesn't look so good. I think that makes it easier for them to get this booster.

Speights: I haven't heard anything from Johnson & Johnson on this, but I assume that the company would still sell boosters at cost as it's done for its single-shot vaccine.

Orelli: Yeah. I haven't heard anything either, but they said they were going to do it at cost until the pandemic was over. I haven't [laughs] heard anybody declare the pandemic over.

Speights: [laughs] No.

Orelli: So I guess [if] we're holding them to that, what they said earlier then, yes, that will be the case.

Speights: The closest I've heard is that I think the country of Malaysia is planning to change its labeling to endemic sometime in October. So, there you go. 

Keith Speights owns shares of Pfizer. The Motley Fool recommends Johnson & Johnson and Moderna Inc. The Motley Fool has a disclosure policy.

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