- The FDA and CDC recently authorized the distribution of Johnson & Johnson's COVID-19 vaccine.
- It will soon be the third vaccine available in the U.S., the other two being vaccines produced by Pfizer-BioNTech and Moderna.
- The new vaccine has a lower efficacy rate, but clinical data suggest its highly effective at preventing hospitalization and death.
A Food and Drug Administration committee is set to vote Friday (February 26) on recommending the approval of Johnson & Johnson's COVID-19 vaccine for emergency use. If the FDA's Vaccines and Related Biological Products Advisory Committee recommends approval, the next step would be getting a green light from the Centers for Disease Control and Prevention, which could authorize the distribution of up to 4 million doses of the vaccine as early as next week.
Approval from the CDC would make Johnson & Johnson's vaccine the third available vaccine in the U.S., joining those currently being distributed by Pfizer-BioNTech and Moderna. The U.S. government has already purchased 100 million doses of the Johnson & Johnson vaccine.
On Wednesday, the FDA released an analysis of clinical trial data on Johnson & Johnson's vaccine saying "there were no specific safety concerns identified in subgroup analyses by age, race, ethnicity, medical comorbidities, or prior SARS-CoV-2 infection," and that the vaccine was "consistent with the recommendations set forth in FDA's guidance Emergency Use Authorization for Vaccines to Prevent COVID-19."
So, what are the key differences between the three vaccines?
Credit: Mediteraneo via Adobe Stock
What makes Johnson & Johnson's vaccine unique is that it's effective after just one dose, while the vaccines produced by Pfizer-BioNTech and Moderna require two doses administered over several weeks.
And unlike the other two vaccines, Johnson & Johnson's vaccine doesn't need to be frozen during shipping and storage, it just needs to be refrigerated. That's because the vaccine protects against COVID-19 by delivering coronavirus proteins to the body through a common cold virus known as adenovirus type 26. In contrast, the other two vaccines perform a similar function, but they do it through mRNA, which is more delicate and requires freezing.
Not having to freeze the single-shot vaccine will make it cheaper and easier to distribute across the country, and it could result in many more people getting vaccinated.
But it's worth noting that Johnson & Johnson's vaccine doesn't seem to be as effective as the other two vaccines. According to the FDA analysis, the vaccine is about 66 percent effective at preventing moderate to severe cases of COVID-19, "when considering cases occurring at least 28 days after vaccination." Meanwhile, clinical data show that the Pfizer-BioNTech and Moderna vaccines are about 95 percent effective at preventing severe cases of the disease.
Credit: peterschreiber.media via Adobe Stock
Still, that doesn't necessarily mean Johnson & Johnson's vaccine is inferior. The FDA analysis found that nobody who received the Johnson & Johnson vaccine was hospitalized or died due to COVID-19 (at least among cases that occurred 28 days after getting the shot).
So, while some people who receive the Johnson & Johnson vaccine may still contract coronavirus, the vaccine does seem to significantly reduce the severity of COVID-19. The same holds true for the other two vaccines: Getting the shot (or shots) won't completely protect you from the virus, but it does protect you from the disease, reducing the chances of becoming hospitalized or dying to almost zero.
COVID-19 vaccines and transmission
But what's less clear is the extent to which the vaccines prevent the spread of the novel coronavirus. Because the vaccines don't completely protect against infection, it might be possible for a vaccinated person to spread the virus. But COVID-19 vaccines might make transmission less likely.
After all, even if a person who gets vaccinated contracts the coronavirus, the virus would have a harder time replicating in their body, because the vaccine bolsters the immune response. So, one would expect that person to "shed" less of the virus out of their mouth and nose. In short: fewer infections means less replication, less shedding, and less transmission.
That's the theory, anyway.
Scientists are still working to understand how exactly these vaccines affect transmission. But early data is promising. In a preprint paper published on medRxiv, Israeli researchers measured the amount of coronavirus within about 2,900 people who had received the Pfizer-BioNTech vaccine.
"Analyzing positive SARS-CoV-2 test results following inoculation with the BNT162b2 mRNA vaccine [the Pfizer vaccine], we find that the viral load is reduced four-fold for infections occurring 12-28 days after the first dose of vaccine," the paper said. "These reduced viral loads hint to lower infectiousness, further contributing to vaccine impact on virus spread."
But until the data on vaccines and transmission become clear, the CDC recommends that vaccinated people still wear masks and practice social distancing.
UPDATE: The CDC voted on Sunday to recommend the vaccine for the United States. CDC Director Dr. Rochelle Walensky signed off on the recommendation.
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Ash deposits of some of North America's largest volcanic eruptions.
The end of the world as we know it
Panoramic view of Yellowstone National Park
Image: Heinrich Berann for the National Park Service – public domain
Of the many freak ways to shuffle off this mortal coil – lightning strikes, shark bites, falling pianos – here's one you can safely scratch off your worry list: an outbreak of the Yellowstone supervolcano.
As the map below shows, previous eruptions at Yellowstone were so massive that the ash fall covered most of what is now the western United States. A similar event today would not only claim countless lives directly, but also create enough subsidiary disruption to kill off global civilisation as we know it. A relatively recent eruption of the Toba supervolcano in Indonesia may have come close to killing off the human species (see further below).
However, just because a scenario is grim does not mean that it is likely (insert topical political joke here). In this case, the doom mongers claiming an eruption is 'overdue' are wrong. Yellowstone is not a library book or an oil change. Just because the previous mega-eruption happened long ago doesn't mean the next one is imminent.
Ash beds of North America
Ash beds deposited by major volcanic eruptions in North America.
Image: USGS – public domain
This map shows the location of the Yellowstone plateau and the ash beds deposited by its three most recent major outbreaks, plus two other eruptions – one similarly massive, the other the most recent one in North America.
Huckleberry Ridge
The Huckleberry Ridge eruption occurred 2.1 million years ago. It ejected 2,450 km3 (588 cubic miles) of material, making it the largest known eruption in Yellowstone's history and in fact the largest eruption in North America in the past few million years.
This is the oldest of the three most recent caldera-forming eruptions of the Yellowstone hotspot. It created the Island Park Caldera, which lies partially in Yellowstone National Park, Wyoming and westward into Idaho. Ash from this eruption covered an area from southern California to North Dakota, and southern Idaho to northern Texas.
Mesa Falls
About 1.3 million years ago, the Mesa Falls eruption ejected 280 km3 (67 cubic miles) of material and created the Henry's Fork Caldera, located in Idaho, west of Yellowstone.
It was the smallest of the three major Yellowstone eruptions, both in terms of material ejected and area covered: 'only' most of present-day Wyoming, Colorado, Kansas and Nebraska, and about half of South Dakota.
Lava Creek
The Lava Creek eruption was the most recent major eruption of Yellowstone: about 640,000 years ago. It was the second-largest eruption in North America in the past few million years, creating the Yellowstone Caldera.
It ejected only about 1,000 km3 (240 cubic miles) of material, i.e. less than half of the Huckleberry Ridge eruption. However, its debris is spread out over a significantly wider area: basically, Huckleberry Ridge plus larger slices of both Canada and Mexico, plus most of Texas, Louisiana, Arkansas, and Missouri.
Long Valley
This eruption occurred about 760,000 years ago. It was centered on southern California, where it created the Long Valley Caldera, and spewed out 580 km3 (139 cubic miles) of material. This makes it North America's third-largest eruption of the past few million years.
The material ejected by this eruption is known as the Bishop ash bed, and covers the central and western parts of the Lava Creek ash bed.
Mount St Helens
The eruption of Mount St Helens in 1980 was the deadliest and most destructive volcanic event in U.S. history: it created a mile-wide crater, killed 57 people and created economic damage in the neighborhood of $1 billion.
Yet by Yellowstone standards, it was tiny: Mount St Helens only ejected 0.25 km3 (0.06 cubic miles) of material, most of the ash settling in a relatively narrow band across Washington State and Idaho. By comparison, the Lava Creek eruption left a large swathe of North America in up to two metres of debris.
The difference between quakes and faults
The volume of dense rock equivalent (DRE) ejected by the Huckleberry Ridge event dwarfs all other North American eruptions. It is itself overshadowed by the DRE ejected at the most recent eruption at Toba (present-day Indonesia). This was one of the largest known eruptions ever and a relatively recent one: only 75,000 years ago. It is thought to have caused a global volcanic winter which lasted up to a decade and may be responsible for the bottleneck in human evolution: around that time, the total human population suddenly and drastically plummeted to between 1,000 and 10,000 breeding pairs.
Image: USGS – public domain
So, what are the chances of something that massive happening anytime soon? The aforementioned mongers of doom often claim that major eruptions occur at intervals of 600,000 years and point out that the last one was 640,000 years ago. Except that (a) the first interval was about 200,000 years longer, (b) two intervals is not a lot to base a prediction on, and (c) those intervals don't really mean anything anyway. Not in the case of volcanic eruptions, at least.
Earthquakes can be 'overdue' because the stress on fault lines is built up consistently over long periods, which means quakes can be predicted with a relative degree of accuracy. But this is not how volcanoes behave. They do not accumulate magma at constant rates. And the subterranean pressure that causes the magma to erupt does not follow a schedule.
What's more, previous super-eruptions do not necessarily imply future ones. Scientists are not convinced that there ever will be another big eruption at Yellowstone. Smaller eruptions, however, are much likelier. Since the Lava Creek eruption, there have been about 30 smaller outbreaks at Yellowstone, the last lava flow being about 70,000 years ago.
As for the immediate future (give or take a century): the magma chamber beneath Yellowstone is only 5 percent to 15 percent molten. Most scientists agree that is as un-alarming as it sounds. And that its statistically more relevant to worry about death by lightning, shark, or piano.
Strange Maps #1041
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Stoicism can help overcome anxiety
Are you a worrier? Do you imagine nightmare scenarios and then get worked up and anxious about them? Does your mind get caught in a horrible spiral of catastrophizing over even the smallest of things? Worrying, particularly imagining the worst case scenario, seems to be a natural part of being human and comes easily to a lot of us. It's awful, perhaps even dangerous, when we do it.
But, there might just be an ancient wisdom that can help. It involves reframing this attitude for the better, and it comes from Stoicism. It's called "premeditation," and it could be the most useful trick we can learn.
Practical Stoicism
Broadly speaking, Stoicism is the philosophy of choosing your judgments. Stoics believe that there is nothing about the universe that can be called good or bad, valuable or valueless, in itself. It's we who add these values to things. As Shakespeare's Hamlet says, "There is nothing either good or bad, but thinking makes it so." Our minds color the things we encounter as being "good" or "bad," and given that we control our minds, we therefore have control over all of our negative feelings.
Put another way, Stoicism maintains that there's a gap between our experience of an event and our judgment of it. For instance, if someone calls you a smelly goat, you have an opportunity, however small and hard it might be, to pause and ask yourself, "How will I judge this?" What's more, you can even ask, "How will I respond?" We have power over which thoughts we entertain and the final say on our actions. Today, Stoicism has influenced and finds modern expression in the hugely effective "cognitive behavioral therapy."
One of the principal fathers of ancient Stoicism was the Roman statesmen, Seneca, who argued that the unexpected and unforeseen blows of life are the hardest to take control over. The shock of a misfortune can strip away the power we have to choose our reaction. For instance, being burglarized feels so horrible because we had felt so safe at home. A stomach ache, out of the blue, is harder than a stitch thirty minutes into a run. A sudden bang makes us jump, but a firework makes us smile. Fell swoops hurt more than known hardships.
What could possibly go wrong?
So, how can we resolve this? Seneca suggests a Stoic technique called "premeditatio malorum" or "premeditation." At the start of every day, we ought to take time to indulge our anxious and catastrophizing mind. We should "rehearse in the mind: exile, torture, war, shipwreck." We should meditate on the worst things that could happen: your partner will leave you, your boss will fire you, your house will burn down. Maybe, even, you'll die.
This might sound depressing, but the important thing is that we do not stop there.
Stoicism has influenced and finds modern expression in the hugely effective "cognitive behavioral therapy."
The Stoic also rehearses how they will react to these things as they come up. For instance, another Stoic (and Roman Emperor) Marcus Aurelius asks us to imagine all the mean, rude, selfish, and boorish people we'll come across today. Then, in our heads, we script how we'll respond when we meet them. We can shrug off their meanness, smile at their rudeness, and refuse to be "implicated in what is degrading." Thus prepared, we take control again of our reactions and behavior.
The Stoics cast themselves into the darkest and most desperate of conditions but then realize that they can and will endure. With premeditation, the Stoic is prepared and has the mental vigor necessary to take the blow on the chin and say, "Yep, l can deal with this."
Catastrophizing as a method of mental inoculation
Seneca wrote: "In times of peace, the soldier carries out maneuvers." This is also true of premeditation, which acts as the war room or training ground. The agonizing cut of the unexpected is blunted by preparedness. We can prepare the mind for whatever trials may come, in just the same way we can prepare the body for some endurance activity. The world can throw nothing as bad as that which our minds have already imagined.
Stoicism teaches us to embrace our worrying mind but to embrace it as a kind of inoculation. With a frown over breakfast, try to spend five minutes of your day deliberately catastrophizing. Get your anti-anxiety battle plan ready and then face the world.
Jonny Thomson teaches philosophy in Oxford. He runs a popular Instagram account called Mini Philosophy (@philosophyminis). His first book is Mini Philosophy: A Small Book of Big Ideas.
