For the first time, some Oregonians will be able to get a COVID-19 vaccine at their local Walmart or Bi-Mart.
It’s an early example of how the arrival of a third vaccine, made by Johnson & Johnson, could reshape the effort to vaccinate all Oregonians. The new medication only requires one shot and can be kept in a normal refrigerator.
The state used about half of its first allocation of the Johnson & Johnson shot, 15,400 doses out of 34,000 total, to add the two new partners to the list of pharmacies that receive direct shipments of the vaccine, along with Safeway-Albertsons, Costco, and Walgreens.
Oregon Health Authority Director Patrick Allen said Walmart needs some time to get its vaccination program up and running, but the shots could be available starting this weekend.
Health officials in rural counties welcomed the news and said it would improve access to the vaccine for poorer residents who lack the time and resources to travel to a mass vaccination site or pop-up clinic.
“Walmarts are often located in high poverty areas, so we’re thrilled to hear that they will be increasing access to counties without more affluent partnerships,” said Sarah Poe, director of the Malheur County Health Department.
The state expects a two-week lag before the next allocation of Johnson & Johnson vaccine, due to production delays.
Oregon officials are still developing a strategy for how to deploy the new vaccine, and state leaders say they will ultimately allow decisions about which populations receive it to be made at the local level.
OHSU’s mass vaccination drive-through site at the Portland International Airport received 5,000 doses of the Johnson & Johnson version this week, the second-largest allocation.
The rest of the shipment has gone all over the state, with every local or county public health department receiving at least 100 doses. Counties told OPB they planned to use their allocations to reach home-bound seniors and people in jail.
Four counties — Clackamas, Multnomah, Douglas, and Baker — received extra doses the Oregon Health Authority said were intended to help them vaccinate residents in adult foster homes.
In global clinical trials, the Johnson & Johnson vaccine was highly effective at preventing hospitalization and death. But some health officials, including those in Oregon, worry that members of the public may view the Johnson & Johnson vaccine as less effective or less desirable.
“We want to take care not to create a perception of, we’re giving the less good vaccine to people who are vulnerable and marginalized,” Allen said.
The perception problem fears stems from the challenges of how to interpret nuanced clinical trial results.
The Johnson & Johnson vaccine reduced the risk of a participant getting COVID-19 by 66%, and reduced the risk of severe illness by 85%. The Pfizer vaccine was 95% effective at preventing symptomatic COVID-19, while the Moderna vaccine was 91.4% effective.
But scientists say understanding the protection each vaccine offers against COVID-19 is much more complicated than comparing the percent efficacy from each trial.
“It’s really too early to distinguish between the three vaccines, other than to know that all three of them protect against severe disease, hospitalization and death,” said Mark Slifka, a professor and vaccine expert at OHSU. “Whichever one you can get is the one you should choose.”
Slifka said several factors make it impossible to do a side-by-side comparison. Each trial took place at a different time, using a different population, against different versions of COVID-19.
For example, the Johnson & Johnson vaccine was tested worldwide, during a period of high transmission of COVID-19, and those tests included participants in Brazil and South Africa who were exposed to more contagious variants of the virus.
Furthermore, we don’t know how long the protection from any of the three vaccines will last, or if one could provide more durable protection than the others.
Slifka questions whether the public has already developed a bias against the shot. In trials, the Johnson & Johnson vaccine caused fewer side effects, and as a single dose shot it has an obvious appeal.
“People who don’t like needles might prefer that one,” he said.