Third COVID vaccine candidate releases data in hopeful boost to US, California rollout
California’s coronavirus infection and hospitalization metrics remain on a downward trajectory, but the looming threat of troublesome variants taking hold has increased the pressure to speed up the state’s sluggish vaccine rollout.
There were important developments Friday regarding vaccines and COVID-19 variants, both coming from data laid out by U.S. drugmaker Johnson & Johnson.
J&J on Friday announced that its large-scale clinical trial showed its vaccine candidate to be 66% effective against COVID-19.
That is less effective than those from Pfizer and Moderna, which are mRNA vaccines that use a different technology than J&J. Clinical trials showed Pfizer and Moderna’s vaccines each as about 95% effective.
But both Pfizer and Moderna require two doses, spaced a few weeks apart, and require storage at ultra-cold temperatures. The J&J vaccine is a single-dose regimen, is less expensive to produce and can simply be refrigerated — all major advantages for shipping, supply chains and other logistics.
J&J’s 66% effectiveness, if affirmed by the U.S. Food and Drug Administration, would clear the bar of 50% that the agency has set as a minimum for granting emergency use authorization to a COVID-19 vaccine. It’s also a higher efficacy than a standard flu shot, which can often range from 50% to 60% effective.
J&J also reported that none of the vaccine recipients who contracted COVID-19 in its clinical trial required hospitalization and that it was 85% effective in preventing severe cases of the disease.
However, here’s where the variant concern kicks in: In the J&J clinical trial, the vaccine showed only 57% effectiveness for recipients in South Africa — where a particularly concerning genetic variant of the virus has recently surfaced — compared to 72% in the U.S. Overall, the vaccine showed 66% effectiveness across all countries that participated in the trial.”
That heightens some concern that some of the variants emerging worldwide may be not only more infectious but also resistant, perhaps significantly, against some vaccines.
The variant first identified in South Africa, known as B.1.351, has been detected in the U.S., with the Centers for Disease Control and Prevention on Thursday confirming two cases have been located in South Carolina.
Dr. Anthony Fauci, the nation’s leading infectious disease expert, said during a White House COVID-19 briefing Friday that the J&J data is promising but also “a wake-up call to all of us” that we are continuing to see “the evolution of mutants.”
“So that means that we — as a government, the companies, all of us that are in this together — will have to be nimble to be able to adjust readily to make versions of the vaccine that actually are specifically directed toward whatever mutation is actually prevalent at any given time.”
Fauci said the emergence of genetic variants is an incentive “to vaccinate as many people as we can, as quickly as we possibly we can” to prevent even more concerning variants from arising.
“The virus has a playing field, as it were, to mutate. If you stop that, and you stop the replication, the viruses cannot mutate if they don’t replicate.”
J&J’s announcement of its vaccine trial data could put it on a timeline to be distributed within a few weeks. Pfizer and Moderna each shared efficacy data from their late-stage trials in November. Both promptly applied for emergency use authorization, which the FDA granted for each a little over three weeks later in mid-December. Each drugmaker began vaccine distribution a few days after that.
If the J&J vaccine candidate were to follow the same timeline and earn emergency use authorization without any snags, J&J shots could start shipping out by around late February.
Latest on California’s vaccine rollout
The California Department of Public Health reported in a Thursday update that about 2.89 million doses have been administered statewide, out of about 4.74 million that have been shipped to local health departments, multi-county hospital systems and state agencies.
The CDC on its own data tracker Thursday showed California as having received about 5.55 million doses and having administered 2.75 million of them.
That works out to 49.5%, which ranks California 12th lowest among the 50 states plus D.C. It’s a notable improvement, though: at one point late last week, CDC data showed California ranking dead last in this metric.
About 83%, or 2.3 million, of the doses administered in California have been first doses of the two-dose regimens, according to the CDC. CDPH does not maintain breakdowns between first and second doses on its online dashboard.
California by the numbers: Deaths climbing, but cases are down
To date, more than 3.2 million Californians have tested positive for COVID-19 and at least 39,578 have died of the disease, CDPH reported Friday.
State health officials in Thursday’s update reported 737 new virus deaths, the second-highest daily total of the entire pandemic, followed by 617 on Friday to push the two-week average to 521 deaths per day, a 12-fold increase from mid-November.
However, essentially all other markers of COVID-19 activity in the Golden State are plummeting from severe peaks earlier this month.
The daily case rate, as a rolling two-week average, has fallen from nearly 40,000 to less than 25,000 in just 11 days. The rate of diagnostic tests returning positive dropped from 12.2% to 8.2% in that same stretch, likely indicative that spread of the virus is on a true decline.
In turn, hospitalizations have declined substantially, from a peak of nearly 22,000 confirmed cases in hospital beds on Jan. 7 to 15,705 as of Friday’s update, which brought a one-day decline of nearly 550 patients. The total has fallen 28% in the past three weeks.
The number of those patients in intensive care units has fallen from 4,812 to 4,145 in the same stretch, nearly a 14% decrease.
ICU totals decline more slowly than overall hospitalizations for the virus because the most severely ill COVID-19 patients can remain in hospital beds for weeks.
Because virus deaths correlate strongly with ICU rates but lag behind them by a few weeks, it is likely that California’s COVID-19 death rate will peak soon but experience a similarly slow decline to pre-surge rates.
When might Sacramento-area schools reopen?
Most students across Sacramento County’s largest K-12 districts are continuing in distance learning, and whether they will return to campus before the end of the academic year this spring will hinge largely on how the area’s COVID-19 rates and vaccine rollout proceed in the next several weeks.
CDPH guidelines for campus openings updated two weeks ago make distinctions between elementary and secondary school openings: they call for counties to be below 25 new daily cases per 100,000 residents to allow schools to reopen for transitional kindergarten to sixth grade, but below seven new cases per 100,000 to reopen grades seven through 12.
Sacramento County is obviously closer to the 25-case mark than to seven cases per 100,000, but predicting when it may fall beneath the higher threshold is difficult and below the tighter threshold virtually impossible at this point.
CDPH in its weekly tier list data — the official source for metrics that will govern school openings — this past Tuesday reported the county’s case rate at about 44 per 100,000, down from a peak of 57 two weeks earlier.
The state data incorporate a lag time to account for reporting issues, so the 44 case per 100,000 calculation looked at numbers for the week ending Jan. 16. More recently, Sacramento County on its own local health office dashboard reported the case rate at 26.6 per 100,000 on Thursday.
So as the surge continues to wane, the county may be closing in on the metric required for elementary students to return to classrooms.
At the same time, though, the California Teachers Association in a letter to Gov. Gavin Newsom this week demanded that educators be vaccinated before campuses reopen.
Newsom earlier in the week said teachers will remain high on the vaccine priority list — but with the state also centering its focus to those ages 65 and older, and state health leaders estimating it could take until June to vaccinate that cohort at the current pace, it remains largely unclear when teachers may actually be widely administered their doses.
Nearly 1,800 dead in six-county Sacramento area
The six counties that make up the bulk of the 13-county Greater Sacramento region — Sacramento, El Dorado, Placer, Sutter, Yolo and Yuba counties — have reported more than 135,000 combined positive cases and at least 1,770 virus deaths.
Following the statewide trend, the rate of new cases is slowing in all six of those counties while deaths, which lag a few weeks behind infections, continue to pour in.
Sacramento County has confirmed 85,392 cases since the start of the pandemic, and at least 1,239 of those residents have died of COVID-19. The county reported 491 cases and 23 new deaths Friday, after adding 603 cases and eight deaths Thursday.
By date of death occurrence, December was by far Sacramento County’s deadliest month of the pandemic. County health officials have confirmed 375 deaths for December.
With Friday’s update, January’s confirmed death toll is up to 183, with fatalities occurring through Jan. 25 reported.
With the figure still preliminary, as death confirmations can take weeks to be made official, and lacking the final six days of the month, January has already surpassed August as the second-deadliest month of the pandemic in Sacramento County.
Virus hospitalizations in Sacramento County have trended mostly down while the ICU patient total remains elevated but may also be showing early signs of dropping. The overall patient total fell from 379 in Thursday’s state data update to 365 by Friday.
The countywide ICU total, which hit a record-high 130 early last week, dropped to 107 this past Monday and was at 111 by Friday. However, the state now reports only 48 ICU beds remaining available in the county, the fewest reported since April.
Placer County health officials have confirmed a total of 18,267 infections and 192 deaths. Placer on Thursday reported 138 new cases and no deaths after adding 95 new cases and four fatalities in Wednesday’s update.
State data showed 115 hospitalized in Placer on Friday, up from 105 reported Thursday, but the ICU total fell by four from 27 to 23. The number of available ICU beds increased by one, from seven to eight.
Yolo County has reported a total of 11,246 cases and 149 deaths. Yolo added 80 cases and two new deaths on Friday, after reporting 60 cases and one death Wednesday and 90 cases and eight deaths Tuesday.
State data showed Yolo with 19 virus patients Friday, down from 27 on Wednesday and 22 on Thursday. The ICU total held at eight patients, with zero ICU beds available.
El Dorado County has reported 8,268 positive test results and 74 deaths. The county reported just 23 new cases Wednesday but five new deaths, following 61 cases and four deaths Tuesday.
El Dorado has reported a surge of COVID-19 deaths. In the past week, the county disclosed 29 deaths, which is 41% of its death toll for the nearly 11-month health crisis.
Following just five deaths from March through late November, at least 66 El Dorado residents have died of COVID-19 in the past two months, dating back to Thanksgiving.
State health officials reported 15 virus patients in El Dorado hospitals as of Friday, which matches the lowest total since Dec. 3 and is down from 23 at the start of this week. The ICU total has dropped, from nine on Tuesday to six by Thursday and three on Friday. Nine ICU beds are now available, up from four on Thursday.
In Sutter County, at least 8,166 people have contracted the virus and 85 have died. Sutter on Wednesday added 38 new cases and one new death, following 63 cases and one death reported Tuesday.
Sutter reported 26 residents hospitalized with COVID-19 including six in intensive care as of Wednesday, down from 27 and nine on Tuesday.
Neighboring Yuba County has reported 5,237 infections and 30 dead. The county added only 10 new cases and no deaths Wednesday, following 52 cases Tuesday.
Yuba said Wednesday it had 33 residents hospitalized with the virus, same as Tuesday, with five still in the ICU.
Not all patients are hospitalized in-county, but the only hospital serving the Yuba-Sutter bicounty region — Adventist-Rideout in Marysville — had 49 hospitalized virus patients as of Friday, down from 51 on Thursday. The ICU total went from 11 to 12, and available ICU beds dropped from four to two.
This story was originally published January 29, 2021 at 9:31 AM.
