Detroit Mayor Mike Duggan appeared Friday to walk back comments he made this week after turning down doses of the Johnson & Johnson COVID-19 vaccine amid pushback from public health experts.
The more positive comments about the Johnson & Johnson one-shot vaccine came on the same day that President Joe Biden’s senior adviser on COVID response claimed Duggan’s comments were misinterpreted. The mayor’s office issued Friday afternoon a more forceful endorsement of the Johnson & Johnson vaccine.
The developments followed a statement earlier in the week by the U.S. Conference of Catholic Bishops that advised Catholics against taking the vaccine if given a choice.
Duggan said Thursday the city declined 6,200 doses because officials wanted to focus instead on vaccines that are “the best” in the market. The mayor said his decision didn’t result in any Detroiters losing out on vaccination opportunities. Duggan, the former CEO of the eight-hospital Detroit Medical Center, acknowledged the city would administer future shipments of the vaccine, should there be a need for them.
By Friday morning, the mayor was more forceful in emphasizing the benefits of the Johnson & Johnson vaccine. “I have full confidence that the Johnson & Johnson vaccine is both safe and effective,” he said in a statement. “We are making plans now for Johnson & Johnson to be a key part of our expansion of vaccine centers and are looking forward to receiving Johnson & Johnson vaccines in the next allocation.”
By Friday afternoon, the mayor was more emphatic.
“The city of Detroit is excited that there are now three highly effective vaccines that will save lives,” Duggan said in the later statement. “The data from the clinical trials is clear — the FDA, the CDC and Dr. Fauci all have been clear — Pfizer, Moderna and Johnson & Johnson are all highly effective at what we care about most, which is preventing hospitalizations and deaths.
“We always intended to distribute Johnson & Johnson once the demand warranted it and we had our distribution plan in place so we can make it just as accessible to our residents as we have Moderna and Pfizer,” he added. “By the time the next J&J shipment arrives, we will have our plan in place to make it available.”
Public health officials have been united in saying all COVID-19 vaccines approved by the federal Food and Drug Administered for emergency use are safe and effective — and people should take whatever kind they’re offered.
The one-dose Johnson & Johnson vaccine was approved by the FDA this week, following approval of vaccines developed by Pfizer and Moderna in December.
“Folks all need to be working together with their medical team or health department to make sure there’s no misalignment in terms of messages,” said Enrique Neblett, a professor of health behavior and health education at the University of Michigan School of Public Health and an associate director of the Detroit Urban Research Center.
Vaccine prompts debate
In an article published Friday in The Conversation, an academic journal, authors including Tinglong Dai, an associate professor in the Johns Hopkins Carey School of Business and an expert in medical supply chain issues, said the Johnson & Johnson vaccine could be a “game changer” since it does not need to be frozen and requires only one dose.
But there has been a backlash against the Johnson & Johnson vaccine due mostly to a lack of clarity about its effectiveness, the authors said.
The article noted objections by the U.S. Conference of Catholic Bishops, which on Wednesday issued a statement saying Catholics, if given a choice, should not choose the Johnson & Johnson vaccine because it was derived from cell lines that originated with the cells of aborted fetuses. The Pennsylvania Conference of Bishops issued a Thursday statement recognizing that most people don’t have a choice of vaccine, and “Catholics may in good conscience, receive any vaccine, in order to protect themselves.”
The single-shot vaccine has an efficacy level of 66% compared with an efficacy level of 90% for the Pfizer and Moderna vaccines, Dai said.
But the clinical trials for the two-dose vaccines took place before the arrival of variants of the SARS-CoV-2 virus.
“It’s like comparing apples and oranges,” Dai said.
Johnson & Johnson clinical trial data show the vaccine is effective in fighting the variants that emerged in the United Kingdom, South Africa and Brazil. In terms of preventing severe disease, hospitalizations and deaths, results of the Johnson & Johnson clinical trials were comparable with those of Pfizer and Moderna.
Public health officials need to consider and plan for bias that exists against the Johnson & Johnson vaccine, Dai said. “Otherwise people scheduled to get the Johnson & Johnson vaccine might cancel their appointments to wait for the Pfizer or Moderna product, potentially resulting in wasted doses and delayed vaccinations.
One-shot vaccine defended
Public health experts including Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, have encouraged people to take whatever vaccine they are offered.
In trials, the Johnson & Johnson vaccine completely prevented hospitalizations and deaths, including in South Africa against a more transmittable variant, and was 85% effective at protecting against severe cases of illness.
The White House on Friday cast Duggan’s earlier vaccine comments as being misinterpreted.
“We’ve been in constant dialogue with Mayor Duggan, who said in fact that was not what he said, or however it was reported,” said Andy Slavitt, White House senior adviser for COVID response. “In fact, he is very eager for the Johnson & Johnson vaccine, and I think we would reiterate the message that, for all of us, the first vaccine we have an opportunity to take makes absolute sense to take.”
Fauci, chief medical adviser to President Joe Biden, also ended up responding after another question about Duggan came up at the White House COVID briefing. He said all three are “highly efficacious vaccines with a high safety profile.”
“Importantly, all three of them have a very important effect of being extraordinarily effective in preventing severe disease and particularly preventing hospitalizations and deaths,” Fauci said. “We don’t compare one to the other. The only way you can do that is by head-to-head comparisons in a clinical trial, which was not done.”
“If you go in and a vaccine is available to you, I would take the first available vaccine, because the most important thing to do is to get vaccinated and not to try to figure out which one may or may not be better than the other,” he added.
Public health experts have been concerned that some African Americans are hesitant to be vaccinated due to a history of poor treatment in clinical trials and with the medical system in general. But Neblett said a lack of access to vaccines due to the absence of pharmacies in Black neighborhoods as well as a lack of transportation to get to the shots are the greatest reasons for fewer Blacks getting vaccinated.
Neblett said some Detroiters may find it reassuring that Duggan has been considering what would be the best vaccines to inoculate residents with.
“Someone in the Black community might read that as …’I want the best for the residents, I want (the vaccine) to work really well,'” Neblett said.
About 11% of Detroit’s residents older than 16 have had at least one shot as of Tuesday, according to the city’s website. By comparison, 18.5% of Michigan residents older than 16 have received at least one dose, according to the state Department of Health and Human Services.
Washtenaw County at 21% is slightly higher than the state average, while outer Wayne County at 18% and Macomb County at 16.5% trail the statewide average.
“I believe that Mayor Duggan shouldn’t have said that,” said Detroit resident Quentis Leverett, 65. “I just think any of the vaccines that can help our people, or American people, should be accepted.”
“I think it’s just the availability of getting it,” he added. “They can’t get it — they don’t have transportation, or you have to be a certain age. In our community, there has been a lot of hesitancy because of our past. People have their own suspicions. I believe that the vaccine works.
Staff Writer Sarah Rahal contributed.