What do we need to know about the Johnson & Johnson vaccine?

On Monday March 1st, the first truckload of Johnson and Johnson (J&J) vaccine arrived at the worldwide distribution center of the UPS in Louisville, Kentucky. This marked the day 1 of the entry of the 3rd American COVID vaccine into the market. In this blog my main goal is to highlight the outstanding features of the J&J vaccine and to compare and contrast it with the Moderna and Pfizer vaccines.

The Cardinal Contrasts

The J&J vaccine is contrasted with Moderna and Pfizer vaccines in four important respects:

1. It is a DNA and not an RNA vaccine. This makes a major part of its interaction with our cellular machinery different from the Moderna and Pfizer vaccines.
2. It is a single-jab and not a two-jab vaccine. This makes the use of it more convenient for the recipients.
3. It is more stable in higher temperatures and it can be stored in the refrigerators instead of the freezers. This makes the challenge of transportation and storage of it more convenient and practical.
4. It uses a different mechanism of entry into the cells that sets it apart from the other two American vaccines  and makes it similar to AstraZeneca vaccine that has been primarily used in the United Kingdom. 

Delivery Method of the J&J Vaccine

One of the intriguing aspects of the DNA and RNA vaccines that are developed against the COVID-19 is their methods of delivery into our cells. These delivery methods remind me of the Trojan horses. The J&J vaccine likewise the AstraZeneca, as indicated in the item #4 of the above shortlist, employs the shell of another viral pathogen, the “adenovirus” as a Trojan horse for this particular purpose. 

What do the Pfizer, Moderna, AstraZeneca and J&J vaccines all have in common?

These  vaccines resemble each other in two important respects. Firstly, they train our immune systems to attack the surface spike proteins that the SARS-CoV-2  uses for entering, mainly, into our respiratory cells. Secondly, they employ our cellular bodily machinery to produce replicas of the spike proteins. The latter, in turn, trains our immune system to identify and nullify COVID viruses in the event of future encounters, and before they get the opportunity to enter into our bodily cells.    

Essential Pieces of the Puzzle

From the onset of the COVID pandemic the foremost challenge of vaccinologists has been identification of the spike protein’s structure. More specifically, they were interested to know the structure and the focal point of the spike protein. By focal point I mean the part of the protein that is responsible for attaching to target receptors on our respiratory cells  and injecting the viral genome into our cells. We knew about the portal of entry of the COVID virus into our cells several years prior to the current pandemic situation. We knew this from prior meticulous research works on the two other nasty close siblings  of the COVID-19, namely, the SARS and the MERS viruses. The entry portal for these three viruses has been the  “ACE-2 receptors” that are abundant in our respiratory system. This reminds me to mention that one the most prevailing theories that tries to explain why men are more at risk of acquiring COVID-19 infections is related to the ACE-2 receptors. It is believed that these receptors are expressed more predominantly in males as opposed to females.

The next hurdle of the vaccinologists has been identifying the type of vehicles or “Trojan horses” that could effectively deliver the vaccines from their injection site, the deltoid muscle, into our bodily cells. Of course, effective delivery, firstly, presumes that the right vehicle is not immediately singled out and rejected by our innate immune cells, and secondly it should induce our bodily cells to readily pick it up. 

Do we owe anything to China?

From the onset of the COVID-19 pandemic so much blame has been going to China for letting this rabid rascal out of its cage. However, what most of us tend to neglect is that the Chinese vaccinologists were the first group of scientists who solved the first and the foremost important COVID vaccine’s puzzle for us. They already had been able to identify the structure of the spike protein, and they readily shared that information with the world almost a year ago. Can you guess what was the most important immediate implication of this piece of information for me? It helped me to reevaluate the effects of toxic Sinophobic rhetoric that have been floating around in our country since the COVID frenzy began! Actually, it busted all traces of Sinophobia that had been subliminally marring my vision within the past several years. It helped me to understand the pain and suffering of all humans across our globe during our current pandemic. It enforced less animosity, more tolerance, and more unconditional love of humanity in me! It reinforced, at least for now, the powerful soothing effects of love on my soul. 

The Trojan Horse!

As I’ve said before, the second COVID vaccine puzzle was related to the type and structure of Trojan horses that we had to employ for effective delivery of the DNA or RNA recipes of the COVID’s spike protein into our cells. Oh, I just remembered something that I should have mentioned earlier! I am sorry that I took it for granted that everyone knows what I mean when I use the “Trojan horse analogy”. To quickly get us all on the same page, the term of “Trojan horse” is traced back to the Greek mythology and to the Trojan war. At the time, the Spartans infiltrated the Greek city of Troy by hiding inside a big wooden horse that was disguised as a gift. The Trojans were fooled , and they  gladly accepted the Spartan’s gift and brought the horse into their city. This resulted in Troy’s downfall and ended the 10-year Trojan war! Well, having this in mind … now let’s see how the Trojan horses that are employed by our vaccinologists allow us to win our war against COVID!

The first two American vaccines used a mini-lipid capsule, the so-called “nanoparticles” that would have allowed them to fuse, innocuously, with our cell membranes. The AstraZeneca and J&J vaccines use another ingenious way for delivering the DNA molecules that encode for the spike protein. They use adenoviruses  as their Trojan horses. It’s noteworthy to mention that adenoviruses are a group of viruses that cause common cold in the humans. As such evolutionary-wise they have acquired surface structures, namely proteins or glycoproteins, that would have allowed our cells, and in particular our respiratory cells, to readily pick them up. Remember that a clever virus that has survived for so long alongside the humans, must have acquired outstanding masquerading abilities for getting into our bodily cells, and then using our cellular machinery to its own advantage! Of course, as you can guess the adenovirus shells that vaccinologists use as Trojan horses for delivering the spike protein information into our cells should not, and must not, have any pathogenic viral DNA inside them! What do they have to harbor instead? The DNA instructions for the spike proteins of the COVID virus! 

Before leaving you and for the sake of completeness, I must reiterate the importance of another piece of information:  the adenoviral shell that is used for delivering the spike protein information must not evoke a counter immunologic response in our bodies. This has prompted use of certain chimpanzee adenovirus shells with the least historical likelihood of cross contaminating humans. Why is this so important? Because it minimizes the possibly of inducing any reactive immunologic response in the vaccine recipients and allows for successful delivery of the spike protein instructions into our bodily cells.

Well…folks my intention was to only provide you with a quick and an easy-to-understand introduction and synopsis of what the J&J vaccine is all about. I realize that many of my medical students and several of my inquisitive followers would love to learn more about the J&J vaccine. All I can say is that I love you all and that’s why I would like to leave you with the following three awesome articles. 

Hope to catch you all healthily down the road! 

https://jamanetwork.com/journals/jama/fullarticle/2777172

https://www.nytimes.com/interactive/2020/health/johnson-johnson-covid-19-vaccine.html

https://www.cdc.gov/vaccines/covid-19/hcp/viral-vector-vaccine-basics.html