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Dr. Bill Smith: The best COVID-19 vaccine is the one you can get the soonest

Tennessee could receive up to 40,000 doses of the Johnson & Johnson vaccine this week. We asked Dr. Bill Smith what you should know ahead of its arrival.

KNOXVILLE, Tenn. — On Saturday, the Food and Drug Administration issued an emergency use authorization for a third COVID-19 vaccine created by Johnson & Johnson.

In Tennessee, state health commissioner Dr. Lisa Piercey said up to 40,000 doses could arrive this week, possibly as soon as Monday.

"Health authorities recommend that you take whichever vaccine you can get the soonest," said Dr. Bill Smith, CEO of AMR in Knoxville. "That continues to make absolutely the most sense."

Dr. Smith helped with clinical trials for all three authorized vaccines currently authorized for use in the United States: Pfizer, Moderna and Johnson & Johnson. 

"The bottom line is that they all work. They all have minimal side effects and they all prevent severe disease," he said. "There is not enough difference to base your selection on anything other than what you can get the soonest."

10News asked him what you should know before getting your shot.

WBIR: How many doses are required?

Dr. Smith: Pfizer and Moderna both require two injections. Johnson & Johnson is a single dose rather than multiple doses, which doubles the vaccine supply. 

WBIR: How do the vaccines work?

Dr. Smith: Pfizer and Moderna are very similar. They are both RNA vaccines. Johnson & Johnson is different. It is an adenovirus vector delivered vaccine, which means there is a common virus that is modified to deliver the protein from the Coronavirus, the piece of the spike that they use to cause the antibody response.

WBIR: How effective are the different vaccines?

Dr. Smith: Pfizer and Moderna's efficacy is comparable. Those studies were done earlier, before the variants arose, and we don't have a lot of data about them as to whether or not they'll be effective. We do have some lab antibody data that suggests they will be — although maybe not quite as much. The efficacy data that Johnson & Johnson published is slightly lower. However, when you do all this statistical analysis, they're very similar, particularly when you add in the fact that this study was done later than Pfizer and Moderna. The variants were present in some of the areas where the J&J study was done. If indeed there is a lower protection rate, that may also explain part of the difference.

WBIR: What kind of storage is required?

Dr. Smith: Pfizer previously had required ultra-cold refrigeration. But, the FDA now has moved them back to regular freezers and they have made that issue go away. Johnson & Johnson can be stored in a refrigerator rather than the freezers.

WBIR: How do the side effects vary?

Dr. Smith: The side effect profiles are very similar. Having worked with all three of them, I couldn't tell you on a per subject basis whether someone received Pfizer, Moderna or J&J. Some people will have the significant vaccine reactions, meaning they feel bad, the fever, etc. With all of them, some will have absolutely nothing. In terms of safety, all of the safety data seems to be equivalent. 

WBIR: When will there be enough vaccine?

Dr. Smith: Obviously, adding J&J to the mix will speed the process. There also are two other vaccines that are very late in the process that will likely have data they can present to the FDA within the next few weeks. Those are NovaVax and AstraZeneca. It is my hope and expectation that within another few weeks that we will have two other vaccines to add to the mix. The more we have, the sooner we can get this pandemic behind us.

WBIR: Are there more vaccine trials going on?

Dr. Smith: We continue to be doing other coronavirus vaccine studies. We just started the new one Friday and we need volunteers. One of the ways that people can help to bring an end to it sooner is to volunteer in these studies. For more information, you can call 865-305-DRUG (3784).

Editor's note: Answers have been edited for clarity and length.