ACIP Issues Interim Recommendation for Janssen COVID-19 Vaccine

The Advisory Committee on Immunization Practices (ACIP) issued an interim recommendation to the Janssen COVID-19 vaccine for use in individuals aged ≥18 years for the prevention of COVID-19 this past Sunday.

The committee is composed of both medical and public health experts that develop recommendations for the use of vaccines in the civilian population. The recommendation is a respected guidance in public health for the safe use of vaccines and related biological products.

During the assessment prior to the recommendation, the committee employs the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, followed by the Evidence to Recommendations (EtR) framework to guide their deliberations.

The GRADE approach rates the vaccine on a scale of 1 to 4, with 1 being a high certainty of evidence for outcomes related to the vaccine, and 4 being a very low certainty. Within the EtR framework, the committee reviewed the importance of COVID-19 as a public health problem, as well as resource use, benefits and harms, patients’ values and preferences, acceptability, feasibility, and equity.

The committee graded the Janssen vaccine a type 2 (moderate certainty), for the prevention of symptomatic disease and for the estimate of prevention of COVID-19–associated hospitalization and death. Evidence for possible harms after vaccination was given a type 1 (high certainty) for reactogenicity and type 2 for serious adverse events.

The ACIP came to the conclusion that COVID-19 is a major public health issue and that the “use of the Janssen COVID-19 vaccine is a reasonable and efficient allocation of resources” under the EtR framework.

They noted that the 1 shot vaccine may be appropriate for those who want to complete their vaccination schedule quickly due to difficulties getting back for a second dose. They also stated that it will allow for a wider variety of settings to administer the shots, improving equitable access.