A week after the Covid-19 vaccine trial goes on hiatus, Johnson & Johnson and the FDA will not reveal critical details



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Public health experts have encouraged transparency in clinical trials of the Covid-19 vaccine, considering that eventually hundreds of millions of Americans will be asked to roll up their sleeves and get vaccinated.

The company and the FDA declined to answer two questions from CNN: one, whether the study volunteer who became ill received the vaccine or placebo, and two, whether this is the first pause in the trial.

The answers to both questions are critical to understanding what this participant’s illness might mean for the safety of a vaccine.

Dr. Paul Offit, a member of an FDA advisory committee that will review vaccines, said Johnson & Johnson should answer these basic questions.

“The goal is to inform the public. When it’s not done, people imagine the worst,” said Offit, a member of the FDA’s Advisory Committee on Vaccines and Related Biologics.
Dr. Peter Hotez, director of the Center for Vaccine Development at Texas Children’s Hospital, agreed, noting that surveys show that many Americans do not want to receive a Covid-19 vaccine once it is marketed.

“By hiding this in secret and filtering things into pieces, it somehow conveys the message that something strange is happening,” Hotez said.

Responses from the FDA and Johnson & Johnson

FDA Commissioner Dr. Stephen Hahn has written about the importance of transparency in the Covid-19 vaccine development process.

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“We believe that transparency in this process will help build public trust and provide a greater understanding of the work of the FDA,” Hahn. tweeted on September 15.

Spokesmen for his agency declined to respond to CNN’s questions about the Johnson & Johnson lawsuit, saying, as with other lawsuits, that federal regulations prohibit the agency from releasing information. The agency referred CNN to Johnson & Johnson.

The pharmaceutical company has also said that it is committed to transparency, including transparency about its Covid-19 vaccine trial.

“At Johnson & Johnson, we believe that transparency of clinical trial data advances science and medicine and is in the best interest of the patients and consumers who use our pharmaceuticals and the healthcare professionals who prescribe them. We stand behind the general principles of clinical trials data transparency with the aim of promoting medical sciences, “according to a statement on the company’s website.

When asked about the COVID-19 trial pause, a Johnson & Johnson spokesperson referred CNN to the Oct. 12 statement when it announced the pause.

In an email to CNN, the spokesperson, Jake Sargent, highlighted this phrase from the statement: “We are also learning more about the disease from this participant, and it is important to have all the facts before sharing additional information.”

Did the sick recipient receive a vaccine or a placebo?

It shouldn’t take a week to determine whether a study participant received the vaccine or a placebo, according to vaccine specialists.

The Johnson & Johnson trial began on September 23, with the intention of recruiting 60,000 patients in eight countries, including the United States.
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The company learned of the “unexplained illness” from the study volunteer on Sunday, Oct. 11, Dr. Mathai Mammen, global head of research and development for Janssen Pharmaceuticals, a division of Johnson & Johnson, said on the conference call Tuesday. on the company’s third-quarter earnings.

In the study, half of the participants receive the vaccine and the other half receive the placebo, which is an injection of saline that does nothing. The study is blinded, which means that the company does not know who receives which, nor do the participants or the doctors conducting the trial.

If the participant who got sick got the placebo, that doesn’t mean anything to the trial. However, if the participant received the vaccine, that could raise safety concerns.

Only the trial’s Data Safety and Monitoring Board, a group of independent scientists, can unmask the sick participant’s condition and find out whether they received a vaccine or a placebo.

“They could find out very quickly, certainly in 24 hours,” said Dr. Jesse Goodman, director of the FDA’s Center for Biological Evaluation and Research from 2003 to 2009, and the agency’s chief scientist from 2009 to 2014.

When CNN asked whether the volunteer received the vaccine or the treatment, the Johnson & Johnson spokesperson pointed to the company’s Oct. 12 statement, which notes that “as many trials are placebo-controlled, it is not always immediately apparent whether a participant received a study “. treatment or a placebo. ”

On Oct. 13, on the earnings call, Mathai, the Johnson & Johnson executive, said the company had shared data with the monitoring board.

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“We have provided our set of information that we know to the DSMB, and they have asked a number of specific questions. We do not know if, they have not informed us of their, they are entitled to blind. We are still blind. So we do not know the treatment arm, the vaccine arm, “he said.

On Wednesday, Johnson & Johnson’s CFO repeated that the company did not know what the volunteer received.
“We don’t even know at this point if that individual is on the placebo arm or the vaccinated arm,” Joseph Wolk told CNN’s Richard Quest.

It is not clear whether Johnson & Johnson learned as of Wednesday whether the participant received the vaccine or the placebo.

“It’s certainly possible that DSMB is investigating and the company doesn’t yet know which group it’s in, and it would be helpful if they clarified that,” said Goodman, a former FDA official.

Offit said that it is clear to him that the participant received the vaccine; otherwise, the trial would not have been suspended or held on hold for one week.

“Why would you pause a trial if the person got the placebo? It just doesn’t make sense,” said Offit, director of the Center for Vaccine Education at Children’s Hospital of Philadelphia.

“I find it hard to believe that they have hundreds of researchers in this trial that will have 60,000 participants, this huge steamboat is moving forward, and you stop because a participant who received the placebo got sick? That just defies logic.”

Is this the first pause of the trial?

Johnson & Johnson and the FDA also declined to answer whether this was the first hiatus for their Covid-19 vaccine trial.

It took AstraZeneca researchers 1 month to submit the vaccine trial data to the FDA, according to a source at CNN.

The answer is important, because if two or more participants develop similar illnesses after receiving the vaccine, it is an important red flag that the vaccine could pose safety risks.

Speaking generally about vaccine trials, former FDA Commissioner Dr. Peggy Hamburg said openness is important.

“Transparency is always better, especially with simple, basic questions,” he said.

Participants who took a similar vaccine made by another company also fell ill.

The Johnson & Johnson vaccine and the AstraZeneca vaccine use an adenovirus as part of their Covid-19 vaccine. Adenoviruses cause the common cold and other illnesses, but the viruses are genetically modified so they don’t reproduce or cause illness, according to the companies.

Johnson & Johnson uses a human adenovirus and the AstraZeneca and Oxford vaccine uses a chimpanzee adenovirus.
Volunteers in the trial conducted by AstraZeneca and the University of Oxford developed “unexplained neurological symptoms including changes in sensation and weakness of the limbs,” according to a fact sheet for participants from the university.

The AstraZeneca trial was stopped once in July and again in September due to illness. The September break is still in effect in the United States.

Offit said drug companies should inform the public about the breaks and, if the trial is allowed to continue, explain why the illnesses were a coincidence and not due to the vaccine.

“You can inform them so that people don’t assume that something bad happened, so they don’t assume the worst and think ‘this makes me very hesitant to take this vaccine,'” he said.

Casey Hicks contributed to this story.



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