with Alexandra Ellerbeck

It’s taking months to OK more coronavirus vaccines for use in the United States, after the Pfizer and Moderna shots got quick approval in December. 

But two more candidates are poised to enter the spotlight – poised to double the number of options for vaccines approved for emergency use by the Food and Drug Administration. 

This could help move the nation closer to reaching herd immunity. The government has already purchased enough vaccine doses from Pfizer and Moderna for every American adult. But getting more vaccines into production could speed the process, as Americans yearn for a return to normal life.

First up: Johnson & Johnson’s vaccine.

The FDA could authorize the vaccine candidate from Johnson & Johnson as soon as tomorrow, now that it has found the single-shot vaccine to be safe and effective and completely prevented hospitalizations and deaths in a large clinical trial.

The vaccine was 85 percent effective at preventing severe illness, including in a region dominated by a concerning variant, but only 66 percent protective overall when moderate cases were included, The Post's Carolyn Y. Johnson and Laurie McGinley report. 

“The review, although positive, was more nuanced than regulators’ assessments of the first two coronavirus vaccines, reflecting a pandemic that has entered a more complicated phase as variants capable of slipping by some aspects of immunity have emerged,” Carolyn and Laurie write.

Johnson & Johnson is already lagging on the timeline it initially outlined. 

The company, which is under a $1 billion contract with the federal government, had promised 12 million doses of vaccine would be ready by the end of February, but has reportedly fallen as much as two months behind schedule.

Yet if it’s approved, it will bring some logistical advantages to the immunization effort.

Public health officials have eagerly awaited the arrival of the Johnson & Johnson vaccine because it is expected to streamline the logistics of a complicated mass vaccination campaign,” Carolyn and Laurie write. “The vaccine can be stored in a refrigerator for several months, which should ease the challenges of distributing frozen products, and it doesn’t require a follow-up visit for a booster shot.

Novavax could be the next company to seek vaccine approval.

The small Maryland-based biotech company is aiming to apply to the FDA for emergency use authorization sometime in the second quarter of 2021, Gregory Glenn, president of research and development at Novavax, said during a Washington Post Live event yesterday.

Gregory M. Glenn, MD, president of research and development at Novavax, says the drug developer plans to apply for emergency use authorization in the U.S. in the second quarter. (Washington Post Live)

That would be a huge step for the company, which was severely struggling early last year before it started pursuing a coronavirus vaccine. After some stumbles along the way, Novavax recently succeeded in enrolling 30,000 people in a trial in the United States and Mexico. If it goes according to plan, the vaccine could become the fourth approved for U.S. use.

Glenn declined to get more specific about what month the company might apply for an EUA — but he noted that it took about six weeks to collect enough data in trials held in the United Kingdom and South Africa before applying for use in those countries. In the United States, that could place the timeline around April or early May.

And Novavax will reference trial findings in those other countries — along with submitting U.S. trial data — when applying for authorization, Glenn said.

“The U.K. data is very good,” Glenn said. “That trial and the South African trial are all conducted in a way that the FDA will take that data seriously.”

In a UK trial, Novavax’s vaccine was 89.3 percent effective overall in preventing the original virus and the variant first discovered there. Gregory M. Glenn, MD, president of research and development at Novavax, explains how their vaccine candidate produces a strong immune response. (Washington Post Live)

Ahh, oof and ouch

AHH: A new ad campaign will encourage coronavirus vaccinations.

“For tens of millions of Americans still unsure about getting taking a coronavirus vaccine shots, advertising industry experts and government scientists have a new message: ‘It’s Up to You,’ ” The Post’s Dan Diamond reports. 

That message will feature in an ad campaign across TV and digital video, social media and audio platforms such as Pandora and Spotify. The campaign is backed by $50 million in donations and overseen by the Ad Council — the nonprofit communications industry group that made the public health message “Friends Don’t Let Friends Drive Drunk.”

The Ad Council is launching a national campaign to promote taking available coronavirus vaccines and a website with answers about their safety. (Ad Council)

“The goal of the campaign is to win over skeptical Americans, whose numbers are considered likely to be the difference between enough people being vaccinated and failing to curb the spread of the novel coronavirus,” Dan reports.

The Ad Council and other messaging suggests that the best way to make the case to skeptical Americans is to recognize and respond to hesitancy about vaccines. People want to see vaccines as a personal choice, according to Liz Hamel, who helped lead coronavirus public opinion surveys for the Kaiser Family Foundation. Researchers for the Ad Council found that messages that say getting vaccinated is the “right thing to do” came across as pushy or accusatory in surveyed groups.

OOF: Xavier Becerra expressed concerns that Medicare Advantage is too generous.

Republican senators quizzed Biden's health secretary nominee on his views of the program, in a confirmation hearing before the Senate Finance Committee yesterday, The Post’s Amy Goldstein and Brittany Shammas report. Medicare Advantage, a version of Medicare where private plans offer the benefits, is extremely popular among seniors and is often championed by Republicans.

Becerra pledged to support Medicare Advantage, but indicated he had qualms about more generous benefits it offers, saying he “will make sure that there is a level playing field” between traditional Medicare and the private-sector version. He said it's especially important to avoid overpaying private health plans because Medicare is financially fragile, with the trust fund for Medicare-paid hospital services forecast to become insolvent in three years. “We don’t have the dollars to spare and to waste,” Becerra said.

“[D]rawing out Becerra’s position on private-sector Medicare was part of an attempt by several committee Republicans to portray him as a proponent of what one called ‘socialist-type policies’ that would eliminate the private insurance industry,” Amy and Brittany write. 

During his time serving as a congressman, Becerra supported a single-payer health-care system, along the lines of some Medicare-for-all plans. The nominee stressed, however, that, if confirmed, he would focus on achieving Biden’s goal of expanding the Affordable Care Act.

Becerra’s appearance before the committee was the second of his two confirmation hearings, coming a day after he testified before the Senate Health, Education, Labor and Pensions Committee.

Becerra also faced questions about his views on religious liberty, with several GOP senators accusing him of suing nuns — a claim that Becerra denies. In his capacity as California attorney general, Becerra sued the Trump administration over a rule that made it easier for employers to refrain from providing birth control if they had objections on moral and religious grounds. The Little Sisters of the Poor, an order of Catholic nuns, intervened in the case to defend the Trump administration’s policy.

OUCH: The CDC traced dozens of coronavirus infections to a gym in Chicago.

Researchers at the Centers for Disease Control and Prevention identified 55 coronavirus cases among 81 people who attended high-intensity indoor exercise classes in a Chicago gym between Aug. 24 and Sept. 1. While gym members were required to wear masks upon entering the facility, they were allowed to remove them while exercising. Most of the people who attended the finesses classes wore them infrequently, the New York Times's Roni Caryn Rabin reports.

A separate CDC report linked 21 coronavirus infections to a fitness instructor in Honolulu who in days before he became symptomatic taught multiple classes in which no participants wore masks. 

Public health officials are urging fitness centers to enforce mask use and improve ventilation, among other protective measures. When possible, moving classes outdoors could also reduce risk.

More in coronavirus news

States are passing their own coronavirus relief packages as they wait on federal help.

“Maryland and California recently moved forward with help for the poor, the jobless, small businesses and those needing child care. New Mexico and Pennsylvania are funneling grants directly to cash-starved businesses. North Carolina’s governor wants additional state aid for such things as bonus pay for teachers and boosting rural internet speeds,” the Associated Press’s Brian White reports.

Critics of Biden’s coronavirus relief plan have seized on the state initiatives to argue that the billions in federal relief targeted at state and local governments are unnecessary amid stronger-than-expected state finances. But many governors and local leaders say that federal aid is still needed to help shuttered businesses and families desperate for relief. While some states saw tax revenue increase last year, at least 26 states were hit with declines, according to a Post analysis.

State and local stimulus aid is just one of several flash points that have emerged in debates around Biden’s $1.9 trillion coronavirus relief package, which House Democrats are preparing to advance Friday. Lawmakers have also clashed over the inclusion of a $15-an-hour minimum-wage mandate, with at least two Senate Democrats suggesting that they might oppose the measure. The fate of the minimum-wage increase also hangs on a ruling by Senate officials, who will determine whether it can be included in legislation passed under the Senate’s complex budget reconciliation process.

AHH: Doctors and nurses are battling online misinformation about the coronavirus.

“A family medicine doctor in rural Kansas, who is also her county’s health officer, responds to a daily flood of pandemic-related texts and social media messages while running her clinic and taking emergency room shifts. A pregnant nurse in California opens up online about her decision to get vaccinated, hoping that her personal story might persuade others to do the same. A pulmonary and critical care physician in Baltimore, who’s done more than 170 virtual town halls, gives out his personal email address to anyone with questions or concerns,” The Post’s Allyson Chiu writes.

Countless health-care workers have found themselves “combating the coronavirus on two fronts,” Allyson writes. During the day, they work in hospitals and clinics, and in off-hours, they go online to spread public health messages and combat misinformation about the virus and vaccines. Some workers draw on their own stories working in overwhelmed hospitals, or, more recently, being inoculated against the coronavirus. Many have faced online harassment and vitriol.

“You wrap up your day, and you’re hoping the fight ends,” Atul Nakhasi, a doctor and co-founder of #ThisIsOurShot, a digital campaign to promote positive messaging about coronavirus vaccinations, told The Post. “You’re fighting for lives that whole day … keeping people here to the next morning. And then you get home and you feel like the fight never stopped. It just changed turf. The landscape just changed.”

Sugar rush

In Florida, local leaders like Rev. R.B. Holmes Jr. and Tammy Jackson-Moore are striving to encourage their communities to take the coronavirus vaccine. (Drea Cornejo/The Washington Post)