Had Johnson & Johnson’s COVID-19 vaccine been the first to get the FDA’s green light, it might have been hailed from the get-go for what it actually is: a scientific and technological marvel. It requires just one injection to confer full immunity—a boon for needlephobes and tough-to-reach populations who can’t easily access a second dose. It’s relatively cheap and has forgiving refrigeration requirements, making it a breeze to ship and store. And clinical trials showed that it’s a knockout at guarding against hospitalization and death, and 66 percent effective at preventing moderate to severe cases of COVID-19, even amid the rise of antibody-dodging coronavirus variants. Johnson & Johnson accomplished all this in less than a year, granting the world a safe and effective vaccine crucial to hastening the pandemic’s eventual end.

That’s not how the J&J story played out.

The Johnson & Johnson vaccine is not, experts repeatedly told me, a “worse” vaccine. Among the three options available to Americans—Pfizer-BioNTech, Moderna, and J&J—“the best vaccine you can get is the one you can get in your arm as soon as possible,” Chrissie Juliano, the executive director of the Big Cities Health Coalition, told me.

But J&J’s vaccine is undeniably different, and its portability and convenience have prompted health departments to shuttle it into distinct populations, such as incarcerated individuals and people experiencing homelessness. In practice, this may be contributing to some unintended stratifications. David Lazer, a computer scientist at Northeastern University, told me his team has collected data showing that Black people are almost twice as likely to have received the J&J vaccine than white people, a disparity that doesn’t seem to be accounted for by preferences alone.


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