In January 2020, at the start of the
COVID-19 pandemic, Barouch began studying the
immunology and
pathogenesis of
SARS-CoV-2 infection in collaboration with
Johnson & Johnson and developing a COVID-19 vaccine. It underwent rapid preclinical testing and advanced into initial clinical trials by July 2020, after which tested in a large international phase three efficacy trial. The resulting vaccine, known as the Johnson & Johnson COVID-19 vaccine, or
Ad26.COV2.S, was approved by
WHO and commenced global distribution in February 2021. This vaccine was the third COVID-19 vaccine authorized for use in the United States, and the first vaccine deployed in South Africa. Its utilization was lower than
mRNA vaccines in the western world, but deployed extensively in
developing countries, given its efficacy, durability, and stability without freezing. With over 200 million doses distributed, it has been credited with saving nearly one million lives in 2021. Barouch's research also involved studying the immunology of SARS-CoV-2 infection, the
immunogenicity and durability of mRNA vaccines and boosters, and the impact of SARS-CoV-2 variants on immune escape and
vaccine efficacy. He also defined immune correlates of protection for COVID-19 vaccines. In February 2021, Barouch co-authored a paper on how a certain level of
COVID-19 antibodies may provide lasting protection against the virus. In 2021 and 2022 he also co-authored papers exploring the protective mechanisms by COVID-19 antibodies, based on blood samples provided by 4300 employees of
SpaceX. In 2022, he reported that the bivalent ancestral+BA.5 mRNA boosters were limited by immune imprinting to the ancestral strain, which contributed to the FDA decision in 2023 to remove the ancestral strain for the XBB.1.5 mRNA booster. In 2023, Barouch served as part of a panel of experts advising the
Biden administration on the potential risk of another
Omicron-like wave of COVID. In 2024, he demonstrated the importance of
mucosal immunity for improving vaccine protection against COVID-19. == Mpox ==