CDC advisors recommend caution, more data before resuming J&J one-shot COVID-19 vaccine
Advisors say the mRNA vaccines are better options until thorough search for unreported adverse events. Meanwhile, new cases and hospitalizations are up >6% week-to-week.
UPDATE: ACIP will meet again to review the J&J vaccine data on Friday, April 23 and consider updating recommendations.
Here's my write-up of the April 14, 2021, ACIP meeting and a few other headlines.
After considering known data on six cases of dangerous blood clots associated with the Johnson & Johnson COVID-19 vaccine, the CDC’s panel of independent advisors recommended continuing to pause the use of the single-shot vaccine to determine if the risk is larger than currently visible and develop more specific guidelines for identifying and treating the rare blood clots that have been reported. (Technically, they did not recommend anything, but the absence of a decision was affirmation that the pause should continue.)
The experts noted that the risk-benefit analysis is influenced by the fact that the other two vaccines in use (by Pfizer and Moderna) do not have these same possible risks and are good alternatives for people needing vaccination.
Complicating the issue is that the blood clots identified in six women, including one who died, are a specific, rare form that requires treatment very different from other blood clots. The clots occurred 6-13 days after vaccination.
If properly identified, they can be treated effectively. FDA and CDC officials said making sure that clinicians are alerted to this would be one of the necessary steps before use of the J&J shots can resume.
The committee’s next meeting is scheduled for May 5 but a decision on resuming use could come sooner, if the data meets the committee’s expectations.
Commenters urged ending the pause, despite the concerns, because the benefits of the vaccine - especially to vulnerable and difficult-to-reach people - outweigh the risks as described.
The delay reflects “a desire to better characterize the risk in order to provide the best guidance going forward,” said Dr. Jeffrey Duchin, Seattle-King County, Washington, health officer, who was speaking at the meeting on behalf of the Infectious Diseases Society of America
Healthcare providers scrambled to update patients who got or were scheduled to get the J&J vaccine. The White House says every state has enough Pfizer and Moderna doses available to cover every adult on the existing timelines. State and local health officials expressed concerns about logistics, since the mRNA shots require two doses.
The 7-day rolling average of new cases in the USA was 67,530, up 6% over the previous week, according to the CDC. Hospital admissions are up 7%.
Those who lived mostly sedentary lifestyles had a much higher risk of hospitalization or other severe illness from COVID-19, according to a new study in the BMJ.
Laboratory study estimates that keeping airplane middle seats open may cut COVID-19 exposure risk by 57%. However, there are multiple reasons not to put much weight on this finding. This CDC study calculated risk of airborne viral particles passing from one person to another — i.e., exposure — and did not evaluate risk of the recipient getting infected. It also does not account for reduction in risk from masks. On the more positive side, the researchers note that with current aircraft air conditioning systems, “most virus particles are removed within several seat rows from a source on an aircraft.”
Pfizer promised it would boost supplies of vaccine to the European Union, with an additional 50 million doses to be delivered this month.
Denmark “permanently” halted use of the AstraZeneca vaccine over blood clot concerns.