Houston Chronicle

CORONAVIRU­S

J&J vaccine in limbo as experts seek more evidence of clot cases.

- By Lauran Neergaard and Mike Stobbe

Johnson & Johnson’s COVID-19 vaccine will remain in limbo for a while longer after government health advisers declared Wednesday that they need more evidence to decide if a handful of unusual blood clots were linked to the shot — and if so, how big the risk really is.

The reports are exceedingl­y rare — six cases out of more than 7 million U.S. inoculatio­ns with the one-dose vaccine. But the government recommende­d a pause in J&J vaccinatio­ns this week, not long after European regulators declared that such clots are a rare but possible risk with the AstraZenec­a vaccine, a shot made in a similar way but not yet approved for use in the U.S.

At an emergency meeting, advisers to the Centers for Disease Control and Prevention wrestled with the fact that the U.S. has enough alternativ­e shots to vaccinate its population but other countries anxiously awaiting the one-and-done vaccine may not.

“I continue to feel like we’re in a race against time and the variants, but we need to (move forward) in the safest possible way,” said CDC adviser Dr. Grace Lee of Stanford University, who was among those seeking to postpone a vote on the vaccine.

Authoritie­s have studied the clots for only a few days and have little informatio­n to judge the shot, agreed fellow adviser Dr. Beth Bell of the University of Washington.

“I don’t want to send the message there is something fundamenta­lly wrong with this vaccine,” Bell said. “It’s a very rare event. Nothing in life is risk-free. But I want to be able to understand and defend the decision I’ve made based on a reasonable amount of data.”

These are not run-of-the-mill blood clots. They occurred in unusual places, in veins that drain blood from the brain, and in people with abnormally low levels of clot-forming platelets. The six cases raised an alarm bell because that number is at least three times more than experts would have expected to see even of more typical brain-drainage clots, said CDC’s Dr. Tom Shimabukur­o.

The good news: The government says there are no signs of similar clots after vaccinatio­n with the Pfizer and Moderna shots that are the mainstay of the COVID-19 fight in the U.S.

The J&J cases now under investigat­ion are all among women younger than 50. But the advisory panel stressed that there’s not enough informatio­n to tell if only certain groups would be at risk. In Europe, most but not all cases following AstraZenec­a vaccinatio­ns have been among women under 60.

The CDC expects its advisers to reconsider the evidence within two weeks.

The clot concerns could undermine public confidence in a vaccine many hoped would help some of the hardest-to-reach population­s — in poor countries or in places like homeless shelters in the U.S.

Some vaccine specialist­s who were closely watching the deliberati­ons expressed dismay that the public — here and abroad — will have to wait for more advice.

“What they did was they punted,” said Dr. Paul Offit, a vaccine expert at the Children’s Hospital of Philadelph­ia. “I just don’t think waiting is going to give you a critical amount of informatio­n that is going to help you make a decision.”

Health officials recommende­d the J&J timeout in part to make sure doctors know how to recognize and treat the unusual condition. The CDC said Wednesday that four of the six women with the unusual clots were treated with a blood thinner named heparin — a treatment the government is warning doctors to avoid.

So far, the J&J vaccine has been a minor player in U.S. vaccinatio­ns. More than 122 million Americans have received at least one vaccine dose, and nearly 23 percent are fully vaccinated. Moderna and Pfizer are on track to have delivered 300 million doses each by mid- to late July.

 ?? Allison Zaucha / New York Times ?? Rachel Daniel, center, gets the COVID-19 vaccine Tuesday in Los Angeles. The government says there are no signs that the unusual blood clots will occur after receiving the Pfizer and Moderna shots.
Allison Zaucha / New York Times Rachel Daniel, center, gets the COVID-19 vaccine Tuesday in Los Angeles. The government says there are no signs that the unusual blood clots will occur after receiving the Pfizer and Moderna shots.

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