Marin suspends J&J vaccine
County follows US guidance after clot reports
Marin County is suspending its use of the Johnson & Johnson coronavirus vaccine while federal officials evaluate whether it is linked to rare cases of blood clots, the county’s public health officer said Tuesday.
Dr. Matt Willis reported the move after regulators with the Centers for Disease Control and Prevention and the Food and Drug Administration recommended that local agencies pause J&J vaccinations.
Willis said the decision was made “out of an abundance of caution.” He noted that there have been only six cases of potential association with blood clots out of nearly 7 million J&J doses administered in the United States.
“It’s so rare, less than one in a million,” he said.
The suspension will have a minimal effect on the county’s drive to vaccinate all its residents, since the county hasn’t been able to get as much of the vaccine as it would have liked, Willis said. The Johnson & Johnson vaccine has accounted for only about 2% of the doses dispensed in Marin. There have been no local adverse reactions to the product reported to date.
Marin is well positioned to comply with the state’s guidance to open eligibility for vaccines to residents of all ages on Thursday, he said.
“For us, it will primarily impact our mobile vaccine operations,” Willis said. “This is the best product for us when we’re out moving into harder to reach communities because it is a one-and-done. We don’t have to do a second visit.”
The county joined the Bay Area and the state in the move. Gov. Gavin Newsom and Biden administration officials insisted the setback announced Tuesday would not significantly limit vaccine supply or delay the loosening of pandemic restrictions.
California’s plan to open eligibility for vaccines to everyone 16 and older on Thursday remains “on track,” Newsom said at a bill signing event Tuesday. Several Bay Area counties have already taken that
step.
Newsom said 8,800 people with appointments to receive Johnson & Johnson shots in the state’s MyTurn system were being switched to Moderna or Pfizer appointments.
The CDC and FDA are investigating the six reported cases of a “rare and severe type of blood clot” among more than 6.8 million people nationwide who received the Johnson & Johnson shot, the agencies said in a joint statement Tuesday morning. The cases involved women between the ages of 18 and 48 whose symptoms occurred six to 13 days after vaccination. One of the women died.
The risk of an adverse reaction for people who received the Johnson & Johnson vaccine more than a month ago is extremely low, according to the CDC. People who got a shot more recently should contact a health care provider immediately if they develop symptoms such as severe headaches, severe abdominal pain, severe leg pain or shortness of breath — these symptoms are different than the usual, minor reactions that some people may experience in the day or two following their vaccination.
Because the Johnson & Johnson vaccine does not need special refrigeration or a second dose, like the Pfizer and Moderna vaccines, it was seen as a key component in the nation’s effort to quickly immunize the population against COVID-19 before new virus
variants render vaccines less effective.
But the J&J shots so far have made up a small share of the vaccine supply. They represent just 3.7% of doses administered nationwide, according to the CDC, and 7.2% of doses the federal government has delivered to California. State epidemiologist Dr. Erica Pan said J&J represented “less than 4% of the state’s allocation this week.”
Willis made his statement about the J&J vaccine during a briefing before Marin supervisors on Tuesday. He also said the county could move into the least restrictive tier of the state’s COVID-19 safety rating system as early as April 20.
Qualifying to move into the least restrictive yellow tier is easier now that California has revised the requirements. Formerly, a county had to lower its rate of new infections below one per 100,000 residents per day to transition to the yellow tier.
However, after the state achieved its goal of administering 4 million doses of vaccine to low-income communities that have been greatly affected by COVID-19, it eased the requirement to two new cases per 100,000 residents per day.
“Our current adjusted case rate is 1.7 cases per 100,000 residents per day,” Willis said.
Counties must post the required numbers for two consecutive weeks before advancing to the next tier.
“So as of today we have
accumulated one week,”
Willis said.
A move into the yellow tier would mean bars and breweries would be allowed to operate indoors for the first time since the advent of the state of emergency, at 50% capacity. Many other businesses would be permitted to increase the capacity of their indoor operations.
Hotels, gyms, fitness centers, wineries, family entertainment centers and card rooms would be able to increase their indoor capacity from 25% to 50%.
Outdoor professional sports stadiums and live outdoor performances would be allowed to increase their capacity from 33% capacity to 67% capacity, and theme parks could boost their capacity from 25% to 35%.
“Even though the yellow tier is less restrictive and creates a sense of relief, employers are also concerned for the health and safety of their employees,” said Joanne Webster, chief executive of the San Rafael Chamber of Commerce. “So some may choose not to open up completely, while others will do so with caution.”
About 68% of Marin’s population over the age of 16 has received at least one dose of vaccine, and 44.6% of the population over 16 is completely vaccinated. More than 90% of residents above age 65 have been completely vaccinated.
Despite these positive developments, Willis said, “It’s important to recognize that we still have a long way togo.”
Willis noted that 35% of Marin’s adults and all of its residents under the age of 16 — or about 20% of the population — remain unvaccinated.
“So that is plenty of room for outbreaks right there,” he said.
Most worrisome is the emergence of COVID-19 variants, some of which are more infectious and potentially more deadly and vaccine resistant.
Marin is having genomic sequencing done on about 5% of its cases. Last week, two of the 15 cases sequenced were identified as the so-called United Kingdom variant, B.1.1.7. The U.K. variant accounts for 5% of COVID-19 cases in California.
“When we talk about the race with the vaccine,” Willis said, “that is the most important factor, keeping ahead of this particular variant.”
The B.1.1.7 variant is believed to be responsible for COVID-19 surges in parts of the eastern United States and Europe.
Willis said the ability of COVID-19 to mutate relatively quickly makes it all the more important to ensure that disadvantaged communities in the U.S. and underdeveloped countries around the globe gain ready access to vaccines.
“Until the entire globe has access,” he said, “we all remain at risk.”