CDC advisers downgrade J&J shot
Panel: Pfizer, Moderna doses don’t have same risk of rare blood clots
Most Americans should be given the Pfizer or Moderna vaccines instead of the Johnson & Johnson shot that can cause rare but serious blood clots, U.S. health advisers recommended Thursday.
The strange clotting problem has caused nine confirmed deaths after J&J vaccinations — while the Pfizer and Moderna vaccines don’t come with that risk and also appear more effective, advisers to the Centers for Disease Control and Prevention said.
It’s an unusual move and the CDC’s director, Dr. Rochelle Walensky, must decide whether to accept the panel’s advice.
Until now the U.S. has treated all three COVID-19 vaccines available to Americans as an equal choice, since large studies found they all offered strong protection and early supplies were limited.
J&J’s vaccine initially was welcomed as a single-dose option that could be especially important for hard-toreach groups like homeless people who might not get the needed second dose of the Pfizer or Moderna options.
But the CDC’s advisers said Thursday that it was time to recognize a lot has changed since vaccines began rolling out a year ago. More than 200 million Americans are considered fully vaccinated, including about 16 million who got the
J&J shot.
New data from unprecedented safety tracking of all those vaccinations persuaded the panel that while the blood clots linked to J&J’s vaccine remain very rare, they’re still occurring and not just in younger women as originally thought.
In a unanimous vote, the advisers decided the safer Pfizer and Moderna vaccines are preferred. But they said the shot made by J&J’s Janssen division still should be available if someone really wants it — or has a severe allergy to the other options.
“I would not recommend the Janssen vaccine to my
family members” but some patients may — and should be able to — choose that shot, said CDC adviser Dr. Beth Bell of the University of Washington.
The clotting problems first came up last spring, with the J&J shot in the U.S. and with a similar vaccine made by AstraZeneca that is used in other countries. Eventually U.S. regulators decided the benefits of J&J’s one-and-done vaccine outweighed what was considered a very rare risk — as long as recipients were warned.
European regulators likewise continued to recommend AstraZeneca’s two-dose vaccine although,
because early reports were mostly in younger women, some countries issued age restrictions.
COVID-19 causes deadly blood clots, too. But the vaccine-linked kind is different, believed to form because of a rogue immune reaction to the J&J and AstraZeneca vaccines because of how they’re made. It forms in unusual places, such as veins that drain blood from the brain, and in patients who also develop abnormally low levels of the platelets that form clots. Symptoms of the unusual clots, dubbed “thrombosis with thrombocytopenia syndrome,” include severe headaches a week or two after the J&J vaccination — not right away — as well as abdominal pain and nausea.
While it’s still very rare, the Food and Drug Administration told health care providers this week that more cases have occurred after J&J vaccinations since the spring. They occur most in women ages 30 to 49 — about once for every 100,000 doses administered, the FDA said.
Overall, the government has confirmed 54 clot cases— 37 in women and 17 in men, and nine deaths that included two men, the CDC’s Dr. Isaac See said Thursday. He said two additional deaths are suspected.
The CDC decides how vaccines should be used in the U.S., and its advisers called the continuing deaths troubling. In comparing the pros and cons of all the vaccines, the panelists agreed that side effects from the Pfizer and Moderna vaccines weren’t as serious — and that supplies now are plentiful.
Nor is J&J still considered a one-and-done vaccine, several advisers noted. The single-dose option didn’t prove quite as protective as two doses of the Pfizer and Moderna vaccines. Plus, with extra-contagious virus mutants now spreading, booster doses now are recommended.
Meanwhile, Penatagon officials said Thursday that the U.S. military services have now begun disciplinary actions and discharges for troops who have refused to get the mandated coronavirus vaccine, with as many as 20,000 unvaccinated forces at risk of being removed from service.
The Marine Corps said it has discharged 103 Marines so far for refusing the vaccine, and the Army said it has reprimanded more than 2,700 soldiers and will begin discharge proceedings in January. The Air Force said earlier this week that 27 airmen had been discharged for refusing the vaccine order. And the Navy laid out its new discipline procedure this week, and has already fired one sailor from his command job for refusing to be tested while he pursues an exemption.
Military leaders have warned for months that troops would face consequences if they did not follow what is considered to be a lawful order to get the COVID-19 vaccine.