PUBLIC HEALTH: City leaders urge against panic after J&J shot paused
State and local health officials paused their use of the Johnson & Johnson COVID-19 vaccine Tuesday, and experts warned against panic over its potential link to a handful of cases involving blood clots.
The temporary moratoriums from Houston and Harris County public health agencies came hours after the Centers for Disease Control and Prevention advised against using the vaccine while it investigates six cases in which women, all aged 18 to 48, developed serious blood clots.
No such complications have been reported in Texas, which has inoculated roughly a halfmillion people with the compa
ny’s single-shot dose.
Doctors and Mayor Sylvester Turner were quick to note that the six cases account for an infinitesimal share of the roughly 6.8 million Johnson & Johnson doses administered nationwide. They warned against panic and said Texans should continue getting vaccinated and wearing masks.
“We’re talking about six people who’ve had complications,” Turner said at a Tuesday morning news conference. “Just in the month of April alone, in the city of Houston, more than 50 people have died from COVID-19. I want to put that in perspective.
“I would be more frightful or fearful of getting COVID,” the mayor added.
Dr. H. Dirk Sostman, president of the Academic Institute at Houston Methodist, echoed that sentiment.
“People focus on these one-ina-million events, and they forget about the fact that your chance of dying from COVID is about 1 in 600,” he said.
The Houston Health Department said it only had about 300 of the doses on-hand, and immediate effects of the pause would be “minimal.”
The Harris County Health Department meanwhile said it would substitute the Pfizer inoculation until further notice, including at the NRG Park supersite.
There are currently more than 60,000 available J&J doses in Harris County, according to state health data.
Texas’ Department of State Health Services also advised all health care providers to pause use of the vaccine.
“Right now, these adverse events appear to be extremely rare and are being further evaluated to ensure vaccine safety,” the agency said in a statement. “People who have received the Johnson & Johnson vaccine who develop severe headache, abdominal pain, leg pain or shortness of breath within three weeks after vaccination should contact their health care provider.”
The CDC’s announcement is likely to cause a hiccup in vaccination efforts in Texas, which as of Tuesday had fully vaccinated 20 percent of its population but still ranks among the worst of all states on a per-capita basis.
Experts also worry the pause could exacerbate vaccine skepticism, which remains high in many parts of the country, including in more rural Texas counties.
Dr. Peter Hotez, dean of Baylor College of Medicine’s National School of Tropical Medicine and co-director of Texas Children’s Hospital Center for Vaccine Development, said he hopes the CDC issues updated guidance within a few days.
Tuesday’s announcement is “not going to help” efforts to persuade people to get vaccinated, he said, but he also thinks there’s reason to be optimistic.
“The most important piece to this is to look at it as the glass being half full,” Hotez said. “The U.S. system is so robust that it picks up rare events. I think it’s a testament to the quality” of the work of the nation’s public health agencies.
Many people had been hoping to get the Johnson & Johnson vaccine because it requires only one dose.
Lisa Anguiano, 30, was scheduled to receive the Johnson & Johnson vaccine at NRG Park on Friday. The pause makes it less convenient to get inoculated before returning to work in early May, said Anguiano, who had been weighing the convenience of the Johnson & Johnson vaccine against the more effective one from Pfizer.
“I kept going back and forth, but was set on the J&J (vaccine),” Anguiano said. “I feel much better receiving the Pfizer after hearing about the news.”
The CDC reported that the six cases all presented with cerebral venous sinus thrombosis (CVST), in combination with low blood platelet levels (thrombocytopenia).
Dr. George Williams, associate professor of anesthesiology and critical care medicine at McGovern Medical School at UTHealth, said CVST is a brain-based blood clot with symptoms similar to a stroke. The clot affects the brain’s ability to drain blood, which creates a backlog of pressure, and can lead to brain swelling and a possible brain hemorrhage.
“It’s a blood clot occurring in the brain, but it’s not a stroke,” Williams said. “It’s really on the other end where the blood is trying to leave the brain, but the exits are blocked.”
The CDC’s announcement prompted some chatter online about possible connections to birth control pills because all of the reported cases have involved young or middle-aged women.
Sostman, of Houston Methodist, said it’s possible birth control pills “could be a factor” but that they were unlikely the main culprit.
He noted that clots have been reported by Europeans who received the AstraZeneca vaccine, which is very similar to the Johnson & Johnson inoculation.
Recent studies of the European cases are “relatively convincing that it is some kind of immunological reaction,” he said. “That would certainly sway you toward it being related to the vaccine in some way.”
But there’s no reason to panic, he said. “You’re much more likely to die in a car crash than you are to have a bad reaction.”