Johnson & Johnson shot on hold in state
Arizona health officials follow CDC, FDA recommendations
COVID-19 inoculation plans in several counties across the state were adjusted Tuesday as federal officials reviewed safety concerns about the Johnson & Johnson vaccine.
The Arizona Department of Health Services late Tuesday morning recommended a pause in the use of the vaccine based on federal concerns, though providers may still administer the vaccine, “if they feel it is clinically appropriate after a discussion with their patient,” a department statement says.
At least five Arizona counties have confirmed they will pause use of the Johnson & Johnson vaccine, too.
So far in Arizona,122,000 doses of the Johnson & Johnson vaccine have been administered out of 226,300 doses available in the state, health officials said. A total of more than 4 million doses of COVID-19 vaccine have been administered statewide. The other two COVID-19 vaccines in use are from Pfizer-BioNTech and Moderna.
Health officials in Arizona counties
and at vaccine sites are reworking plans for the week as the federal government recommended a pause in administering the single-shot Johnson & Johnson vaccine to investigate rare, severe blood clots in six individuals who received the vaccine. Some people have searched out the Johnson & Johnson vaccine because it’s just one dose, while the Moderna and Pfizer vaccines require two shots several weeks apart.
For some people, the “one and done” advantage of the Johnson & Johnson vaccine is the best strategy for getting immunized. County health departments have been using the vaccine to vaccinate hard-to-reach groups that may have trouble returning for a second shot, including people who have inflexible work schedules and housing or transportation issues.
Officials in Maricopa, Pima, Navajo, Mohave and Cochise counties said Tuesday that they will suspend administering the Johnson & Johnson vaccine pending more investigation. A free vaccine clinic scheduled for Tuesday at a park in Sedona was canceled because it had planned to administer doses of Johnson & Johnson.
“While the occurrence of this rare blood clot are extremely rare compared to the number of doses of the Johnson & Johnson vaccine administered nationwide, we are following the guidance of the CDC and FDA out of an abundance of caution and we will continue to work with our federal and statewide partners about the status of the vaccine,” Arizona’s health director, Dr. Cara Christ, said in a statement.
Fry’s grocery stores, which have been administering the Johnson & Johnson vaccine at some of its Arizona pharmacies, also paused administration effective immediately, according to Kroger spokesperson Pam Gianno
natti.
Patients scheduled for the Johnson & Johnson vaccine will be offered the Pfizer or Moderna vaccines, or if they’re not available, Kroger will work to reschedule appointments, Giannonatti said.
Walgreens on Tuesday issued a statement that it would be “immediately suspending the administration of the J&J vaccine at our stores and off-site clinics and are awaiting further guidance.”
The pharmacy chain said it would reach out to patients with appointments to reschedule vaccinations from other manufacturers, as supply allows.
An Arizona State University interim dean sent an email to students saying the university would not give the Johnson & Johnson vaccine to students as planned this week or next because of the federally recommended pause.
Similarly, CVS has paused the use of Johnson & Johnson’s COVID-19 vaccine based on the recommendation from federal health agencies and will continue to offer both the Moderna and Pfizer vaccines, corporate spokesperson Monica Prinzing wrote in an email.
CVS will be emailing all customers who have a scheduled appointment to receive a Johnson & Johnson COVID-19 vaccine at a CVS pharmacy to inform them that their appointment is being canceled, the spokeswoman wrote.
Other pharmacy chains that receive doses through a federal program also were expected to pause administering the J&J vaccine.
The Johnson & Johnson vaccine also is known as the Janssen vaccine.
Blood clot incidents
The U.S. Food and Drug Administration and the Centers for Disease Control and Prevention said Tuesday that of the more than 6.8 million doses of the Johnson & Johnson vaccine administered nationwide, six individuals, all women ages 18 to 48, had concerning blood clots that showed symptoms six to 13 days after vaccination.
The CDC’s immunization committee is expected to meet Wednesday to review the cases, and the FDA also will investigate.
“Until that process is complete, we are recommending a pause in the use of this vaccine out of an abundance of caution,” the agencies said. “This is important, in part, to ensure that the health care provider community is aware of the potential for these adverse events and can plan for proper recognition and management due to the unique treatment required with this type of blood clot.”
Federal officials said the reactions “appear to be extremely rare.”
Still, it’s important for people who received the Johnson & Johnson COVID-19 vaccine to be aware of the symptoms of cerebral venous sinus thrombosis blood clots. That’s because treatment of those specific type of blood clots is different from the treatment that typically might be administered, FDA and CDC officials said.
While an anticoagulant drug called heparin is typically used to treat blood clots, in these cases, heparin may be dangerous, and alternative treatments need to be given, according to the federal agencies.
Banner Health, Arizona’s largest health care system, said in a statement on Twitter that the FDA and CDC will provide health care providers guidance after completing their review so that doctors know about possible adverse effects and can plan for the “unique treatment” required by that kind of blood clot.
“These blood clots are very rare; only 1 in more than a million are affected. In addition, while side effects may occur from any vaccination, it is still strongly advised that people continue to receive vaccines,” the statement said. “Health care providers spend a great deal of time preparing for the very rare possibility of severe reactions to vaccines, and are ready to respond to those events if or when they occur.”
Banner Health is pausing administration of the J&J vaccine until the federal reviews as it waits for guidance on how to keep using the vaccine while being prepared for rare blood clots, according to the statement.
If you got the J&J vaccine
People who received the Johnson & Johnson vaccine and get severe headaches, abdominal pain, leg pain or shortness of breath within three weeks of the vaccine should see their doctor or seek medical care, the federal agencies said. These symptoms are different than the short-term side effects people may feel in the days after getting the shot, including headaches or muscle pains.
Christ said Friday that state officials were watching the adverse reaction to the Johnson & Johnson vaccines out of other states, but that she was not aware of anything similar in Arizona.
Arizona this week was expected to receive just 12,000 doses of the Johnson & Johnson vaccine, down from the 101,700 delivered last week, because of manufacturing ebbs and flows, Christ said.
The state has been receiving steadier allocations of the Pfizer and Moderna vaccines.
Maricopa County recommends that vaccine providers pause use of the Johnson & Johnson vaccine “out of an abundance of caution” until the CDC and FDA review the data, according to county spokesperson Ron Coleman.
“The primary goal is to understand all of the information available and to ensure that the health care provider community is aware of the potential for this rare adverse event and can recognize and manage this unique type of blood clot,” Coleman wrote in an email. “It is important for the public to know that this rare blood clot has not been reported following receipt of the Pfizer or Moderna vaccines.”
Maricopa County is working to keep as many scheduled vaccine events running as it can by switching in another available vaccine type, Coleman said.
The county did pause its efforts to vaccinate inmates in county jails with the J&J vaccine after Tuesday’s news. Of the 1,542 COVID-19 vaccines administered in Maricopa County jails as of Monday, 1,358 were J&J and 184 were Moderna.
Pima County similarly chose to temporarily pause use of the J&J vaccine.
The county has administered 24,600 doses of the J&J vaccine since it first arrived in early March, mostly at mobile sites, and there have been no reports of adverse reactions, officials said Tuesday. Pima County health officials plan to switch out J&J appointments for the Moderna vaccine and do not anticipate any appointment or event cancellations.
Cochise County hit pause on dispensing the Johnson & Johnson vaccine, according to County Health Director Alicia Thompson. The county has been using that vaccine for farmworkers.
“This is a pause for further investigation. This is not a recall or removal of the Janssen vaccine from the community,” Thompson wrote in an email. “We will pause until these agencies (CDC and FDA) make a final determination on the safety and use of this vaccine.”
In Mohave County, the Moderna vaccine will be used until ADHS lifts its recommendation to pause use of the Johnson & Johnson vaccine, Mohave County Health Director Denise Burley said in a written statement.
Pharmacies in Mohave County are not scheduling Johnson & Johnson vaccines either, county officials said. Those pharmacies include Walmart, Safeway, Albertsons, CVS, Walgreens, Fry’s/ Smiths and Bashas’/Food City.
Raymond Embry, who is the CEO of Embry Health, said a production glitch with the Johnson & Johnson vaccine already had decreased supply to Arizona prior to the announcement of Tuesday’s pause.
“It’s less of an impact now, simply because of the production issues,” Embry said of the pause. “It’s actually very peculiar timing that this happened literally the week that vaccine inventory has decreased across the country for Johnson & Johnson.”
Embry Health, which provides COVID-19 testing and vaccines across the state, had been administering the Johnson & Johnson vaccine in Mohave County until 7 a.m. Tuesday, when the federal agencies announced the pause. Embry patients in Mohave County scheduled to receive the Johnson & Johnson vaccine were contacted and now will be receiving the Moderna vaccine, Embry said.
Other providers are having to change their plans given the abrupt recommended pause, including Sedona’s cancellation of its free vaccine clinic on Tuesday. Northern Arizona Healthcare has called everyone who had an appointment to inform them of the cancellation, and is giving people with canceled appointments a list of other places where they can get either the Moderna or Pfizer vaccine.
A weeklong vaccination event for people experiencing homelessness in Phoenix had been giving out both the Moderna and Johnson & Johnson vaccines on Monday and had planned to administer more Johnson & Johnson vaccines this week.
But Circle the City, the nonprofit Phoenix-based health care organization operating the event, switched to administering only the Moderna vaccine after Tuesday’s federal recommendation. Maricopa County provided organizers with the extra doses to make sure the event continues.
ADHS recommends that anyone who had appointments to receive the Johnson & Johnson vaccine schedule an appointment for the Pfizer or Moderna vaccine online at azdhs.gov/findvaccine.
At 11 a.m. every Friday, ADHS makes appointments available at state-run sites for the following week. Registration for these and many other sites is available at podvaccine.azdhs.gov or by calling 844-542-8201 between 8 a.m. and 5 p.m. seven days a week.
Both resources offer assistance in English and Spanish.