In-Depth: UC San Diego expert weighs impact of unpausing the Johnson & Johnson vaccine

Johnson and Johnson vaccine
Posted at 5:04 PM, Apr 23, 2021
and last updated 2021-04-23 21:13:58-04

SAN DIEGO (KGTV) -- Federal health agencies lifted the 11-day pause on the Johnson and Johnson vaccine Friday after a panel of advisers to the Centers for Disease Control and Prevention voted to recommend continued use of the life-saving shots despite a handful of reports of serious blood clots.

The vaccines will carry a new warning about the risks of a rare blood clotting disorder called thrombotic thrombocytopenia detected in 15 people, primarily in women under the age of 50. The CDC estimates the highest-risk group is women in their 30s, with 11.8 cases per million doses.

After hours of presentations on the cases Friday, the CDC’s panel of outside health experts determined the public health benefits of the one-dose vaccine vastly outweigh the rare risk of complications.

Over the next six months, the CDC projects the J & J vaccine will prevent 1,435 COVID-19 deaths and 2,236 ICU admissions. The agency estimates there will be another 26 cases of these rare clots with low platelet counts over the next 9.8 million doses.

“It's crystal clear to me that the risks of the vaccine are far less than the public health risks of COVID running rampant through our communities,” said Dr. Gary Firestein, Senior Associate Vice Chancellor of Health Sciences at UC San Diego, who was not involved in the CDC vote.

After federal health agencies recommended a pause on the vaccine last week, regulators found 9 new cases of these rare clots with low platelet counts, bringing the total to 15.

All 15 cases involved women, primarily women in their 30s. Three of the women died. Seven remain hospitalized.

There have been nearly 8 million doses of the J & J vaccine administered in the U.S. so far.

“There are no 100 percent safe therapies or vaccines. It always comes down to risks versus benefits,” said Dr. Firestein. “Even with some of the issues that have been raised, we've lost more than a half a million Americans in the last year” to COVID-19.

Many doctors have pointed out that COVID-19 itself causes blood clots at an alarming rate. About 20 percent of people infected with the virus develop clots, according to a study by researchers at UC San Diego.

But the rare kinds of clots linked to the J & J vaccine, which have occurred primarily in the brain and accompany low platelet counts, have caused concern because they’re similar to ones connected to the AstraZeneca vaccine.

That vaccine uses the same viral vector technology, but is not available in the U.S.

Many countries including the UK, Australia, Germany and France have added age restrictions on the AstraZeneca jab, restricting its use in younger people. But the CDC’s advisory panel decided not to do that with J & J.

“Based on the comparative risk, it’s much lower in J&J overall than what we know about AstraZeneca so far,” said Dr. Peter Chin-Hong, an infectious disease expert at UC San Francisco.

Dr. Chin-Hong said the nationwide pause was useful to fully investigate the clots and warn physicians.

“We’ve become better at recognizing these super rare events and most importantly, we have a better paradigm for treating them,” he said.

But other experts worry about lasting damage to public confidence in the J & J vaccine.

“If the agency wanted to warn doctors, I think there were better ways to do it,” said Dr. Firestein.

There have been zero cases of these rare clots with low platelet counts linked to the Pfizer and Moderna vaccines after nearly 200 million doses administered.