Pittsburgh-area medical experts split on Johnson & Johnson vaccine pause

At least one Pittsburgh-area medical expert believes it’s a mistake to altogether halt shots of the Johnson & Johnson single dose covid-19 vaccine after six women developed dangerous blood clots and one died.

“Something that is this rare and recognizable and treatable is not something that should derail use of the Johnson & Johnson vaccine, especially in this atmosphere of vaccine hesitancy,” said Pittsburgh-based infectious disease expert Dr. Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security. “People are not going to remember that this was not a major risk. They’re going to remember the bad headline.”

Adalja emphasized that while it’s important to investigate and understand the cases where blood clots occurred, the rare side effect is not something he’s overly concerned about. He pointed out that 6.8 million doses have been administered.

“It doesn’t change my basic opinion of the Johnson & Johnson vaccine — that it’s a safe and efficacious vaccine — and I don’t think that this pause is necessarily the best way to go about understanding what this link may or may not be.”

Following a recommendation by both the Centers for Disease Control and Prevention and the U.S. Food and Drug Administration, the Pennsylvania Department of Health on Tuesday ordered all covid-19 vaccine providers to pause administering doses of the Johnson & Johnson vaccine until at least April 20.

Adalja expressed concern that by calling for a pause, federal and state government might be losing sight of the “big picture” of the vaccines’ effectiveness versus the overall risk factors.

“What ends up happening is the entire risk/benefit calculation kind of gets skewed toward really putting a lot of weight on very rare occurrences. (We’re) forgetting that this whole thing is occurring in the midst of a pandemic where we have record numbers of people dying, where we still have tens of thousands of cases occurring in the United States. The goal is to get vaccines into people’s arms,” he said.

Dr. Patrick Moore, a virologist at UPMC Hillman Cancer Center, served on the Food and Drug Administration scientific committee that approved the earlier covid vaccines. He said he supports pausing the Johnson & Johnson vaccine.

“I think it’s appropriate for the FDA to halt the vaccinations until the scientists there and the CDC and outside agencies can look at the data and be able to tell us how much risk there is from the vaccine, whether there is a risk from the vaccine that’s unknown, and how much benefit we get from the vaccine if we reinstitute vaccination,” Moore said Tuesday.

He said it’s not unheard of to pause a new vaccine.

“Sometimes there are cases where relatively rare events are revealed and they’re sufficiently concerning that vaccine approval is revoked,” Moore said. “In this case, this is a special emergency use authorization and because it’s so important to convince people that the public health people are working in their best interest, they want to make sure that this is as safe as it can be.”

Moore said the clotting is something that occurs from one to three weeks after the Johnson & Johnson vaccine is given.

Moore said he expects the investigation into the link between the single-shot vaccine and the rare blood clots to take at least a week.

Mark Sevco, president of UPMC Children’s Hospital of Pittsburgh, said he also supports pausing the J&J vaccine, and that for anyone who has already received the vaccine, there is no cause for panic.

“It’s really, extremely rare (that blood clots form). They just want to explore and investigate the causal effects of these six women between 18 and 48 who experienced a type of blood clot issue,” said Sevco. “We are in alignment with the pause and will follow those orders.”