December 16, 2021 – Expert Council advising the CDC on use vaccines said Pfizer and Modern mRNA COVID-19 vaccines Adult injections should be preferred in the U.S. because a Johnson & Johnson injection carries a risk of a rare but potentially fatal side effect that causes Blood clots and bleeding in the brain.
At an emergency meeting Thursday, the CDC’s Advisory Committee on Immunization Practices, or ACIP, unanimously (15-0) voted to favor mRNA vaccines over Johnson & Johnson. After the vote, the panel heard safety information on thrombosis cases thrombocytopenia syndrome or TTS, a condition that causes large clots to consume platelets, resulting in uncontrolled bleeding.
The move brings the United States in line with other rich countries. In May, Denmark withdrew Johnson & Johnson injection from its vaccination program because of this risk. Australia and Greece have restricted the use of a similar vaccine, AstraZeneca, in younger people because of the risk of TTS. Both vaccines use the envelope of another type of virus, called adenovirus, to sneak the vaccine instructions into the cells. On Thursday, health officials said they had determined that TTS was likely due to a class effect, meaning it happens with all adenoviral vector vaccines.
The risk of dying from TTS after Johnson & Johnson injection is extremely rare. It is estimated that there is 1 death for every 2 million doses of vaccine given in the general population. This risk is higher for women aged 30 to 49, increasing to about 2 deaths for every million doses given in this age group. There is no doubt that the Johnson & Johnson shot saved many more lives he took, experts said
However, the committee had previously paused the use of the Johnson & Johnson vaccine in April after the first cases of TTS came to light. That break was lifted just 10 days later, after a new warning was added to the vaccine label to raise risk awareness.
Updating safety information on Johnson & Johnson today, the commission noted that the warning label did not sufficiently reduce the risk of death from TTS. Doctors seem to be aware of the condition because none of the patients who developed TTS were treated with a blood thinner heparin, which can worsen the syndrome. But patients continued to die even after the label was added, the commission noted, because TTS can progress so quickly that doctors simply don’t have time to treat it.
For this reason, and since there are other, safer vaccines, the commission decided to make a so-called preferential statement, saying Pfizer and Modern mRNA should be given priority over Johnson & Johnson.
The statement leaves the J&J vaccine on the market and available to patients at risk of serious illness allergic reaction on mRNA vaccines. It also means that people can still choose the J&J vaccine if they still want it after being informed of the risks.
About 17 million first doses and 900,000 second doses of Johnson & Johnson have been given in the United States. By the end of August, 54 cases of thrombosis with thrombocytopenia syndrome (TTS) occurred after J&J vaccination in the United States. Almost half of them were women aged 30 to 49 years. There were nine deaths from TTS after Johnson & Johnson vaccination.