Va. woman died, was among 6 who experienced blood clots from J&J vaccine

The coordinator of Virginia’s vaccination program on Tuesday said that a woman in the commonwealth had died from the effects of the Johnson & Johnson vaccine, one of six who experienced clots that prompted a federal investigation.

Dr. Danny Avula said during a conference call Tuesday afternoon that he didn’t know where in Virginia the woman, who died in mid-March, lived. However, the Virginia Department of Health said in a statement to WTOP that the Centers for Disease Control and Prevention confirmed the woman was the one fatality listed on its database of adverse vaccination effects.

Avula also outlined some of the effects that the pause on the Johnson & Johnson vaccine would have on Virginia, the thought processes behind the recommendation and what people who have received the one-shot vaccine should look out for.

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  • Q: How long will this last?
  • The pause on vaccines may or may not last long, Avula said; Dr. Anne Schuchat, the deputy director of the CDC, told him it would be “days to weeks” while they look into the data, but he emphasized “This could be just a couple of days.” The CDC’s Advisory Committee on Immunization Practice will meet Wednesday afternoon to go over the relevant data, and more will be known on when and whether the recommendation will be lifted after that.

  • Q: What might happen then?
  • It’s possible, he said, that the Johnson & Johnson vaccine will no longer be recommended for people with the conditions of the six women (who are all ages 18 to 48). It’s also possible that medical providers will be advised not to prescribe the common treatment heparin for people who have gotten the J&J vaccine. Again, he said, more will likely be known late Wednesday, after the CDC commission meets.

  • Q: What does this mean for Virginia’s vaccination efforts?
  • Meanwhile, Virginia was slated to give out about 72,000 doses of the Johnson & Johnson vaccine this week at about 30 events, Avula said. Some of those doses will be switched to first doses of the two-shot Moderna and Pfizer vaccines, while some will be rescheduled, he said.

    The impact is “not insignificant,” given that about 15% of the doses scheduled for this week in Virginia were Johnson & Johnson. But enough of the other vaccines remain that he foresaw no problems meeting the commonwealth’s goal of moving into Phase 2 (full public eligibility) April 18, or President Joe Biden’s goal for every adult who wants to be vaccinated to get a shot by the end of May.

    That said, it might slow down Virginia’s efforts at moving through Phase 2 once it begins.

    “We will not be able to have quite as many appointments available for first doses” in the next week or so, he said.

    Still, he foresaw no problems — in most places in Virginia, there’s more vaccine out there than there are people who want to take it. And while that’s not true in the very populous area of the state near D.C., he said, more large-scale community clinics are on the way.

  • Q: Why did the CDC and FDA make this move for such a rare event?
  • While the blood clotting and stroke-like symptoms – called thromboembolic events – that led to the recommendation to pause Johnson & Johnson vaccines were extremely rare – six known cases out of 6.8 million people who have been vaccinated — Avula said, the “concerning pattern of medical conditions” led the authorities to issue the recommendation.

    “It’s pretty rare to have that kind of a stroke with a low platelet count,” Avula said. The recommendation was spurred by “not the frequency, but the establishment of the pattern.”

    He also said that the pause on vaccines would give people more faith in the system. “The CDC surveillance system is doing exactly what it’s supposed to do. … Everybody recognizes how important public trust is in the process, in the government. I think they were very conservative about the decision because they know we need to maintain public trust.”

  • Q: I got the J&J vaccine. What should I be looking out for?
  • The onset of the cases so far happened within six to 13 days after the vaccination, Avula said. “Anyone who’s more than a month out of their vaccination is likely at very minimal risk.”

    If you’re in that 6- to-13-day zone, he said, look out for severe, acute-onset headaches, abdominal pain or leg pain. If you feel any of those symptoms, seek medical attention immediately.

    About 184,000 Virginians have gotten the Johnson & Johnson shot.

  • Q: What about the Moderna and Pfizer vaccines?
  • They work on a “completely different platform,” in a completely different way than the Johnson & Johnson shot, Avula said, and there haven’t been any reports of the same kind of problem.

    Johnson & Johnson is “an adenovirus vector – it uses the shell of another common cold virus,” Avula said.

  • Q: Is this a total ban?
  • It isn’t, Avula said. Local providers might look at patients who are particularly vulnerable and particularly suited for the one-shot vaccine due to their health conditions, age or job and say it’s worth the risk.

    About 10% of the population of the U.S. has had COVID-19, and about 1 in 585 of those have died, Avula said. “When you look at that, six [cases] out of 6.8 million is really rare. … There probably will be cases where local providers will decide to continue using it.”

  • Q: Why wasn’t this caught in the clinical trials that led to the approval of the J&J vaccine?
  • Because those tests are run on a large scale, but not as large as the 6.8 million shots that have been given out so far. “It didn’t show up on the scale of tens of thousands,” Avula said.

Rick Massimo

Rick Massimo came to WTOP, and to Washington, in 2012 after having lived in Providence, R.I., since he was a child. He went to George Washington University as an undergraduate and is regularly surprised at the changes to the city since that faraway time.

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