New York paused its use of Johnson & Johnson's one-shot COVID-19 vaccine Tuesday in accordance with federal guidance, causing a minor setback to local inoculation efforts. Officials and local experts nevertheless played up the importance of moving forward with the other two vaccines available, from Pfizer and Moderna, so that the state does not lose its momentum.
The Centers for Disease Control and Prevention and the U.S. Food and Drug Administration have reported that six women between the ages of 18 and 48 developed a rare and severe blood clot in the brain six to 13 days after receiving the J&J vaccine. Use of the vaccine was temporarily suspended, and an advisory committee will convene today to review the cases.
Gov. Andrew Cuomo on Tuesday announced that the state would switch to using the doses from Pfizer and Moderna at its vaccination sites. Cuomo added that the state has enough Pfizer and Moderna doses to keep to its schedule.
A state Department of Health spokeswoman noted that more than 535,000 Johnson & Johnson doses have been administered in New York to date. New Yorkers who were anticipating the one-dose shot at state-run sites Tuesday were offered Pfizer shots instead, she said. Of all the state-run sites, only Yankee Stadium had scheduled J&J shots, and those would be back-filled with Pfizer doses as well, she said.
Local experts say there is no need for alarm over the J&J reports.
"The CDC and FDA are recommending a pause, but that isn't saying the vaccine caused the blood clots," said Dr. Bruce Y. Lee, professor of health policy and management at the CUNY Graduate School of Public Health. "It's important to keep in mind only six out of 6.8 million people had these blood clots, and they could be coincidence."
Dr. Jeffrey Laurence, professor of medicine in the division of hematology-oncology at Weill Cornell Medicine, said these problems are similar to those reported in Europe with AstraZeneca's vaccine, which uses a similar adenovirus technology. However, what is not clear is who might be predisposed to developing this reaction.
"The only thing we know is it has only happened to women at this point," Laurence said.
Pfizer's and Moderna's vaccines, which use mRNA technology, have not been known to show such blood clotting risks, Laurence added.
That is not to say J&J vaccines should be thrown out in vaccination efforts, Lee said.
The J&J vaccine has its advantages: It does not require ultra-cold storage, unlike the Pfizer vaccine, and it requires only one dose, Lee noted.
"This vaccine really opened up access for many populations that might otherwise have had difficulties getting vaccinated," he said.
These include lower-income communities that cannot take too much time off to get the vaccine, the elderly and those with conditions that leave them homebound, Lee said. "Having to pause J&J will really affect things like mobile vaccine programs that only have to deliver the vaccine once and will disproportionately affect these groups," he said.
The city had launched a vaccination program for the homebound elderly in March, bringing the one-dose Johnson & Johnson vaccine to seniors' homes. When asked about the status of the program with the doses paused, a spokesman referred to Mayor Bill de Blasio's Tuesday press conference, in which the mayor said new appointments are being scheduled for everyone who was to take the Johnson & Johnson vaccine.
To maintain the city's momentum, it is key to communicate to the public that vaccination is still safe, Lee said. And being able to develop a risk profile for the J&J vaccine might be a good start, Laurence said.
"The risk of getting COVID-19 by not getting vaccinated, that is so much higher than this 1-in-a-million chance of getting blood clots," Lee said.