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5 Doctors Explain Why the Johnson & Johnson Pause Was Necessary

Johnson & Johnson COVID vaccine.

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Key Takeaways

  • This week, U.S. health officials recommended a pause in the administration of the Johnson & Johnson COVID-19 vaccine due to the development of 6 rare cases of a severe blood clot.
  • Doctors say this pause is necessary for fueling trust in the vaccines, informing providers, and evaluating risk for different groups of people.

On April 13, the Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) recommended a temporary pause on the administration of the Johnson & Johnson COVID-19 vaccine while health officials investigate six reports of a rare and severe blood clot. 

Six female recipients of the vaccine, between the ages of 18 and 48, developed cerebral venous sinus thrombosis (CVST), a type of clot that prevents blood from draining out of the brain. The CDC met with its Advisory Committee on Immunization Practices (ACIP) on Wednesday, April 14, to review the six rare cases and come to an official recommendation. They have not yet lifted their pause. 

This pause, while a demonstration of caution and prioritization of safety from the FDA and CDC, has understandably raised some concern among those who’ve received the shot or were slated to. On social media, many have taken to hypothesizing about whether this pause will breed mistrust and hesitancy toward the vaccines—which has been a top concern among health officials since the beginning of the vaccine rollout.

But doctors are clearing the air, offering explanations about why this pause is important and necessary, and what the next steps may look like for Johnson & Johnson. Here are a few of their most helpful points. 

What This Means For You

If you've received the Johnson & Johnson vaccine, your risk of developing severe blood clots is very low. But just in case, monitor yourself for specific symptoms in the three weeks following vaccination, including severe headache, abdominal pain, leg pain, and shortness of breath.

A Pause Helps Providers React Appropriately

The FDA and CDC messaging is crucial for informing providers about CVST and what to look out for in patients, according to Craig Spencer, MD, MPH, a New York City ER doctor and director of Global Health in Emergency Medicine at Columbia Medicine. He describes how the news helped inform his own diagnosis of a young female patient he saw this week who recently received the Johnson & Johnson vaccine.

Doctors Have Guidance to Get Side Effect Treatment Right

Céline Gounder, MD, ScM, FIDSA, an infectious diseases specialist at NYC Health and a clinical assistant professor of medicine at NYU Grossman School of Medicine, points out that a typical blood thinner given by providers for clotting, heparin, can actually do more harm than good for CVST. Arming doctors with that knowledge may help keep any additional cases that develop from going down a dangerous path.

We're Learning More About Risk

While the cases of this severe blood clot are extremely rare (less than 0.0001% of cases), the risk may not be equal for all groups of people, Megan Ranney, MD, MPH, an emergency physician and director of the Brown-Lifespan Center for Digital Health, explains. Studies have shown that the risk of CVST may be higher in younger women when compared to the rest of the population, although as of right now, there's no information to show that experiencing CVST from a vaccine is linked to any sort of trait or a certain age range.

Dismissing Risk Fuels Mistrust

Ashish K. Jha, MD, MPH, physician and dean of the Brown University School of Public Health, argues that the pause may actually increase the general public's trust in the vaccines. An abundance of caution, he says, will show that the FDA and CDC are taking vaccine safety seriously, and are willing to back up this sentiment with actions.

Experts Can Re-think Distribution Methods

Many doctors including, Jeremy Faust, MD, MS, an emergency physician at Brigham and Women’s Hospital and an instructor at Harvard Medical School, are calling for the CDC and FDA to lift their pause, with some age restrictions in place. Faust points out that it's likely safe to resume vaccination for everyone over 50 and men of all ages.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.

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  1. Johns Hopkins Medicine. Cerebral venous sinus thrombosis (CVST).

  2. Bajko Z, Motataianu A, Stoian A, et al. Gender differences in risk factor profile and clinical characteristics in 89 consecutive cases of cerebral venous thrombosis. J Clin Med. 2021 Mar 30;10(7):1382. doi: 10.3390/jcm10071382