Hot Topics in Public Health

Locally

• DC Health has asked all providers to pause using the J&J vaccine for the time being.
• All appointments between Tuesday and Saturday with the J&J vaccine made through the DC Health portal have been cancelled. 
• Appointments made through the vaccinate.dc.gov portal will be rescheduled and the individuals will be contacted Wednesday evening to set new appointments. 
• Sites using a federal supply of vaccines will have their plans communicated to them through the appropriate federal channel.
• Private pharmacies supplied the J&J vaccine will not have those doses replaced from the District stock.

Nationally

• On April 16, the CDC and FDA announced a pause in the use of the Janssen/J&J vaccine.
• The agencies announced the pause after six (6) cases of cerebral venous sinus thrombosis (CVST) were observed after the J&J vaccine was administered. The CVST was observed in combination with low levels of blood platelets. 
• All six cases were women between the ages of 18 and 48, and symptoms occurred 6-13 days post-vaccination.
• The agencies noted that the usual treatment of these types of blood clots is not advised in these situations.
• The Advisory Committee on Immunization Practices (ACIP) met on Wednesday, April 14. The Committee recommended extending the pause until it meets again between April 14 and 24, when it has more data to consider.
• These 6 cases are among the 6.8 million doses of J&J vaccines administered this year.
• If your patient has extreme pain or shortness of breath within 3 weeks of being vaccinated, they should contact you immediately. Maintain a high index of suspension for symptoms that might represent serious thrombotic events in patients who have received the J&J vaccine. 
• Adverse effects to vaccines should be reported to the Vaccine Adverse Event Reporting System at https://vaers.hhs.gov/reportevent.html.

Takeaways for speaking to your patients:

• Vaccinations are safe.
• If the FDA and CDC confirm the vaccine did cause the clots, you still have only a 1 in 1,000,000 chance of it happening to you. You are less likely to suffer a blood clot from the J&J vaccine than lightning hitting you at the same time a shark eats you.
• This process shows the government is watching the vaccines very carefully, because they are pausing this one vaccine despite very little evidence it is dangerous.
  

Hear more from MSDC member Dr. Lisa Fitzpatrick:

Worried about new info re J&J vaccine? 6 out 7 million not bad for a side effect that was known before now. But the optics are awful! More later. #vaccines #JohnsonandJohnson #coronavirus #COVID19 #clinicaltrials pic.twitter.com/jrBn6pjmb5

— Lisa Fitzpatrick,MD (@askdrfitz) April 13, 2021