The Johnson & Johnson Risk-Reward Calculus
Johnson and Johnson vaccine distribution was put on pause Tuesday after six vaccine recipients developed a rare blood clot disorder. The news comes on the heels of an alarming spike in places like Michigan, reminding us that the pandemic is far from over.
All six were women between 18 and 48 and experienced symptoms between 6 and 13 days after vaccination. The government should exert caution when talking about this issue. Agencies attempted to skirt the narrative by framing the pause as a recommendation—still, every state, including D.C.announced a pause. There’s a risk-reward calculus here that warrants discussion. About 6.8 million people have taken the Johnson & Johnson vaccine, but only six have reported clots. That’s 1 in 1.1 million. For comparison, about 12 in 100,000 Americans die of car crashes every year, and 316 people are shot every day. Should we halt gun sales too? It’s essential to keep these statistics in mind when sounding the alarm over something that creates vaccine hesitancy.
Why the Pause, Then?
Regardless of the statistics, federal agencies still recommended a pause. The CDC and the Food & Drug Administration issued a joint statement.
“CDC will convene a meeting of the Advisory Committee on Immunization Practices (ACIP) on Wednesday to further review these cases and assess their potential significance,” the statement said. “FDA will review that analysis as it also investigates these cases. Until that process is complete, we are recommending a pause in the use of this vaccine out of an abundance of caution. This is important, in part, to ensure that the health care provider community is aware of the potential for these adverse events and can plan for proper recognition and management due to the unique treatment required with this type of blood clot.”
Johnson & Johnson also issued a statement declaring their intent to delay vaccine rollout in Europe. They reiterated that it’s an event that is extremely rare but that those who have taken Johnson & Johnson Covid-19 vaccine should contact a healthcare provider if they experience any of the following: severe headaches, abdominal pain, leg pain, and/or shortness of breath within three weeks after vaccination.
How did Dr. Fauci Respond?
Although the pause may result in vaccine hesitancy, Dr. Fauci explained at a briefing that there was a reason for extra caution. The normal treatment for blood clots, heparin, could exacerbate the disease when administered for this type of clot, known as a cerebral venous sinus thrombosis. Therefore, if the vaccine is attributable to the clots, doctors need to know so they don’t administer the wrong medication.
When speaking with Chris Hayes on MSNBC Tuesday night, Dr. Fauci expressed a more optimistic view that acting “out of an abundance of caution” may decrease vaccine hesitancy. He argued that the FDA’s quick response and prudence could give people confidence that the government takes safety seriously.
Watch Dr. Fauci explain the pause at Tuesday’s press briefing.
Michigan Covid-19 Infection Rate is Surging
The news comes at a time when many states are experiencing surges. Michigan is the new coronavirus hotspot, with cases climbing to higher numbers than they did even during the fall. Cases per million are four times higher than they were in mid-February. Hospitalizations are also increasing, particularly among young individuals. That could be because most older adults are already vaccinated. Vaccine rollout has managed to reach about 70% of that population.
Will this pandemic ever end? Perhaps, but it’s tearing up the country on the way out the door.
What Happens Next?
An expert advisory committee to the CDC decided Wednesday to continue the pause, needing more time to consider the case. They will make a new recommendation within 10 days. Whether or not this will inflame vaccine hesitancy remains to be seen, but I’m not as optimistic as Dr. Fauci. Republicans are too distrustful of government institutions to suddenly appreciate the government doing their due diligence. I hope I’m wrong, but I doubt it. Until then, we should continue to adhere to CDC guidelines when it comes to COVID-19, keep wearing a mask, and get vaccinated.
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