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UNC health experts weigh in on safety of the Johnson & Johnson vaccine after pause

UNC's first on-campus vaccine clinic opens Wednesday
The first vaccine dose given at UNC’s vaccination clinic is administered in the Student Union on March 31, 2021. As North Carolina began to allow college students to receive coronavirus vaccines, UNC opened a clinic on campus where students can receive the Johnson & Johnson vaccine.

On April 13, the Centers For Disease Control and Prevention and the Food and Drug Administration issued a recommended pause on the Johnson & Johnson COVID-19 vaccine due to a rare and severe type of blood clot reported in six women aged 18 to 48 between six and 13 days after the shot was administered. Over 6.8 million doses of the vaccine had been administered before the pause was announced.

The pause affected UNC's Student Vaccination Clinic, as well as vaccination rollout at UNC Health and across North Carolina. 

We asked some local health experts what this means, and how it will affect vaccine distribution going forward:

UNC experts have said any risk associated with the Johnson & Johnson vaccine seems to be minimal, and that the pause issued April 13 is being used to assess what groups of people are most at risk for any side effects.

The CDC recommends that anyone who has received the Johnson & Johnson vaccine seek urgent medical care if they experience symptoms associated with blood clots, such as a severe headache, new neurological symptoms and severe abdominal pain — among others.

Noel Brewer, a professor in the Department of Health Behavior at UNC Gillings School of Global Public Health who has previously advised the World Health Organization, said these blood clots are rare and most likely will not end use of the vaccine.

"The same system that has approved the vaccines that are currently available has approved this one, and has also put a pause on it," he said. "So we should trust the system. It's what's helping guide all of our vaccines and it's a really good system."

Audrey Pettifor, a professor in the Department of Epidemiology, said blood clots are a much larger issue for people who actually contract COVID-19.

The risk of developing a blood clot is eight to 10 times higher with COVID-19 than with the vaccines that have blood clots as a side effect, an April 15 study led by Oxford University researchers found.

Pettifor also said the chance of getting a blood clot was much higher for people who take birth control or smoke than for people who have taken the Johnson & Johnson vaccine. This point had previously gained traction on Twitter and other platforms.

However, the type of blood clot associated with the Johnson & Johnson vaccine — cerebral venous sinus thrombosis — is different from the types associated with birth control. The type associated with the Johnson & Johnson vaccine occurs in the brain and requires special treatment, according to the CDC.

Dr. Anthony Fauci said Sunday that he expects a decision about the Johnson & Johnson vaccine by Friday. Brewer predicted the vaccine will be brought back into use with recommendations against use for certain subgroups of people.

Brewer also emphasized that the Johnson & Johnson and AstraZeneca vaccines — which have both experienced blood clots as a side effect — are a different type of vaccine than the Moderna and Pfizer vaccines.

"Just because the J&J is having this side effect does not mean that other vaccines will," Brewer said. "So if people are worried about the J&J vaccine for whatever reason, don't get that vaccine, just get another one."

Before the pause, the Carolina Student Vaccination Clinic had been offering the Johnson & Johnson vaccine. Pettifor said people who previously received the Johnson & Johnson vaccine should not be worried.

"We're talking about a one-in-a-million chance right now of this happening to people," Pettifor said. "So especially on campus where a lot of people have had the J&J vaccine, I think most people should feel reassured that they're going to probably be fine."

Whitney Robinson, a professor in the Department of Epidemiology, said she is worried about vaccination appointments being interrupted due to the pause.

"Trying to reschedule it is a big burden for people," she said. "And so that might affect people who have less access more than people who have more resources."

Before the pause, Johnson & Johnson was the only vaccine available in the form of a one-dose shot in the U.S. Robinson said the loss of a one-dose option could affect how equitable vaccine distribution is.

"Some people just have a preference for one shot," she said. "It's easier for them to schedule, it's easier for them to just get done. So when we lose that option, I think that does hurt some of our efforts to have a toolbox that can address people and meet them where they are."

Robinson said she was unsure what type of effect the pause will have on how hesitant people are to get the vaccine.

For now, Pettifor recommends those who were planning on getting the Johnson & Johnson vaccine sign up to receive the Pfizer or Moderna vaccine.

"If you were planning on getting J&J, there's definitely availability of Pfizer and Moderna, which don't have these side effects," Pettifor said. "Hopefully people will continue to get vaccinated if they haven't done so yet with these other vaccines until we know more."


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