ST. LOUIS — Missouri and Illinois health officials on Tuesday barred, at least temporarily, the COVID-19 vaccine manufactured by pharmaceutical giant Johnson & Johnson, after federal regulators said they were investigating unusual blood clots in six women who had received the vaccine in the U.S.
In a joint statement Tuesday, the Centers for Disease Control and Prevention and the Food and Drug Administration said the clots occurred 6 to 13 days after vaccination in veins that drain blood from the brain. All six cases were in women between the ages of 18 and 48.
By Tuesday morning, St. Louis-area health care providers were already starting to cancel vaccination appointments or switch them to different vaccine brands. Universities began re-figuring how to vaccinate students.
“With the suspension of the Johnson & Johnson vaccine, the race to get everyone vaccinated will slow down,” St. Louis Metropolitan Pandemic Task Force chief Dr. Alex Garza said in a statement, “thus pushing us farther away from herd immunity.”
More than 6.8 million doses of the J&J vaccine have been administered in the U.S., the vast majority with no or mild side effects.
Missouri Department of Health and Senior Services Director Dr. Randall Williams on Tuesday morning rescinded the health order that allows providers to administer the Johnson & Johnson vaccine. In a statement, Williams said the move was made out of “an abundance of caution.” The Illinois Department of Public Health said it had notified providers throughout the state to discontinue the Johnson & Johnson vaccine for the time being.
The Johnson & Johnson vaccine was authorized by the FDA for emergency use in late February, and provided a boost in health officials’ collective outlook on the pandemic. Still, the vaccines manufactured by Pfizer and Moderna make up the majority of the states’ vaccine supply: Of the 157,000 doses allocated to Missouri this week, 10,600 were Johnson & Johnson. Next week, Illinois was scheduled to receive 483,700 total doses, but just 5,800 from Johnson & Johnson.
In Missouri, about 105,700 doses of Johnson & Johnson vaccine have been administered so far, according to Lisa Cox, spokeswoman for the Department of Health and Senior Services, including around 49,000 doses in the last three weeks. Cox said that there have been no reports of blood clots in patients who received the vaccine in Missouri.
Acting FDA commissioner Dr. Janet Woodcock said during a briefing Tuesday morning that the time frame for the “pause” would depend on what the agency learns in its review, but that it is expected to be “a matter of days.”
Missouri health officials asked providers to keep any on-hand J&J vaccine in storage and label it “quarantine — do not use” until further notice.
Dr. Steven Lawrence, an infectious disease expert at Washington University, said scientists in the coming days will try to determine if the reactions were related to the vaccine.
“Even if this is determined to have a cause-and-effect relationship, it appears to be extremely rare — less than one in a million,” Lawrence said.
People who have received the J&J vaccine in the past three weeks should contact their health care provider if they develop severe headache, abdominal pain, leg pain, or shortness of breath. Patients with other clinical questions should contact their health care provider or call the COVID-19 hotline at 877-435-8411.
CDC’s Advisory Committee on Immunization Practices will meet Wednesday to discuss the cases. “Right now, these adverse events appear to be extremely rare,” said a joint statement issued by Dr. Anne Schuchat, the CDC’s principal deputy director and Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research.
Johnson & Johnson said it was aware of the reports of “thromboembolic events,” or blood clots, but that no “causal relationship” to its vaccine had been established.
In a call with health care providers Tuesday afternoon, Missouri officials said they no longer expected to receive about 10,000 Johnson & Johnson doses next week, as anticipated last week. The state, however, would get more Pfizer and Moderna doses, they said, stabilizing supply at about 157,000 weekly for the next three weeks.
St. Louis County is mainly receiving the Pfizer vaccine, with 7,000 to 9,400 doses coming in weekly. Dr. Faisal Khan, director of the St. Louis County Department of Public Health, told reporters Tuesday afternoon that the county has administered the Johnson & Johnson shot to 1,800 people, and has not received any reports of adverse reactions.
“There is absolutely no reason to panic, no cause for alarm. No reason to question the efficacy and safety of the vaccine,” Khan said.
Khan acknowledged that the suspension of the one-dose vaccine may complicate efforts to vaccinate residents who are homebound, transient or homeless.
The Washington University School of Medicine on Tuesday began rescheduling 500 to 600 upcoming appointments to use the Pfizer vaccine. BJC HealthCare has been using Johnson & Johnson doses mainly in its Farmington and Sullivan locations, and has begun canceling appointments that would have used the vaccine, or substituting them for another brand.
St. Louis University received 3,000 doses of Johnson & Johnson recently, and planned to begin administering them at a clinic on Tuesday.
The university planned to use the one-dose vaccine for students who will be leaving campus at the end of the semester, and will not be in town to receive the second in a two-dose series. On Tuesday the school offered the students the Moderna vaccine instead, and advised them that they can return to the university in 28 days, or plan to receive their second dose elsewhere.
The Associated Press contributed to this report.
Six U.S. recipients have developed a rare disorder involving blood clots. One died. Another is in critical condition.
Experts cite demographic realities of those who were part of the initial rollout but also women’s greater likelihood to seek preventive health care.