Missouri to immediately pause use of Johnson & Johnson vaccine after rare blood clots

A vial of the Johnson and Johnson vaccine.

Missouri will pause use of the Johnson & Johnson vaccine as recommended by federal authorities who are investigating six instances of blood clots that have arisen after its use.

The Centers for Disease Control and Prevention and the Food and Drug Administration issued the recommendation Tuesday morning “out of an abundance of caution.”

Shortly after, Randall Williams, director of the Missouri Department of Health and Senior Services, issued an order barring the vaccine’s administration effective immediately.

“In an abundance of caution and as per federal guidelines, we are pausing vaccination with Johnson & Johnson’s Janssen vaccine until further notice in Missouri,” Williams said in a statement.

Vaccine providers are asked to appropriately store any Johnson & Johnson vaccine on hand and label it “quarantine-do not use” until further notice, according to a news release from DHSS.

According to Jennifer Bethurem, Lake Regional Health System's Vice President of Public Relations and Marketing, the J&J vaccine was administered at the mass vaccination event held March 7 at School of the Osage.

"Because the event occurred more than five weeks ago, we believe individuals who were vaccinated at the event are now outside of the window of concern," Bethurem said.  "Individuals who had appointments to receive the J&J vaccine at Lake Regional clinics in the coming weeks have been rescheduled to receive the Moderna vaccine."

Bethurem said right now, the adverse events appear to be extremely rare. As of April 12, more than 6.8 million doses of the Johnson & Johnson vaccine have been administered in the United States. The CDC and FDA are reviewing data involving six reported U.S. cases of a certain type of blood clot in individuals after receiving the J&J vaccine. All six were women between the ages of 18 and 48, and symptoms occurred 6 days to 13 days after vaccination.

Symptoms to watch for include severe headache, abdominal pain, leg pain or shortness of breath within three weeks after vaccination.

If you believe you have had a reaction after receiving the COVID-19 vaccine, please contact your health care provider or call the state’s COVID-19 hotline at 877-435-8411.

Lake Regional will continue to post updates at lakeregional.com/vaccine.

Meanwhile, Missouri already anticipated seeing hundreds of thousands of fewer vaccine doses this week, with 77,900 fewer of the one-dose Johnson & Johnson vaccine. Tuesday’s pause may further delay vaccination clinics as the state faces a smaller supply.

As of Monday, Missouri providers have administered 105,721 doses of the Johnson & Johnson vaccine, said Lisa Cox, a spokeswoman for DHSS.

Out of 6.8 million doses of the Johnson & Johnson vaccine administered in the U.S., the CDC and FDA are reviewing six cases of a rare blood clot after receiving the vaccine. The blood clot, known as cerebral venous sinus thrombosis, was present with low levels of blood platelets in women between 18 to 48 years old, according to a joint statement by Anne Schuchat, the CDC’s principal deputy director and Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research.

Symptoms occurred six to 13 days after the vaccine was administered, and must be treated with alternatives other than the typical anticoagulant drug called heparin, according to the statement. Similar symptoms have not been reported following use of Pfizer or Moderna’s vaccines, federal officials said during a press briefing Tuesday morning.

Janet Woodcock, the acting FDA commissioner, said while officials have not identified a definitive cause, their leading hypothesis is that after receiving the Johnson & Johnson vaccine, a person’s immune response can involve their own platelets which can cause the issue.

While instances of severe blood clots were extremely rare, federal officials said the decision was necessary to ensure that healthcare providers could begin to diagnose, treat and report any effects while analyses are underway.

The pause is recommended until the CDC can convene a meeting of the Advisory Committee on Immunization Practices Wednesday for further review. The FDA will then review that analysis as it investigates, according to a news release.

“We anticipate having more information shortly to make further decisions about overall vaccine distribution in light of this new development and will continue to update citizens who have been vaccinated with the J&J vaccine after the advisory committee meets at the federal level tomorrow,” Williams said.

People who develop severe headache, abdominal pain, leg pain or shortness of breath within three weeks after receiving the Johnson & Johnson vaccine should contact their health care provider, who are asked to report any adverse effects. Missourians may also contact the COVID-19 hotline at (877) 435-8411.