Sabrina Xie / Sun Graphics Staff

As the safety of the Johnson & Johnson vaccine is called into question, experts urged students to seek out the Pfizer-BioNTech and Moderna vaccines.

April 14, 2021

Tompkins County Will Pause Distributing the Johnson & Johnson Vaccine. Experts Say It’s the Right Precautionary Call.

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As college students flock to vaccination sites across upstate New York, some students in Tompkins County saw their plans fall apart Tuesday — the local health department canceled its College Student Vaccination Day that planned to administer the Johnson & Johnson vaccine. 

The Centers for Disease Control and Prevention and the Food and Drug Administration paused the distribution of the Johnson & Johnson vaccine Tuesday out of an “abundance of caution,” following six cases of blood clots in women who received the vaccine. Within hours, New York, the State University of New York and Tompkins County followed suit.

Cornell told students Tuesday afternoon that the county would reschedule the event planned to vaccinate college students with the now-suspended vaccines.

“While it is unfortunate that Thursday’s event has been cancelled, we encourage you to continue to seek vaccination through the TCHD COVID-19 Vaccine Registry or by visiting the New York state site registry,” the email read. “It is important to note that this pause is specific to the Johnson & Johnson COVID-19 vaccine. Of note, Pfizer and Moderna vaccines have not been associated with the potential complication currently being evaluated in the Johnson & Johnson vaccine.”

While the pause in distribution will mean that some students will wait longer to get vaccinated, which increases their risk of contracting COVID, experts say that the federal agencies made the right call to pause distribution.

In an email to The Sun, Tompkins County Health Department said that it was slated to administer 1,400 vaccinations to Cornell, Ithaca College and Tompkins Cortland Community College students on its vaccination day. 

The Tompkins County Health Department will wait on further guidance from the CDC and FDA before they distribute the single-dose vaccine again, according to Dominick Recckio, the communications director for Tompkins County. None of the 1,400 doses marked for Thursday’s college vaccination event were defrosted — meaning they will still be viable for the next three weeks. 

Dr. David Evelyn, the vice president of medical affairs at Cayuga Medical Center, said this development is just a juncture in the vaccination long-haul.

When the Johnson & Johnson vaccine was first brought to market, state and local health departments decided who should get two dose vaccines and who should get the one dose. The state initially prioritized the one-dose vaccine for college students because of its convenience — offering students constrained by time and access to transportation a one-and-done option.   

A vial of the Johnson & Johnson COVID-19 vaccine in Jersey City, N.J., in March. The single-dose vaccine was used to target populations that could not as readily travel to vaccine clinics.
Bryan Anselm/The New York Times

As Evelyn encouraged students to sign up for Pfizer and Moderna vaccinations in the meantime, immunology and virology experts said suspending Johnson & Johnson distribution was the right decision — the pause will allow for the federal agencies to fully understand the risk of the vaccine and provide the public a sense of security that any and all concerns are being addressed.  

“My view is that [pausing distribution] was the right thing to do just to be sure. The public needs to have confidence that these risks are not being ignored,” said Prof. Gary Whittaker, virology. “Hopefully it’s temporary, but it’s kind of a necessary thing for right now.”

The odds of developing a blood clot from the Johnson & Johnson vaccine is rare. With more than 7 million people being fully vaccinated with the Johnson & Johnson vaccine already in the U.S., the chance of developing a blood clot stands at around one in a million.

The blood clot — known as cerebral venous sinus thrombosis — blocks blood flow out of the brain and causes blood to spill into the brain’s tissue according to Johns Hopkins Medicine. Still, Whittaker said the overall risk of adverse side effects from a vaccine is low.

Prof. Gary Whittaker at a COVID-19 Panel in March, 2020
Michael Wenye Li/Sun File Photo

“One in a million is a pretty low risk, but it is a risk. And if anything, the FDA can’t ignore it,” Whittaker said. “To me, the risk of getting COVID and getting a clot based on that is far higher than the risk of getting it from a vaccine. But different people have to be aware of that risk and be able to make their own decision.” 

Whittaker also pointed out that all six blood clot cases have been in young women, a group that already balances the much higher risk of a different type of blood clot with oral contraceptives. 

According to the CDC, the risk of blood clots from taking birth control pills is in the range of one in 1,000. This risk is around 1,000 times the number of individuals who have gotten blood clots after taking the Johnson & Johnson vaccine. 

“We accept the risk for oral contraceptives causing these blood clots … Where do we draw the line with the vaccine?” Whittaker said. “People really want [vaccines] to be completely safe. We do a lot of work to make sure they really are safe, but nothing is ever risk free in life.”

Beyond assessing levels of risk, Prof. John P. Moore, immunology and microbiology, said federal regulations are meant to foster public trust in vaccines — meaning agencies investigate concerns of severe illness and communicate their findings.

“How do you maintain confidence in vaccines? You deal with events as they arise, and you don’t ignore them, and you investigate them and you try to understand them. Then you issue new guidance. Think what would happen if there were multiple cases of serious adverse events and CDC and FDA did nothing. There would be an outcry.”

John P. Moore

Evelyn said pausing the distribution of the Johnson & Johnson vaccine was the correct decision, but said students who have received the vaccine or are signing up for vaccinations should remember that having a blood clot is unlikely. 

People who have already received the vaccine should see a doctor if they have neurological symptoms — like twitching or paralysis — and should keep an eye out for stroke-like symptoms, Evelyn said. These include issues with speech, blindness and severe headache.

But experts don’t know exactly why the Johnson & Johnson vaccine is causing blood clots for a small fraction of those who have received it. Whittaker and Moore suggested the platform — the mechanism used to give an individual immunity — used in the vaccine, called an adenovirus, could be causing these symptoms.

Moore said the connection between the two adenovirus vaccines — Johnson & Johnson and AstraZeneca — can provide insight into what is causing life-threatening side effects, and Prof. Cynthia Leifer, immunology, pointed out that the Johnson & Johnson vaccine is made similarly to the AstraZeneca vaccine, which has also been paused in Europe because of concerns about blood clots.

“It’s not proof, but it’s certainly a breadcrumb in the trail to understanding what’s going on,” Moore said.

Despite uncertainty about the adenovirus vaccines, all four experts agreed to temporarily lean on the Pfizer-BioNTech and Moderna vaccines, which use mRNA — strands of genetic code that teach the immune system how to detect SARS-CoV-2. 

“I hope that people understand that the safety of the other two available vaccines is not in question,” Leifer said. “The Moderna and Pfizer vaccines are made differently. There are currently no concerns about blood clotting disorders with those vaccines.”