NOTE:  What I write today is true today. New information is rapidly emerging and updates are forthcoming when relevant.

QUESTION: Can you clarify the pause that was just instituted for the Johnson & Johnson vaccine?

ANSWER: The Johnson & Johnson vaccine may be associated with a one in a million risk of causing a rare blood disorder. The disorder is characterized by simultaneously causing both blood clotting and bleeding. So far in the USA, 7 million people have been vaccinated with the Johnson & Johnson vaccine.

Six women between the ages of 18 and 48 have come down with this disorder, one has died.

Due to an abundance of caution, the FDA and CDC have asked that the Johnson & Johnson vaccine rollout be paused for further analysis.

Along with an independent panel of experts, the Advisory Committee on Immunization Practices, the CDC and FDA expect to be able to make a safety decision in the next few days to week.

It is unclear if there is a vaccine related problem or if it is coincidental, as thousands of people in the general population a year get blood clots or have bleeding issues unrelated to vaccines.

This bleeding disorder, currently named vaccine induced thrombotic thrombocytopenia, has also been seen in Europe with the AstraZeneca vaccine. Both the Johnson & Johnson and AstraZeneca vaccines have a similar design, using an adenovirus as the vector, and mechanism of action.

The AstraZeneca vaccine is yet to be approved in the USA. Initial analysis by European scientists several days ago identified what appears to be the same rare blood disorder in 11 Europeons who received the AstraZeneca vaccine.

QUESTION:  I had the Johnson & Johnson vaccine recently, what do I need to watch out for?

ANSWER: The disorder comes on between one and three weeks after the shot with severe headaches, abdominal pain, leg pain or swelling or shortness of breath.

If you have any of these symptoms seek medical attention immediately. Keep in mind these serious side effects do not come on in the first few days, when the mild symptoms commonly occur such as arm pain, fatigue, muscle aches and headaches.

QUESTION: What is the risk of developing thrombotic thrombocytopenia compared to getting COVID-19 or dying from COVID-19? For the sake of comparison, what is the risk of getting a blood clot related to a commonly prescribed medication such as birth control pills?

ANSWER:  As it is still not clear if there is a cause and effect relationship between the Johnson & Johnson vaccine and thrombotic thrombocytopenia, one needs to review the risk of this extremely rare disorder, one in a million, and the risk of not being vaccinated and getting severe COVID-19 or dying from COVID-19.

As a comparison, millions of women who take birth control pills face a one in a 1,000 chance of getting a blood clot.

You are more likely to be hospitalized or die of COVID-19 than you are to develop a serious blood disorder from being vaccinated with the Johnson & Johnson vaccine. Deaths from COVID-19: 200 in a million in ages 18-49 (Dr. Conners Duke University. based on CDC data.)

INFORMATION:  For more information about COVID-19 and the vaccines, eligibility and appointments, see the links below. Pharmacies will be getting small shipments of vaccines in the near future. Information will be posted in this newspaper and on the county public health web pages.

Pharmacy vaccine resources: Safeway, Salida Pharmacy, Buena Vista Drugs and Valley Wide Health.

QUESTIONS:  

If you have a COVID-19 related question, please send it to pgoetz@themountainmail.com and I will attempt to answer it in the next few weeks.

Dr. Lydia Segal is trying to be a retired board-certified family practice doctor who also has a Masters in Public Health.(In a former life she was a general assignment reporter for a newspaper in Arizona. ) Currently she also co-teaches at the Heart of the Rockies Regional Medical Center with the pelvic physical therapists classes on men’s and women’s health.

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