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How Johnson & Johnson vaccine pause impacts Virginia's vaccination effort

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RICHMOND, Va. -- The leader of Virginia's COVID-19 vaccination effort said the state was "closely monitoring" the situation involving Johnson & Johnson vaccinations.

The U.S. government on Tuesday recommended a “pause” in the administration of the single-dose Johnson & Johnson COVID-19 vaccine to investigate reports of potentially dangerous blood clots.

"In Virginia, we will cease all Johnson &Johnson vaccines until this investigation is complete," Virginia State Vaccination Coordinator Dr. Danny Avula said in a written statement provided to the media. "If you have an upcoming appointment for the Johnson & Johnson vaccine, you will be contacted to reschedule that appointment."

In a joint statement Tuesday, the Centers for Disease Control and Prevention and the Food and Drug Administration said they were investigating unusual clots in six women that occurred 6 to 13 days after vaccination.

The clots occurred in veins that drain blood from the brain and occurred together with low platelets.

All six cases were in women between the ages of 18 and 48.

The reports appear similar to a rare, unusual type of clotting disorder that European authorities say is possibly linked to another COVID-19 vaccine not yet cleared in the U.S., from AstraZeneca.

"This pause is reassuring in that it demonstrates that the systems that are in place to monitor vaccine safety are working," Avula's statement continued. "We look forward to a thorough review by federal health officials. Meantime, we will continue Virginia’s vaccine rollout at this time with the other two authorized vaccines, developed by Pfizer and Moderna."

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Dr. Danny Avula gets Johnson & Johnson's Janssen COVID-19 vaccine at the Richmond Raceway.

New Kent County announced they will not have a Johnson & Johnson vaccination clinic on Friday, April 16 like they originally planned.They said if you had an appointment, you will be contacted to reschedule.

Organizers of the mass vaccination clinic at Richmond Raceway said it did not have any Johnson & Johnson vaccine on-site to distribute.

Those leading the Crater Health Dstrict vaccine site at Tabernacle Baptist Church in Petersburg said they would switch to the Moderna vaccine, which it had on hand.

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.

U.S. federal distribution channels, including mass vaccination sites, will pause the use of the J&J shot, and states and other providers are expected to follow. The other two authorized vaccines, from Moderna and Pfizer, make up the vast share of COVID-19 shots administered in the U.S. and are not affected by the pause.

CDC's Advisory Committee on Immunization Practices will meet Wednesday to discuss the cases and the FDA has also launched an investigation into the cause of the clots and low platelet counts.

“Until that process is complete, we are recommending a pause in the use of this vaccine out of an abundance of caution,” Dr. Anne Schuchat, principal deputy director of the CDC, and Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, said in a joint statement.

They are recommending that people who were given the J&J vaccine who are experiencing severe headache, abdominal pain, leg pain, or shortness of breath within three weeks after receiving the shot contact their health care provider.

U.S. health authorities cautioned doctors against using a typical clot treatment, the blood-thinner heparin. “In this setting, administration of heparin may be dangerous and alternative treatments need to be given,” the FDA and CDC said.

European authorities investigating the AstraZeneca cases have concluded clots appear to be similar to a very rare abnormal immune response that sometimes strikes people treated with heparin, leading to a temporary clotting disorder.

Officials say they also want to educate vaccine providers and health professionals about the “unique treatment” required for this type of clot.

Johnson & Johnson said it was aware of the reports of “thromboembolic events,” or blood clots, but that no link to its vaccine had been established.

“We are aware that thromboembolic events including those with thrombocytopenia have been reported with Covid-19 vaccines," said Johnson & Johnson in a statement. "At present, no clear causal relationship has been established between these rare events and the Janssen Covid-19 vaccine.”

The J&J vaccine received emergency use authorization from the FDA in late February with great fanfare, with hopes that its single-dose and relatively simple storage requirements would speed vaccinations across the country. Yet the shot only makes up a small fraction of the doses administered in the U.S. as J&J has been plagued by production delays and manufacturing errors at the Baltimore plant of a contractor.

Last week the drugmaker took over the facility to scale up production in hopes of meeting its commitment to the U.S. government of providing about 100 million doses by the end of May.

Only about 9 million of the company's doses have been delivered to states and are awaiting administration, according to CDC data.

Until now concern about the unusual blood clots has centered on the vaccine from AstraZeneca, which has not yet received authorization in the U.S. Last week, European regulators said they found a possible link between the shots and a very rare type of blood clot that occurs together with low blood platelets, one that seems to occur more in younger people.

The European Medicines Agency stressed that the benefits of receiving the vaccine outweigh the risks for most people. But several countries have imposed limits on who can receive the vaccine; Britain recommended that people under 30 be offered alternatives.

But the J&J and AstraZeneca vaccines are made with the same technology. Leading COVID-19 vaccines train the body to recognize the spike protein that coats the outer surface of the coronavirus. But the J&J and AstraZeneca vaccines use a cold virus, called an adenovirus, to carry the spike gene into the body. J&J uses a human adenovirus to create its vaccine while AstraZeneca uses a chimpanzee version.

The announcement hit U.S. stock markets immediately, with Dow futures falling almost 200 points just over two hours before the opening bell. Shares of Johnson & Johnson dropped almost 3%