COVID-19: J&J update Thursday, April 15th

Another update for those who recently got the J&J vaccine.

I want to keep you abreast of what we know. As you have most likely heard, the CDC advisory committee met yesterday and reviewed the situation. They determined that they did not have enough information to make an evidence-based recommendation and therefore would continue to "pause" until they had more information. This is anticipated to be anywhere from 7-10 days. During this time they anticipate more cases will emerge. Waiting was wise. They are getting some flack for this decision but it was absolutely the right decision. While they don't have a lot of information, here is what they do know:

"The six cases were in white women ages 18-48 with few common risk factors. Their median age was 33, with a median time to symptom onset of 8 days after vaccination. No patients were pregnant or postpartum, and only one was on oral contraceptives.

Three patients were obese, one had hypothyroidism, one had hypertension, and one had asthma. None had known coagulation disorders. Five of six cases had a headache as an initial presenting feature. Late presentations included severe headache or abdominal pain. In four of the six, thrombocytopenia was severe. Three of the six cases involved thromboses not limited to the cerebral venous drainage system (in the brain), including two occurring in the portal vein" (a vein in the liver and GI tract). Thus the advice about abdominal pain. You can read a full synopsis here: https://www.medpagetoday.com/meetingcoverage/acip/92101?xid=nl_covidupdate_2021-04-15&eun=g1689689d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=DailyUpdate_041521&utm_term=NL_Gen_Int_Daily_News_Update_active

There is an FDA and CDC call that you can listen to where they have a discussion and answer questions: https://www.youtube.com/watch?v=_ELXnGYgsJY

The AstraZeneca vaccine was found to have a causal effect in the blood clots associated with their vaccine. I fully anticipate that the same connection will be found with the J&J one. Two studies were published in the New England Journal of Medicine on the AZ vaccine effect and came to the conclusion that "these unusual severe thrombotic events that are accompanied by thrombocytopenia are caused by rogue antibodies directed against platelet factor 4 (PF4), which causes massive platelet aggregation and thrombosis, and results in a reduced platelet count elsewhere, leading in turn to bleeding. Patients can therefore have both severe thrombosis and severe bleeding" they have named it vaccine-induced immune thrombotic thrombocytopenia (VITT).

With AZ they saw reactions up to 16 days after vaccination. They also found that women in their 20's and 30's were at the highest risk although cases were seen in women up to 54 which has led to some places not recommending the vaccine for women under 55.

That is what we know right now. I would like to remind you that it is rare, and trust me I understand that that provides only a small comfort, but just keep reminding yourself of that. Don't ignore a persistent or severe headache. Once you hit the 16-day post-vaccine mark, you are most likely in the clear.

FINAL THOUGHTS: Deep breaths. We got this and we are in it together.