What Does the Johnson & Johnson COVID-19 Vaccine Pause Mean?

Tomorrow, the Advisory Committee on Immunization Practices (ACIP) will convene an emergency meeting to discuss a series of adverse events reported among 6 women administered the Johnson & Johnson COVID-19 vaccine in the US.

The committee, in conjunction with the US Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC), is tasked with weighing the benefits of the emergency-authorized adenovirus vaccine product from Johnson & Johnson versus the newly observed risks: a half-dozen cases of cerebral venous thrombosis among women aged 18-49 years old.

Whatever their decision, it will likely be reflective of not only unique patient population risks with the vaccine, but the current state of US COVID-19 vaccination rollout—a trend which provides federal agencies the luxury of selectivity.

In an interview with Contagion on the day of the Johnson & Johnson news, Carlos del Rio, MD, executive associate deanof the Emory School of Medicine & Grady Health System, discussed the benefit of the US more greatly distributing and administering mRNA vaccines from Pfizer-BioNTech and Moderna, particularly as it relates to the Johnson & Johnson vaccine pause.

“I think we have enough vaccines to vaccinate everybody with either Moderna or Pfizer,” del Rio said. “If the decision here in the US is to not use Johnson & Johnson or AstraZeneca, I think we will be fine. I’m more worried about the rest of the world.”

As del Rio noted, the Johnson & Johnson product could currently be better served in the global effort to mitigate COVID-19—particularly in at-need countries, where the benefit of the vaccine versus the pandemic greatly outweighs the newly observed and very rare risk.

“I’m 62,” del Rio said. “If I was scheduled to get a COVID-19 vaccine today and it was Johnson & Johnson, I would still get it. I have a much higher risk of getting and dying from COVID at my age than I do of getting any complications from the vaccine.”

In anticipating federal decision on the availability of the vaccine in the US, del Rio looked to how other agencies responded to similar blood clot-related issues reported with the AstraZeneca vaccine.

“I would not be surprised if the regulators here in the US do something similar to what they did in Europe: say that this vaccine should not be used with people under the age of 50 or 60, then keep this adenovirus vaccine for older populations, where the risk is lower,” he said.