A C.D.C. panel recommends that other vaccines be preferred over J.&J. – World News

A C.D.C. panel recommends that other vaccines be preferred over J.&J.

An expert panel to the Centers for Disease Control and Prevention on Thursday voted to recommend that Covid vaccines other than Johnson & Johnson’s should be preferred, citing increasing evidence that the company’s shots trigger a rare blood clot disorder now linked to dozens of cases and at least nine deaths in the last year.

Some committee members expressed the hope that exceptions could be made in cases in which people do not have access to the more popular shots of Moderna or Pfizer-BioNTech, or want Johnson & Johnson’s vaccine despite being informed about an elevated risk of a rare but potentially serious side effect.

The panel’s vote effectively discourages vaccine providers and adults from using Johnson & Johnson’s shot. Data presented on Thursday to the committee indicated that there was a higher risk for the blood clotting condition than had been reported earlier to the panel.

The recommendation, which the C.D.C. must still decide whether to accept, is the latest setback for a vaccine which has largely fallen out of favor in the United States. The company’s vaccine has lost its early promise as a traditional, one-and-done format that would be easy to deploy in more isolated or rural communities, and among people skittish about receiving two doses.

About 16 million people in the United States have received the Johnson & Johnson vaccine as their primary immunization, compared to 73 million fully immunized with Moderna’s vaccine and 114 million with the Pfizer-BioNTech shots. Among Americans who have received a booster, just 1.5 percent chose the Johnson & Johnson shot.

Earlier this week, the Food and Drug Administration issued updated guidance on the risks of the blood-clotting disorder linked to Johnson & Johnson’s vaccine, but reiterated that the benefits outweighed its risks.

The panel’s recommendation lands in the midst of a surge in virus cases driven by the Delta coronavirus variant and Omicron, the latest version that has already become dominant in some countries and is spreading fast in the United States.

Several laboratory experiments suggest that a single dose of Johnson & Johnson’s shot may offer little defense against infection with Omicron. The company said late last month that it was testing blood samples from clinical trial participants who have received its shot as a booster to see how their vaccine-induced antibodies fare against Omicron.

At Thursday’s meeting of the Advisory Committee on Immunization Practices, C.D.C. officials went into detail on the clotting-related syndrome identified in 54 people in the United States who received the shot before the end of August. Overall, the rate of the condition was 3.8 cases per one million people given the vaccine. That is higher than the rate had been previously thought to be.

An increased risk for the condition has been linked to the Johnson & Johnson vaccine and the shot from AstraZeneca, which is not authorized in the United States. It has not been linked to the vaccines from Moderna or Pfizer.

One of the committee members, Dr. Pablo Sanchez, a pediatrician at Ohio State University, said he had steered families away from the Johnson & Johnson vaccine.

“I’m not recommending it to any of my patients’ parents and I tell them to stay away from it,” he said.

Evidence has increasingly shown that one dose of Johnson & Johnson’s shot offers little protection against infection. Federal health officials in October authorized boosters for people who had received a single shot of the company’s vaccine at least two months earlier. They allowed for a “mix and match” approach, allowing people to get a second shot of a Pfizer or Moderna vaccine.

So far, most Johnson & Johnson recipients who have gotten a booster have turned to other shots, and hardly any people originally immunized with other shots have opted for Johnson & Johnson as a booster.

Despite their recommendation, a number of panelists said it was important to keep Johnson & Johnson’s vaccine available as an option.

“It’s really important, though, that we not completely eliminate this vaccine,” said Dr. Jason Goldman, a representative of the American College of Physicians and assistant professor of clinical biomedical science at Florida Atlantic University.

He said the final advice “needs to be straightforward needs to be clear, simple and concise, so that we can get more people vaccinated,” he said.

Dr. Penny Heaton, a Johnson & Johnson executive , said the vaccine makes a “crucial difference” in saving lives as the U.S. surpassed 800,000 Covid-19 deaths.

“The risk of Covid-19 of course is much higher than the risk observed post-vaccination and Covid-19 cases continue to rise during this holiday season,” she said.

C.D.C. officials discussed the clotting-related syndrome identified in 54 people in the United States who received the shot before the end of August. Overall, the rate of the condition was 3.8 cases per one million people given the vaccine. That is higher than the rate had been previously thought to be.

The risk for the condition, which is known as thrombosis with thrombocytopenia syndrome and can cause internal bleeding, was highest in women ages 30 to 49, showing up in about 1 in 100,000 recipients in that age group. The rate at which the condition would normally be expected in the general population is not known, said Dr. Isaac See, a C.D.C. official.

Of all Johnson & Johnson vaccine recipients diagnosed with the condition, 36 were admitted to an intensive care unit and the longest hospital stay was 132 days. Eight of them died. Since September, a ninth person has died.

“We’ve been struck from reviewing these cases by how rapidly the status deteriorates and results in death,” Dr. See said.

The people who died ranged in age from 28 to 62. Seven were women, and all were white. Obesity was the most common underlying medical condition. Two of the people who died did not have known medical problems, Dr. See said.

Dr. See said additional cases had been identified since earlier C.D.C. meetings because of lags in reporting and delays in identifying and confirming illnesses related to the vaccine.

An increased risk for the condition has been linked to the Johnson & Johnson vaccine and the shot from AstraZeneca, which is not authorized in the United States. It has not been linked to the vaccines from Moderna or Pfizer.

In April, soon after Johnson & Johnson’s vaccine started being administered in the United States, federal officials briefly halted use of the shot because of concerns about the risk of blood clots. Other countries also moved to pause use of the shot, and some suggested that women in the at-risk age groups be advised to seek other vaccines.

Internationally, a CDC review of 16 higher-income countries showed others had put the brakes on the adenovirus vector vaccines like Johnson & Johnson’s. That category also includes a vaccine by AstraZeneca, which is not being used in the United States, but was halted for use in five countries and subject to preferential recommendation in seven countries. Finland, Denmark and Slovenia stopped use of the Johnson & Johnson vaccine because of the blood clot risk, and four other nations have ranked it lower for use than the mRNA vaccines like Pfizer-BioNTech and Moderna.

A C.D.C. presentation showed that despite the clotting concerns, the Johnson & Johnson vaccine prevented thousands of U.S. Covid hospitalizations compared to three to a dozen cases of the clotting syndrome, depending on the age group. Those over 64 avoided the most hospital stays. If 1 million were vaccinated with the Johnson & Johnson shot, about 57,000 people would avoid hospitalization.

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