Doctors say clot management advice is key to the resumption of J&J COVID vaccines in the US
© Reuters. FILE PHOTO: Vial labeled “COVID-19 Coronavirus Vaccine” and syringe appear in front of the J&J logo displayed in this image
By Deena Beasley
(Reuters) – The resumption of use of Johnson & Johnson’s (NYSE 🙂 COVID-19 vaccine in the US requires clear guidelines for the medical community on how best to treat patients who also develop a rare type of blood clot Heart doctors and other medical experts say vaccine recipients are made aware that they are aware of the tell-tale symptoms.
U.S. health officials recommended halting use of the J&J vaccine last week after six cases of rare blood clots in the brain, accompanied by low platelet counts, were reported in post-vaccinated women of about 7 million people who received the shot in the United States have received states. A group of expert advisors from the U.S. health department will meet later this week to decide whether to continue the hiatus. A decision is expected on Friday.
“I guess we will continue to use it in some form,” said Dr. Anthony Fauci, Chief Medical Officer of President Joe Biden, on NBC’s Meet the Press on Sunday. “I think there will likely be some kind of warning or restriction or risk assessment.”
Scientists have yet to make a direct link between the J&J vaccine and the unusual blood clots that have also been found in a tiny fraction of the people who received the COVID-19 vaccine from AstraZeneca (NASDAQ 🙂 Plc outside of the United States. It’s not clear how long it would take to determine if the vaccines were causing such symptoms.
In the meantime, however, scientists say both vaccines remain important tools in fighting a coronavirus pandemic that killed more than 3 million people worldwide. The key will be teaching doctors and patients how to look for a “one-in-a-million” aftermath.
“It made sense to take a break,” said Dr. Rishi Mehta, assistant medical director, inpatient surgery at Keck Hospital, University of Southern California in Los Angeles, on the use of the J&J vaccine. “We should say, ‘Look, the side effects are rare, but there is a chance you might get them and this is something to watch out for … We’re talking about headache, stomach ache, confusion.”
The American Heart Association said Friday that other possible symptoms that can occur up to two weeks after vaccination are blurred vision, fainting, sensory changes, seizures, leg pain, or shortness of breath.
Doctors also need to be vigilant when it comes to treatment. Cases identified so far are cerebral venous sinus thrombosis (CVST) or blood clots in the veins of the brain rather than the arteries, which is the case with most strokes.
The U.S. Food and Drug Administration has stated that patients who experience clotting-related symptoms after receiving the J&J vaccine should be given heparin, a blood thinner often used to treat clotting disorders, at least until additional tests are carried out to determine whether They have low platelets, shouldn’t be given counts. The rare combination of clotting and low platelets signals a condition known as heparin-associated thrombocytopenia, and giving heparin can cause harm.
The FDA warned health care providers that heparin use could even be fatal in these cases and advised them to consider non-heparin anticoagulants and high-dose intravenous immunoglobulin (IVIG) instead.
“You would have to do a few tests on anyone with symptoms like this, and based on those tests, you would be in a reasonable position to treat without putting the person at risk,” said Dr. Jeffrey Berger, a cardiologist specializing in blood clotting diseases at New York University.
According to data published Friday in the New England Journal of Medicine, a 48-year-old woman who was shot at the J&J was rushed to the University of Nebraska Medical Center after diagnosed with extensive clotting or thrombosis. She was treated on heparin, but her condition worsened and she was switched to another anticoagulant and IVIG. The patient remained critically ill at the time of the report.
“If they give heparin they can make the situation worse. That’s a good reason to call attention to it,” Fauci, director of the National Institute for Allergies and Infectious Diseases, told Reuters.
Doctors said the break in J&J vaccinations will allow hospital systems time to update their own recommendations.
“It is certainly a very serious condition, but there are recommendations for treatment,” said Dr. Annabelle de St. Maurice, an infectious disease specialist at the University of California, Los Angeles. “Before that, someone who had the vaccine and was having a headache was our first idea not to consider CVST and get the labs and imaging to assess it.”
J&J and AstraZeneca officials did not immediately respond to requests for comment.