Health Advisory: Immediate Pause on the use of Johnson & Johnson COVID-19 Vaccine: Rare but Serious Health Events Under Investigation

| April 13, 2021

Actions Requested

  • DO NOT ADMINISTER Johnson & Johnson (J&J) COVID-19 vaccine until further notice.
  • Continue storing your J&J vaccine appropriately. Do not dispose of it.
  • Maintain a high index of suspicion for symptoms that might represent rare, but serious thrombotic events or thrombocytopenia in patients who have recently received the J&J COVID-19 vaccine.
    • Symptoms can include severe headache, backache, new neurological symptoms, severe abdominal pain, shortness of breath, leg swelling, petechiae, or new or easy bruising.
    • If suspected obtain platelet counts and screen for evidence of immune thrombotic thrombocytopenia.
  • Do not use heparin to treat patients with thrombotic events and thrombocytopenia following J&J COVID-19 vaccination unless HIT testing is negative.
    • If HIT testing is positive or not performed, non-heparin anticoagulants and high-dose intravenous immune globulin (IVIG) should be strongly considered.
  • Report adverse events to VAERS, including serious and life-threatening adverse events and deaths in patients following receipt of COVID-19 vaccines as required under the EUA for COVID-19 vaccines.
  • Read the CDC Health Alert for more details (link below).

For questions, please contact our COVID-19 Vaccination team at (360) 728-2235.

Background

As of April 11, 2021, facilities in Kitsap County have administered approximately 4,740 doses of J&J COVID-19 vaccine, and there have been no reports of cerebral venous sinus thrombosis with thrombocytopenia after receiving the J&J COVID-19 vaccine reported in Kitsap County.

As of April 12, 2021, approximately 6.85 million doses of the J&J COVID-19 vaccine have been administered in the United States. The CDC and the U.S. Food and Drug Administration (FDA) are reviewing data involving six U.S. cases of cerebral venous sinus thrombosis with thrombocytopenia in individuals after receiving the J&J COVID-19 vaccine that were reported to the Vaccine Adverse Events Reporting System (VAERS). All six cases occurred among women aged 18–48 years. The interval from vaccine receipt to symptom onset ranged from 6–13 days. One patient died. When these specific type of blood clots are observed following J&J COVID-19 vaccination, treatment is different from the treatment that might typically be administered for blood clots. Based on studies conducted among the patients diagnosed with immune thrombotic thrombocytopenia after the AstraZeneca COVID-19 vaccine in Europe, the pathogenesis of these rare and unusual adverse events after vaccination may be associated with platelet-activating antibodies against platelet factor-4 (PF4). Usually, heparin is used to treat blood clots. In this setting, the use of heparin may be harmful, and alternative treatments need to be given.

The Washington State Department of Health is immediately pausing use of the J&J COVID-19 vaccine while the federal government begins an investigation into fully understanding recent safety events. Additionally, there will be no state allocations for Johnson & Johnson vaccine this week.

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