Requested actions
- Be aware, on December 16, Centers for Disease Control and Prevention (CDC) recommended mRNA COVID-19 vaccines (Pfizer or Moderna) over Johnson & Johnson (J&J) COVID-19 vaccine for all people 18 years or older. The recommendation is based on the increased risk of thrombosis with thrombocytopenia syndrome (TTS) after getting J&J COVID-19 vaccine.
- Be aware, on December 14, Food and Drug Administration (FDA) updated its emergency use authorization (EUA) fact sheet for J&J COVID-19 vaccine to state:
- People should not get J&J COVID-19 vaccine if they have a history of TTS after getting J&J COVID-19 vaccine or any other adenovirus-vectored COVID-19 vaccine (e.g., AstraZeneca COVID-19 vaccine, which is not authorized or approved in the United States).
- Encourage all patients 5 years or older to get fully vaccinated against COVID-19. Encourage all patients 16 years or older to get a booster dose of COVID-19 vaccine at the recommended interval.
For questions, please contact our Communicable Disease staff at 360-728-2235
Background
On December 16, CDC endorsed Advisory Committee on Immunization Practices’ (ACIP’s) recommendation to express clinical preference for mRNA COVID-19 vaccines (Pfizer and Moderna) over J&J COVID-19 vaccine for all people 18 years or older. ACIP voted unanimously following a review and discussion of the latest evidence showing 54 reports of people developing TTS after getting J&J COVID-19 vaccine. Of these, 36 required intensive care and 9 people died. CDC has seen TTS in all age groups and genders, but it is most common in women 30–50 years old. TTS occurred in 3.8 per 1 million doses, with 0.5 fatalities per 1 million doses.
CDC opted to leave J&J COVID-19 vaccine as an option for people 18 years or older because it is accessible, and some people feel concern about the perceived novelty of mRNA vaccines. Canada and the United Kingdom issued similar guidance.
Supplies of mRNA COVID-19 vaccines are abundant in the United States. If a patient is unable or unwilling to get mRNA COVID-19 vaccine, offer J&J COVID-19 vaccine. Any approved vaccine is better than none.
Additional information
On December 17, CDC hosted a Clinician Outreach and Communication Activity (COCA) call about the latest evidence on TTS after getting J&J COVID-19 vaccine. Presenters discussed TTS and updated vaccine recommendations. If you were unable to attend the call, you can view a recording on CDC’s COCA call page.
COVID-19 vaccine
- Booster dose updates, FDA.
- EUA fact sheets for recipients and caregivers:
- COVID-19 vaccine locator, Washington State Department of Health (DOH).
- Our COVID-19 page for healthcare providers.
- COVID-19 vaccine provider toolkit and resources, DOH.
- COVID-19 vaccination for providers, CDC.
- Clinical considerations for COVID-19 vaccination and guidance for managing anaphylaxis, CDC.
- COVID-19 vaccine quick reference guide for healthcare professionals, CDC.
- COVID-19 vaccine training module on best practices for providers, CDC.
COVID-19 testing
COVID-19 therapeutics
Department of Health and Human Services (HHS) allocates monoclonal antibody and oral antiviral supplies to each state. DOH distributes doses to enrolled providers. Providers must enroll in Healthcare Partner Ordering Portal (HPoP) to manage COVID-19 therapeutics. Email mcm@doh.wa.gov to register for HPoP training, held on Tuesdays at 9 a.m.
- To request an initial supply of Evusheld monoclonal antibody for pre-exposure prophylaxis (PrEP), complete a smart sheet.
- Read more about Evusheld monoclonal antibody for PrEP.
- Find more resources in the COVID-19 monoclonal antibody therapeutics communication toolkit.
COVID-19 prevention patient education
Share the following materials with patients.
- What to do if you have COVID-19.
- What to do if you may have been exposed to COVID-19.
- What to do if you have COVID-19 symptoms and have not been tested or exposed.
Immediately report COVID-19, contact Kitsap Public Health District (360) 728-2235.
Additional Resources