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Connecticut reckons with pause in administering Johnson & Johnson vaccine

Gov. Ned Lamont addressed concerns about the Johnson & Johnson vaccine Tuesday after reports of a combination of severe blood clots and low platelets in several women who got the vaccine.

There are six reported cases of these issues out of 6.8 million vaccines administered. On Tuesday morning, the Centers for Disease Control and Prevention and the Food and Drug Administration recommended a pause in the use of Johnson & Johnson “out of an abundance of caution.”

Lamont and state Department of Public Health Commissioner Deidre Gifford emphasized the low reported odds of having an issue during a noon news conference on Tuesday, telling those who had recently received the Johnson & Johnson vaccination not to panic, and telling those who have yet to get vaccinated that this should not dissuade them from doing so.

“Of these six cases we are not aware that any have come from the state of Connecticut. We have administered more than 100,000 doses of the J&J vaccine here in Connecticut,” Gifford said. “Nationally, almost 7 million doses of J&J have been administered, with only these six cases being reported. So that’s very reassuring as to the rarity of this potential complication.”

She added that although there is “an association” between the vaccine and the reaction, and the FDA and CDC are conducting an investigation, “We don’t know for sure the relationship between these events and the J&J vaccine.”

“If you’ve received the J&J vaccine more than two weeks ago like me, you can be reassured that these rare complications occurred between six and 13 days,” Gifford said. “If you’re somebody who received the J&J vaccine in the last couple of weeks, you can also be comfortable that this is a very, very rare event and not be overly concerned. The advisory right now is that if you do develop unusual symptoms, a very severe headache, shortness of breath, abdominal pain, that you reach out and contact your (health care) provider.”

Lamont said he and other governors met with the White House’s COVID-19 task force. He said he thinks that this pause in Johnson & Johnson distribution will last a matter of days rather than weeks.

The state’s mobile vaccination vans, of which Gifford said there are 13 out of a fleet of 35 operating right now, were held from going out on Tuesday. These units normally administer Johnson & Johnson vaccines but will be switching to Pfizer and Moderna.

For the mobile vans, Gifford said, “We’re going to make every effort to have the units administer the second dose, but we’re not quite sure yet whether we’ll be able to do that in all cases.”

The governor’s Chief Operating Officer Josh Geballe said health care providers have been working to figure out how to get vaccines to people who were scheduled for a Johnson & Johnson shot. He said there will likely be some cancellations, especially for those who were planning to receive the Johnson & Johnson shot Monday or Tuesday. Gifford gave advice to people whose appointments had been canceled.

“You should wait to hear from a provider about an appointment cancellation before you assume your appointment has been canceled,” Gifford said. “Many providers are making the switch and will be providing an mRNA vaccine. However, if you do hear from a provider that an appointment is canceled, you can reach out to the vaccine appointment line, the 211 line, and they will be happy to assist you.”

Connecticut’s supply of the Johnson & Johnson vaccine already had been interrupted in recent weeks due to an error at a facility in Baltimore that prompted the destruction of millions of doses. For that reason, the state already was receiving fewer Johnson & Johnson doses this week — 21,000 compared to 158,000 of Pfizer and Moderna.

Gifford, Geballe and Lamont said providers who have the Johnson & Johnson vaccine in storage should hold on to it while waiting for results from the investigation into the reported side effects. Providers were advised to switch to the Moderna or Pfizer vaccines and to contact the DPH if there is difficulty making that change.

Geballe said the state still expects supply of vaccines to outpace demand by the end of April. Lamont said there will likely be a 7% to 8% increase in Pfizer and Moderna doses next week.

“It’ll take a couple of additional weeks for people to get fully vaccinated, but the majority of our vaccine was Moderna and Pfizer anyway, so it doesn’t make a big dent in our goal toward herd immunity,” Gifford said.

DPH put out a statement Monday notifying the public that if they have the blood clots/low platelets issue, they should contact their health care provider. Gifford on Monday said the DPH is reaching out to health care providers, and that the department already has contacted local health departments and vaccine providers.

Impact to local vaccine appointments

Uncas Health District planned to administer about 100 doses of the Johnson & Johnson vaccine Tuesday at a clinic also offering second doses of the Moderna vaccine, Director of Health Patrick McCormack said.

But he canceled the J&J portion of the clinic just before 8 a.m., with  an email sent to the 32 people who had registered for the J&J slots, which had just been posted Monday night.

McCormack hopes the time spent looking into the J&J vaccine “will be relatively brief, so that we can use the doses that we still have on-hand, and so that we can start our process up again for the use of the Johnson & Johnson,” which is the only vaccine Uncas Health District has been using to vaccinate homebound people.

Steve Mansfield, director of health at Ledge Light Health District, said clinics with the J&J vaccine were in the works but hadn’t been scheduled, so Ledge Light hasn’t had to cancel appointments.

He said the plan was to use the J&J vaccine at “clinics that are targeting specific populations that may be difficult to get a second dose to,” and those clinics will now be planned with Moderna.

He said of the decision to suspend use of the vaccine, “I think it’s a good idea, because we don’t know if this is the cause, and I think whenever we’re looking at a new vaccine, it’s important to pay attention to these things.”

Leslie Gianelli, spokesperson for Community Health Center, said the J&J vaccine has been less than 1% of CHC’s total allocation thus far.

“We did have some upcoming clinics scheduled for colleges, but this morning we just shifted all of those appointments over to Pfizer,” Gianelli said. No appointments have been canceled or postponed.

Walgreens — which is vaccinating in New London, Groton, Norwich, East Lyme, Old Lyme, Pawcatuck and Uncasville — said in a statement Tuesday it is “immediately suspending the administration of the J&J vaccine at our stores and off-site clinics and are awaiting further guidance. We are reaching out to patients with scheduled appointments and rescheduling vaccinations from other manufacturers, as supply allows.”

CVS spokesperson Mike DeAngelis said the pharmacy is emailing affected customers to notify them their appointments are being canceled and will follow up to reschedule appointments “as soon as possible.” CVS is still offering the Pfizer and Moderna vaccines.

Select Stop & Shop pharmacy locations in Connecticut have received allocations of the J&J vaccine over the last several weeks, spokesperson Maura O’Brien said in an email. Stop & Shop is following the recommendation to pause administration of this vaccine “out of an abundance of caution ... until details of the FDA and CDC reviews are released and further guidance is provided.”

Hartford HealthCare held two media briefings Tuesday about the pause. Dr. James Cardon, chief clinical integration officer, said Hartford HealthCare has “had very little scheduled for Johnson & Johnson.”

The health care system is halting programs' use of the J&J vaccine for people in emergency departments and those being transferred to congregate living settings; Pfizer and Moderna won’t be substituted due to the difficulty of bringing people back for a second dose.

“These kinds of pauses actually give me great confidence that we’re paying attention,” Cardon said. He said it’s not clear there is a cause-and-effect relationship between the vaccine and cerebral venous sinus thrombosis, noting that these severe blood clots can happen spontaneously.

“At this point, it’s very difficult to look at the data we do have and create some conclusion or create some narrative that could potentially be, if anything, harmful,” said Keith Grant, senior system director of infection prevention. “So, we’re still waiting for more information to come out from the CDC.”

Grant said he thinks the pause “is the right thing to do at this point,” saying the science community promised to keep a close eye on all vaccines and be clear if something comes up.

e.moser@theday.com

s.spinella@theday.com

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