People who have received the Johnson & Johnson vaccine in the past few weeks shouldn’t be nervous, federal officials said, despite the nationwide hiatus in the administration of the shots after six reports of a rare type of blood clot. However, you should be on the lookout for possible warning signs.
The six cases involved women aged 18 to 48 who developed symptoms six to 13 days after receiving the shots. One died and another patient is in critical condition, officials from the Food and Drug Administration and the Centers for Disease Control and Prevention said Tuesday.
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All women developed a type of clot called cerebral venous sinus thrombosis, or CVST – a blood clot in the vessels that drain blood from the brain – combined with low platelet levels or thrombocytopenia, according to the FDA and the CDC.
Should I be concerned?
There is little to worry about for people who received the Johnson & Johnson vaccine more than a month ago and have no symptoms, said Dr. Anthony Fauci, director of the National Institute for Allergies and Infectious Diseases, during a separate White house meeting later Tuesday.
For those who have received the Johnson & Johnson shot in the past few weeks, it is important to watch out for symptoms.
The symptoms include:
- strong headache
- stomach pain
- Leg pain
- shortness of breath
“First, don’t get a fear reaction because remember, it’s less than one in a million,” said Fauci. “But after you say that, take care.”
Chest discomfort or neurological symptoms, which can include visual changes, are also possible symptoms, he said.
People who recently received the shot and who are experiencing any of the symptoms should contact their doctor, authorities said. Healthcare providers need to be aware that treating this particular type of blood clot is different from treating blood clots, according to FDA and CDC officials.
“Usually an anticoagulant called heparin is used to treat blood clots. In this environment, the administration of heparin can be dangerous and alternative treatments must be used, ”said the joint statement from the two agencies.
Treatment with heparin “would be a mistake in this situation as it could be dangerous and make the situation significantly worse,” said Fauci.
Blood clot symptoms
“If someone has a very severe headache or shortness of breath, leg pain or severe abdominal pain, they want to see a doctor,” said Dr. Peter Marks, director of the FDA Center for Biologics Evaluation and Research, said during the briefing.
For people who received the vaccine more than a month ago, the risk is “very low at this point,” Schuchat said Tuesday.
The clots appear to be extremely rare: nearly 7 million people have received the Johnson & Johnson shots since the FDA approved them for emergency use in February.
The blood clot symptoms are different from the immediate side effects that occur within a few days of receiving a Covid-19 shot. These symptoms include flulike pain or headache.
Although the cases have occurred in women of childbearing age, there doesn’t appear to be any connection with birth control, Marks said. Contraceptive drug clots are typically caused by a different mechanism involving estrogen, while in the vaccine-related cases, a current theory is that the body makes antibodies that activate platelets.
Dr. Seth Trueger, assistant professor of emergency medicine at Northwestern University, understands the concern.
The headache is severe and there may be other neurological symptoms such as double vision that may be associated with it. It’s not an easy headache.
“If you weren’t concerned about these symptoms without a vaccine, you’re unlikely to have serious complications,” he said.
Dr. Ali Raja, a professor of emergency medicine at Harvard Medical School, said that patients he saw with CVST usually have headaches worse than previous headaches.
“Patients I’ve seen with cerebral sinus thrombosis not only have headaches, they are very bad, relentless headaches,” he said.
With health officials still informed of the exact cause, there is currently nothing that can stop the immune response. Raja said if patients develop severe headaches within three weeks of the Johnson & Johnson vaccine, they should be evaluated by a doctor immediately.
“You don’t need to get this mild headache checked out, but if you have severe headaches, especially those that are worse than any other headache you’ve had before, call your doctor or go to the emergency room,” he said.
The estimated incidence of CVST alone is around 2 to 14 per million people per year, Marks said. Because CVST is so rare in combination with low blood platelets, it is unclear how many annual cases of the disease there are in the six women.
There are currently no reports of the condition associated with the Pfizer-BioNTech and Moderna mRNA vaccines. More than 180 million doses of the mRNA vaccines have been administered in the United States since December.
“We are not seeing any low platelet count clotting events with the other two vaccines,” said Dr. Anne Schuchat, deputy chief executive officer of the CDC, on Tuesday. “People who have vaccination appointments with the other two vaccines should continue their appointments.”