The US Meals and Drug Administration restricted use of the Johnson & Johnson (Janssen) COVID-19 vaccine late Thursday, citing the danger of a really uncommon however severe clotting dysfunction known as thrombosis with thrombocytopenia syndrome (TTS).
As of now, the J&J vaccine could solely be utilized in folks aged 18 and older who can not or don’t need to obtain an alternate COVID-19 vaccine. That features individuals who have had a life-threatening allergic response (anaphylaxis) to an mRNA COVID-19 vaccine, individuals who have private considerations about mRNA COVID-19 vaccines and wouldn’t in any other case be vaccinated, and individuals who do not need entry to mRNA COVID-19. -19 vaccines.
The restriction comes as a result of the FDA and the Facilities for Illness Management and Prevention have been carefully monitoring individuals who have acquired J&J COVID-19 vaccinations for TTS. Thus far, companies have recognized and confirmed 60 instances of TTS associated to the vaccine, together with 9 deaths. That represents a fee of three.23 TTS instances per million doses of J&J vaccine administered and a fee of 0.48 TTS deaths per million doses of vaccine administered, the FDA stated Thursday.
Whereas the dangers are small, the FDA has decided that they’re pointless dangers for most individuals, given the broad availability of mRNA vaccines (made by Moderna and Pfizer-BioNTech) which might be equally efficient and don’t carry such dangers of great illness. convey and die.
The FDA’s resolution follows a lowered advice from the Facilities for Illness Management and Prevention final December, which said that the mRNA COVID-19 vaccines are preferable to the J&J vaccine. The CDC outlined particular instances the place the J&J vaccine might be thought of, which match the makes use of listed by the FDA.
Limits and Dangers
In a press release Thursday, Peter Marks, the highest vaccine regulator, defined the timing of the FDA’s transfer. “We acknowledge that the Janssen COVID-19 vaccine continues to play a task within the present pandemic response in the US and world wide. Our motion displays our up to date evaluation of the danger of TTS following administration of this vaccine and restricts the usage of the vaccine to particular people,” he stated, and “demonstrates the robustness of our security monitoring methods and our dedication to making sure that science and information information our choices. … The company will proceed to observe the protection of the Janssen COVID-19 vaccine and all different vaccines, and as has been the case through the pandemic, it’ll completely consider new security data.”
TTS is a severe situation characterised by the bizarre mixture of blood clots that block a blood vessel, generally known as a thrombosis, and thrombocytopenia, an general low variety of platelets that assist blood to clot. The situation will be notably harmful if the blood clot impacts the mind, resembling with cerebral venous sinus thrombosis (CVST), a uncommon however life-threatening type of stroke that forestalls blood from draining from the mind.
The chance of TTS from the J&J vaccine — which makes use of an adenovirus-based vaccine design — was first recognized in early April 2021, after which the CDC suspended use of the vaccine. The FDA and CDC lifted the hiatus later that month after figuring out that the vaccine’s advantages in stopping COVID-19 outweighed the small danger of growing TTS. It nonetheless stays unclear how the vaccine would possibly trigger the situation in uncommon instances, however researchers hypothesized that one thing concerning the adenovirus-based vaccine may set off an immune response that results in platelet activation and low platelet counts. One other adenovirus-based COVID-19 vaccine, made by AstraZeneca, has additionally been linked to uncommon instances of TTS.
Amid the TTS experiences, the CDC’s hiatus, and early scientific trial information displaying mRNA vaccines outperformed the J&J vaccine, use of the adenovirus-based vaccine plummeted within the US. Of the 577 million doses administered thus far, solely 18.7 million had been J&J vaccines.