J & J: The key to community immunity

In an email to students Tuesday morning, Executive Director of the Health Center Dr. Leslie Lawrence informed the community that Rensselaer would be pausing distribution of the Johnson and Johnson (J&J) one shot COVID-19 vaccine. While the side effects of this vaccine can be significant, is that risk prevalent enough to justify an ongoing pause?

The pause follows a joint statement from the Federal Drug Administration and Centers for Disease Control warning of a rare but severe type of blood clot which had been observed in six women between the ages of 18 and 48 after vaccination. The specific diagnosis is cerebral venous sinus thrombosis, essentially a type of stroke as a result of blood clotting. The number of vaccine recipients diagnosed with CVST after receiving the J&J vaccine during a clinical trial has now risen to eight. However, it is unclear whether or not the traditional treatment for this blood clotting—the anticoagulant heparin—will be effective. As a result, the FDA is “recommending a pause in the use of this vaccine out of an abundance of caution.” Similar blood clots have been observed in the distribution of the single-dose AstraZeneca vaccine in Europe and Australia. Both the AstraZeneca and J&J vaccines use viral vector technology, whereas the Moderna and Pfizer vaccines use mRNA technology. Even so, Australia and Europe (with the exception of Denmark) continue to administer the AstraZeneca vaccine.

It is worth noting, however, that over 7.4 million doses of the Johnson & Johnson vaccine have been administered in the U.S. so far and only eight of those resulted in this blood clotting: one out of every 925,000 doses administered. Over the last 14 months, Americans have become increasingly numb to the hundreds of daily COVID-19 deaths, so a new health threat is given priority over the far more present danger. The most basic analysis, as medical experts have stated, will tell you that people are more likely to experience negative outcomes from COVID as a result of not being vaccinated than due to complications from the vaccine.

When asked about how the pause would affect vaccine distribution, White House COVID-19 Response Coordinator Jeff Zients assured Americans that the pause will not have a “significant impact” on vaccine distribution. Zients says that the J&J vaccine currently accounts for less than 5% of U.S. vaccine distribution and vaccination sites would still be able to honor currently scheduled appointments by shifting to either Moderna or Pfizer shots. Still, these two-dose vaccines may not be a perfect replacement for the one-shot J&J vaccine. With move-out scheduled for May 13, students may be unable to receive the vaccine due to their pre-existing travel plans. Studies show that it takes two weeks from receiving the last dose to obtain maximum immunity. With the J&J one-shot vaccine, Rensselaer has two weeks to vaccinate all students and still have enough time for the Rensselaer community to develop maximum immunity before the end of the semester. While well-intentioned, this pause presents logistical problems for RPI students, who will continue to be susceptible to and potential vectors of the virus without the ease of a one-shot vaccine. As the FDA and CDC state, they recommend this pause out of a large amount of caution. Despite this recommendation, they did not revoke J&J’s emergency authorization usage and distribution of its vaccine. Given the low rate of CVST blood-clotting, the continued emergency use, and the continued danger and prevalence of the COVID-19 virus, RPI could and should continue to administer the J&J vaccine.