Las Vegas Sun

March 29, 2024

GUEST COLUMN:

Should you take the Johnson & Johnson vaccine? Yes!

After a temporary halt, the Food and Drug Administration and Centers for Disease Control and Prevention on April 23 ended the pause of the Johnson & Johnson COVID-19 vaccine. It was put on hold for 11 days due to reports of six women developing blood clots, mostly in the brain. That total has increased to 15 cases to date, mostly in younger women.

After carefully reviewing the data from all the cases, as well as similar cases with the AstraZeneca vaccine in Europe, the FDA and CDC decided to reinstate the vaccine on the grounds that the benefits far outweigh the risks. After all, of these 15 individuals, nearly 8 million others received the J&J vaccine with no serious side effects, making these clots extremely rare.

In the face of a pandemic, with still roughly 392 new COVID cases per day in Nevada and only 27% of Nevadans fully vaccinated, we are going to need all the help we can from each of the three vaccine players, including J&J. On the other hand, of the 15 cases, three individuals died, with one Las Vegas teen requiring brain surgery, and many people are understandably still concerned. This raises the question: Even if the risk of blood clots is extremely rare, should you take the J&J vaccine? To answer that question, let’s consider the evidence.

It may be hard to conceptualize the rarity of 15 cases out of 8 million individuals. To put this into perspective, according to the CDC, that probability is roughly equivalent to the chances of being struck by lightning in a year. Even if we look at the most high-risk groups among young women between the ages of 30 to 39, the risk of getting a blood clot is still merely 11.8 cases per million doses. In all likelihood, there is a far greater chance of getting blood clots from COVID itself by not being vaccinated. A landmark study in the Lancet medical journal found that 21% of COVID patients developed blood clots, and these clots were associated with a high degree of mortality when they did occur.

It is also important to note that correlation does not equal causation. As many as 900,000 individuals in the United States develop blood clots each year, and one to two thousand people develop a blood clot each day. So, some of these clots will coincidently occur right around the timing of those receiving the vaccine, but it will falsely be attributed to the vaccine itself.

Also, as research has advanced in the past weeks, doctors have developed a better understanding of the root cause of the clots, and fortunately we have effective medications to treat this problem. Researchers have uncovered that this disorder, also known as vaccine-induced immune thrombotic thrombocytopenia (VITT), is likely due to an autoimmune reaction to the vaccine leading to antibodies that activate the cells responsible for clotting.

“Patients who develop VITT are treated with intravenous immune globulin (IVIG). This is based on early studies with small numbers of patients,” explains Dr. Marc Kahn, dean of the Kirk Kerkorian School of Medicine at UNLV. “In addition to IVIG, patients with VITT are treated with blood thinners.”

Lastly, the J&J vaccine has numerous benefits. Unlike Moderna and Pfizer, only one shot of the J&J vaccine is needed. Many Nevadans may not have the time to make two visits for the shots, or are afraid of needles and want to minimize exposure to them. Another key advantage to the J&J vaccine is how it is stored. Unlike the Pfizer and Moderna vaccines, the J&J version can be stored in a refrigerator and even room temperature for up to two hours. This makes it more accessible to rural parts of Nevada that lack sophisticated freezers.

So should you still get the J&J vaccine if presented the opportunity? Yes!

The incidence of clot formation with the vaccine is about 1 in a million. The incidence of thrombosis with a COVID infection is reportedly up to 20%. “It is much safer to get vaccinated,” Dr. Kahn reiterated.

If and when you get the J&J vaccine, how do you look out for these clots?

“Symptoms of a clot include swelling in the lower extremities, headache, visual changes, abdominal pain, chest pain, and/or shortness of breath,” Dr. Kahn cautioned, with the reminder that VITT is extremely rare. These rare clots most commonly occur one to three weeks after vaccination, and if you develop any of these symptoms during that time, seek immediate care. This should not to be confused with the expected and benign side effects of headaches and body aches that occur one to two days after you receive the vaccine.

If anything, the fact that our lead officials took such drastic measures to evaluate this rare event is a testament to the commitment the CDC and FDA have to vaccine safety and informing the public. Now let’s get vaccinated, Nevada.

Bobak Seddighzadeh is a fourth-year medical student at the Kirk Kerkorian School of Medicine at UNLV, and is a research associate at the Harvard/MGH Center on Genomics, Vulnerable Populations and Health Disparities.