Vaccinations against COVID-19 are continuing at a rapid pace across the country, but the recent pause in the rollout of the Johnson & Johnson vaccine has unfortunately reinforced doubts among the nearly 50% of U.S. adults who have not received a single shot yet. The overwhelming opinion of public health officials is: Don’t panic. Getting protected against the coronavirus is still undeniably the right choice for your health and the safety of others. If you are one of the millions still waiting for their shot, do not let the recent news scare you or make you think twice — get whatever vaccine is available.
Johnson & Johnson vaccine pause
The J&J vaccine was designed as a one-shot inoculation, freeing it of the many logistical constraints of the two-step Pfizer/BioNTech and Moderna vaccines. While extremely efficacious in preventing severe disease, the distribution was halted in the United States last week due to six cases of dangerous blood clot formation (known as cerebral venous sinus thrombosis) among the nearly 7 million who received the shot. Out of an abundance of caution, the Centers for Disease Control and Prevention has recommended taking a pause in using this vaccine until there is more data to determine whether this is a truly linked side effect or a coincidence.
I say “abundance of caution” because the chances of developing this kind of thrombosis are literally less than 1 in a million. That is exceedingly rare, akin to flipping a coin 20 times in a row and landing all heads. The chances of having moderate to severe COVID-19 infection without vaccination, however, remain much more real.
COVID-19 vaccine on April 17, 2021, in Gardena, California. (Photo: Patrick T. Fallon/AFP via Getty Images)
To be sure, the pandemic is certainly winding down, with cases, deaths and hospitalizations significantly lower than three months ago. But every time I advocate for continued precautions until vaccination rates are much higher, I am reminded that some people believe the pandemic is totally over. I, along with fellow physician colleagues and public health officials, including Dr. Anthony Fauci, have been accused of “fearmongering” for such advice. But it’s hard not to continue advising these precautions when I am continuing to treat hospitalized patients struggling to breathe despite massive amounts of oxygen.
The numbers are lower, but there are still more than 70,000 new cases of COVID-19 daily in the United States, and hospitalizations have begun to creep up again.
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This continues to argue for the use of every weapon at our disposal, including the vaccines deemed safe for use by the CDC. In fact, it is a virtue of good science that the blood clot issue was discovered and implementation paused until more facts are known. All drugs, including the J&J vaccine, are rigorously tested, but super rare side effects are not uncovered until it’s used by millions of people. This does not mean we are guinea pigs; even a medication thought to be benign as Tylenol will have super rare side effects for an unfortunate few.
This does not mean we should stop using them; we should understand them and be aware. And again, we do not know yet whether the cerebral venous sinus thrombosis was caused by the vaccine yet.
Time to do our part to end pandemic
Recent surveys suggest we could be hitting a “vaccine wall,” meaning despite the availability of vaccinations, we might be reaching a limit in the number of Americans who want it. One survey indicates that number to be as high as 39% of adults. This is troublesome because many experts believe that at this rate, we will not be able to achieve herd immunity even by summer. This equates to increased viral spread, increased chances of further impactful viral mutations, and unnecessary death and suffering.
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This is all to say, get vaccinated. The J&J data will be analyzed, and the CDC will likely revise the guidelines on its use, with an eye for safety both from side effects and COVID-19 itself. Don’t be scared of the vaccine; be scared of getting COVID-19 and spreading the virus. Am I fearmongering? Yes, but justifiably so — we are not out of this pandemic and we all need to play our part to end it.
Thomas K. Lew, MD, is an assistant clinical professor of medicine at the Stanford University School of Medicine and an attending physician of Hospital Medicine at Stanford Health Care – ValleyCare. All expressed opinions are his own. Follow him on Twitter @ThomasLewMD
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