Missouri to immediately pause use of Johnson & Johnson vaccine after rare blood clots

Missouri will pause use of the Johnson & Johnson vaccine as recommended by federal authorities who are investigating six instances of blood clots that have arisen after its use.

The Centers for Disease Control and Prevention and the Food and Drug Administration issued the recommendation Tuesday morning “out of an abundance of caution.”

Shortly after, Randall Williams, director of the Missouri Department of Health and Senior Services, issued an order barring the vaccine’s administration effective immediately.

“In an abundance of caution and as per federal guidelines, we are pausing vaccination with Johnson & Johnson’s Janssen vaccine until further notice in Missouri,” Williams said in a statement.

Vaccine providers are asked to appropriately store any Johnson & Johnson vaccine on hand and label it “quarantine-do not use” until further notice, according to a news release from DHSS.

The pause will likely affect appointments scheduled for this week, with the Columbia/Boone County Department of Public Health and Human Services informing residents with appointments to expect to hear from their provider about rescheduling after Wednesday’s meeting to review the cases. The Platte County Health Department announced Tuesday morning its Johnson & Johnson appointments for the day would be canceled and asked patients to reschedule.

On a call with vaccine providers Tuesday afternoon, Mindy Laughlin with DHSS’ Division of Community and Public Health, said the state anticipates it will not receive any Johnson & Johnson doses next week “likely due to the halt that we have on the vaccine at the federal level at this point in time.”

Meanwhile, Missouri already anticipated seeing hundreds of thousands of fewer vaccine doses this week, with 77,900 fewer of the one-dose Johnson & Johnson vaccine. Tuesday’s pause may further delay vaccination clinics as the state faces a smaller supply.

As of Monday, Missouri providers have administered 105,721 doses of the Johnson & Johnson vaccine, said Lisa Cox, a spokeswoman for DHSS.

Out of 6.8 million doses of the Johnson & Johnson vaccine administered in the U.S., the CDC and FDA are reviewing six cases of a rare blood clot after receiving the vaccine. The blood clot, known as cerebral venous sinus thrombosis, was present with low levels of blood platelets in women between 18 to 48 years old, according to a joint statement by Anne Schuchat, the CDC’s principal deputy director and Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research.

Symptoms occurred six to 13 days after the vaccine was administered, and must be treated with alternatives other than the typical anticoagulant drug called heparin, according to the statement.

Similar symptoms have not been reported following use of Pfizer or Moderna’s vaccines, federal officials said during a press briefing Tuesday morning.

Janet Woodcock, the acting FDA commissioner, said while officials have not identified a definitive cause, their leading hypothesis is that after receiving the Johnson & Johnson vaccine, a person’s immune response can involve their own platelets which can cause the issue.

While instances of severe blood clots were extremely rare, federal officials said the decision was necessary to ensure that healthcare providers could begin to diagnose, treat and report any effects while analyses are underway.

The pause is recommended until the CDC can convene a meeting of the Advisory Committee on Immunization Practices Wednesday for further review. The FDA will then review that analysis as it investigates, according to a news release.

“We anticipate having more information shortly to make further decisions about overall vaccine distribution in light of this new development and will continue to update citizens who have been vaccinated with the J&J vaccine after the advisory committee meets at the federal level tomorrow,” Williams said.

People who develop severe headache, abdominal pain, leg pain or shortness of breath within three weeks after receiving the Johnson & Johnson vaccine should contact their health care provider, who are asked to report any adverse effects. Missourians may also contact the COVID-19 hotline at (877) 435-8411.

This story has been updated since it was first published.