This is a weekly Q and A column written by Dr. Lydia S. Segal in conjunction with Chaffee County Public Health. This column is focused on questions readers have about Covid-19 news and sciences. As Segal points out, ‘Everything I write today is valid for today. COVID-19 news and science are rapidly evolving, assume updates will be made”
QUESTION: What is going on with the blood disorder that may be a serious side effect of the Johnson & Johnson, J&J, vaccine?
ANSWER: The J & J vaccine may be associated with having a one in a million risk of causing a rare blood disorder. The disorder is characterized by simultaneously causing both blood clotting and bleeding. So far in the USA, seven million people have been vaccinated with the J & J. Six women between the ages of 18 and 48 have come down with this disorder, one has died. Citing an abundance of caution, the FDA and CDC have asked that the J & J vaccine rollout be paused for further analysis. The CDC, along with an independent panel of experts, the Advisory Committee on Immunization Practices, ACIP, and FDA expect to be able to make a safety decision in the next few days.
Because of the rarity of the blood disorder and the frequency of blood clots and bleeding in the general population, it is unclear yet if there is a vaccine-related problem or it is circumstantial.
This bleeding disorder, currently named vaccine-induced thrombotic thrombocytopenia, VITT, has also been seen in Europe with the Astrazeneca vaccine. Both the J & J and AZ have similar designs, using an adenovirus as the vector, and mechanism of action. The AZ vaccine is yet to be approved in the USA. Initial analysis by European medical clinicians and researchers several days ago identified what appears to be the same rare blood disorder in 11 Europeans who received the AZ vaccine. These people may have an underlying unusual blood disorder and be unaware of it. The vaccine may have triggered the activation of their antibodies to cause both bleeding and clotting.
QUESTION: I had the J & J vaccine recently, what do I need to watch out for?
ANSWER: The disorder comes on between one and three weeks after the shot. It does NOT come on in the first few days when the mild symptoms occur such as arm pain, fatigue, muscle aches, and headaches. So, if between one and three weeks after you got the single-dose J & J vaccine you experience severe headaches, abdominal pain, and leg pain or swelling, or shortness of breath, get medical attention immediately.
QUESTION: Is there a way to pre-screen people who might be at risk for this blood disorder.
ANSWER: It is not yet clear if there is a way to pre-screen people who are at risk for this blood disorder.
QUESTION: Has this problem been found in the mRNA vaccines by Pfizer and Moderna.
ANSWER: No, it does NOT seem to be present in the mRNA vaccines.
QUESTION: What is the risk of developing VITT compared to getting covid or dying from covid? For the sake of comparison, what is the risk of getting a blood clot-related to a commonly prescribed medication such as birth control pills?
ANSWER: As it is still not clear if there is a cause and effect relationship between the J & J vaccine and VITT, one needs to review the risk of this extremely rare disorder and the risk of not being vaccinated and getting severe covid or dying from covid. As a comparison, millions of women who take birth control pills face a 1 in a 1,000 chance of getting a blood clot.
You are more likely to be hospitalized or die of COVID than you are to develop a serious blood disorder than from being vaccinated with the J & J vaccine. Because VITT has only been seen in the 18 – 49-year-old age group, included in the last line below is data that focuses on that age group. A few numbers for comparison are below:
J & J vaccine possible related blood disorder risk: one in a million
Dying from COVID in Colorado: 1.3 percent of all COVID-19 cases (Total covid cases in colorado are currently 481,000, hospitalizations currently are 26,400, deaths are currently 6,200 based on Colorado Public Health Dept data)
Deaths from COVID: 200 in a million in ages 18 -49 ( Dr. Conners Duke University based on CDC data.
For more information about covid and the vaccines, eligibility, and appointments, see the links below. Pharmacies are getting small shipments of vaccines. Information will be posted in this newspaper and on the county public health and hospital web pages.
http://chaffeecounty.org/Public-Health-Coronavirus
https://www.hrrmc.com/covid-19-updates/covid-19-vaccine/
Pharmacies with vaccine clinics:
Buena Vista Drug and Valley-Wide Health, Safeway, Salida Pharmacy
NOTE: If you have questions you would like Dr. Segal to address in a future covid Q and A column, please write to arkvalleyvoice@gmail.com
By Lydia S, Segal, MD, MPH
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