North Carolina Puts Johnson & Johnson Vaccine Back in Broad Rotation After CDC Review

UNC Health and medical systems across North Carolina are back to distributing the Johnson & Johnson vaccine against COVID-19 after the CDC reviewed it for a rare complication.

The pause is over: The Johnson & Johnson (J&J) vaccine is back in broad circulation across North Carolina. Medical personnel resumed distribution of the shots Wednesday at the Friday Center vaccination clinic in Chapel Hill and other UNC Health clinics across the state. Wake, Mecklenburg and Johnston county health departments also recently added the shot back into the rotation. Federal officials recommended that states resume giving the Johnson & Johnson vaccine in late April after an assessment of rare complications found the benefits of the vaccine far outweigh the risks. 

Earlier last month, federal health officials recommended that states stop giving the J&J vaccine after serious blood clots developed in six women who’d gotten the dose. There was one death. The side effects were extremely rare, but “out of an abundance of caution,” officials wanted time to review the data and safety. It has now done so. 

After an 11-day review, doctors and scientists with the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration said on April 24 that the Johnson & Johnson vaccine remains highly effective against the virus that causes COVID-19 and that the blood clots, though dangerous to those who develop them, remained very rare. (The other vaccines currently available in the US, Pfizer and Moderna, have had no comparable side effects reported and were not part of the pause.) The same day, the NC Department of Health and Human Services recommended resuming the use of the J&J vaccine. 

Here’s what you need to know:

• The blood clots are serious but rare, “occurring at a rate of about 7 per 1 million,” the CDC says. After the review, the number of reported blood clots moved from six to 17. Nearly 8 million people in the United States have gotten the J&J vaccine, including 259,381 North Carolinians. Most side effects of the J&J vaccine are mild and are in line with those of the other vaccines (or any vaccine, for that matter). A sore arm, headache, fatigue, mild flu-like symptoms. They usually go away within a day or two. 
• The benefits far outweigh the risks. The vaccine prevents infection in more than 70% of people in the US, and has presented nearly 100% protection against severe illness and hospitalization. A study released late last month shows the vaccine also is highly effective against the current variants of the virus that are helping to drive up cases among the unvaccinated. 
• Closely monitor your side effects. But the CDC said it would continue to monitor occurrences of the blood clots. “Nearly all reports of this serious condition, which involves blood clots with low platelets, have been in adult women younger than 50 years old,” the CDC says, and “women younger than 50 years old especially should be aware of the rare but increased risk.” Those who get the vaccines and their doctors should be on the lookout for the following symptoms, health officials say:

• Severe or persistent headaches or blurred vision
• Shortness of breath
• Chest pain
• Leg swelling
• Persistent abdominal pain
• Easy bruising or tiny blood spots under the skin beyond the injection site

Anyone experiencing these symptoms should immediately seek medical care, the CDC said. Federal officials also required Johnson & Johnson to add specific warnings about the risks to its fact sheet on the vaccine. 

• Every vaccine is vital. The supply of the vaccine is beginning to outpace demand. Vaccine hesitancy, and outright disregard, are a threat to a full recovery. 

The New York Times reported this week that many doctors and epidemiologists now fear that the vaccine rate has dropped too low to ever reach “herd immunity,” the point at which enough of the population is inoculated against the virus to kill it off entirely. As the virus continues to infect the unvaccinated, it has more time to produce more contagious or severe variants that could elude vaccine protections. The crisis in India right now, where few people are vaccinated and where masks and social distancing is widely disparaged, serves as a dire warning of how strong the virus remains and what it could do to an area with little vaccine protection. 

The resumption of the Johnson & Johnson vaccine adds to the arsenal in a fight that is still very real. Because the J&J vaccine is also only one dose and is easier to store—unlike the two-dose, more fragile shots of the other vaccines—it has also been a big part of NC’s plan to reach underserved populations, especially in rural counties. 

There were some 132,000 doses available, NC officials said, and they would order more this week. About 8% of the North Carolinians who are fully vaccinated got the single-dose J&J shot. None of the reported cases of blood clots originated within the state.

To schedule an appointment for one of the three vaccines, go to myspot.nc.gov/.