With the federal government calling for a pause on Johnson & Johnson’s COVID-19 vaccine amid reports of six serious blood clots, a Rochester Regional Health doctor weighed in on issues such as trust in the vaccine and how concerned those who received the vaccine should be.
Dr. Ed Walsh, an RRH infectious disease specialist and leader of the Pfizer study at Rochester General Hospital, spoke to the media during a Zoom call Tuesday.
He was asked what the “all clear” to get the Johnson & Johnson vaccine will look like and how people would be told when the vaccine is safe to use after a pause.
“I think what you have to always balance (is) the risk and benefit,” Walsh said. “This is a lethal, viral infection. We are not out of the woods by any stretch of the imagination for the population at large or for any individual who’s not been either infected or immunized with an effective vaccine. A lot of people will get very sick and some will die. You have to always weigh the benefit (of taking the Johnson & Johnson vaccine) and the risk.”
On a societal level, Walsh said, the number of deaths from COVID-19 should be weighed against a risk of, 1-in-2 million or 3 million of dying from a vaccine.
“One thing is very clear. Either of two things are going to happen as an individual: You are going to become infected with coronavirus. This is a given. No one will avoid it,” he said. “You’re alternative is to be vaccinated to either avoid infection completely or to avoid serious outcome. This is a decision that each individual needs to make.”
Asked what a pause means to those who desperately want a vaccine, Walsh said the pause by the Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) means in the U.S., they will not use the vaccine until the pause is lifted.
Roughly 7 million Americans have already received a dose of the Johnson & Johnson vaccine. Johnson & Johnson said it was aware of the reports of blood clots and was working with officials on the matter.
Walsh said the cases of blood clots are rare — for every million people vaccinated, there’s been one case of unusual clotting problems associated with very low platelet count.
“Unfortunately, it can result in death. It becomes very hard to assess, then the risk/benefit to a particular individual patient,” he said. “Clearly the risk far exceeds the risk of dying from one of these very rare, one-in-a-million events. But, it still raises concerns for all individuals and it’s very understandable. One would not expect to see very serious, life-threatening, adverse events from any vaccine that’s intended to prevent disease.”
Walsh was asked how people who have gotten the Johnson & Johnson vaccine and are now concerned can spot one of these blood clots and what they could be looking for.
“This also can be a little difficult. The symptoms of the patients who presented with these unusual blood clots have been headache that is really unremitting and more severe than the usual headache,” he said, adding that abdominal pain has also been associated with this.
“The CDC’s (Centers for Disease Control and Prevention) recommendation is that anyone who has received the Johnson & Johnson vaccine to pay attention to symptoms such as that,” he said. “The headache part is not that (much) of an uncommon symptom in people who have recently vaccinated or even not vaccinated. Unfortunately, headaches are not an uncommon complaint that people have.”
Walsh said the use of the Johnson & Johnson vaccine in the state initially was originally restricted to small populations, such as patients discharged from the hospital.
“Initially, this was elderly persons, persons who were returning, say. to nursing homes, elderly people over age 75,” he said. “It then dropped down, as you know, to lower ages — 60, etc., and those with high-risk conditions.”
Walsh said the other point worth making is the number of Johnson & Johnson vaccines administered is quite small.
“The rollout of J & J was slow. The availability in the Rochester area was very limited, as it was across the country,” he said.
Asked why people should avoid panicking about this, Walsh said the main reason is the rarity of getting blood clots from the Johnson & Johnson vaccine.
Walsh said he spoke to his son in California this morning for that reason.
“He called and said he’d received his J & J vaccine two weeks ago and I said, ‘You know, it’s a very rare event. I wouldn’t lose any sleep over it,’” Walsh said. He said he told his son to pay attention for symptoms and not ignore them if he has them.
“The rarity is something that should give most people reasonable reassurance that they’ll be OK,” he said.