The US Centers for Disease Control and Prevention’s vaccine advisors will meet on Friday to discuss the future of Johnson & Johnson’s Janssen coronavirus vaccine.
The Advisory Committee on Immunization Practices will meet on Friday from 11 a.m. to 5 p.m. ET to vote on updated vaccine recommendations and whether the vaccine is linked to a rare blood clotting syndrome called thrombosis with thrombocytopenia syndrome (TTS).
Some organizations have coined the term “vaccine-induced immune thrombotic thrombocytopenia,” or VITT, but ACIP prefers to use a more neutral term that doesn’t imply that vaccines are to blame.
It’s marked by an unusual form of a blood clot in the brain — as well as probably other big blood clots — and a low number of platelets, which are blood-clotting cells. Some blood experts say it’s caused by an irregular immune response that targets platelets, causing them to clump together and form clots.
ACIP will hear about any new cases that have come to their attention since their last meeting earlier this month. The CDC and the US Food and Drug Administration recommended a pause in vaccine administration after six women developed TTS, one of whom died. Before determining whether and how to adjust vaccination guidelines, ACIP representatives said they needed more time and details.
At least one more case will be presented to them. Oregon health officials said Thursday night that they were looking into the death of a woman in her 50s who had TTS symptoms and died after receiving the vaccine.
“We are very much encouraged by the fact that our safety reporting systems are working,” Dr Shimi Sharief, senior health adviser with Oregon’s health authority, told reporters in a briefing. She noted the coronavirus pandemic is ongoing and killing people.
“This is still extremely rare,” she said — noting that seven cases of blood clots had been reported out of nearly seven million J&J vaccines given, and two of those cases had been fatal.
Dr Michael Streiff of Johns Hopkins University, a blood clot specialist, will likely give a briefing about what is understood about treating TTS. According to reports, blood thinners — except for heparin, a widely used blood thinner — may help remove the clots, and IVIG, an immune agent, may help neutralize the erroneous immune response.
ACIP will also hear from two officials of Johnson & Johnson.
ACIP members will weigh the vaccine’s possible complications against the danger of contracting coronavirus. According to CNN, the risk of forming blood clots of some kind from coronavirus infection is much greater than the risk seen in people who received the vaccine.
TTS has also been applied to AstraZeneca’s vaccine. According to the World Health Organization and European medical authorities, the advantages of the AstraZeneca vaccine, which is not yet approved in the United States, outweigh any possible risks.
Dr William Schaffner, a non-voting ACIP member and infectious diseases professor at Vanderbilt University School of Medicine, told CNN earlier this week that the committee could recommend that the J&J vaccine be used again with no modifications, or that the US avoid using it entirely.
According to Schaffner, ACIP is more likely to suggest that the use of the vaccine be resumed with an alert about potential side effects — and perhaps, recommendations to the highest-risk groups to avoid the vaccine entirely.