By Deena Beasley
© Reuters / Dado Ruvic
FILE PHOTO: Vials with the caption “COVID-19 Coronavirus vaccine” and syringe are shown in front of the J&J logo in this illustration
(Reuters) – To resume the use of Johnson & Johnson’s COVID-19 vaccine in the United States, clear guidelines will be required for the medical community on how best to treat patients who develop a rare type of blood clot, as well as alerting the vaccine recipients according to cardiologists and other medical experts aware of the symptoms.
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U.S. health regulators last week recommended that the use of the J&J vaccine be stopped after six cases of rare cerebral blood clots, accompanied by low platelet levels, were reported in women after vaccination, out of about 7 million people receiving the shot in the United States has. State. A panel of expert advisers to US health agencies will meet later this week to determine whether the break should continue, with a decision already expected Friday.
“My estimate is that we will use it in some form,” said Dr. Anthony Fauci, chief medical adviser to President Joe Biden, said on NBC’s “Meet the Press” on Sunday. “I do think there is likely to be a warning, restriction or risk assessment.”
Scientists have not yet established a direct link between the J&J vaccine and the unusual blood clots, which has also been identified among a small fraction of people who received the COVID-19 vaccine from AstraZeneca Plc outside the United States. It is not clear how long it will take to determine if the vaccines cause such symptoms.
Meanwhile, however, scientists say both vaccines are important tools in the fight against a coronavirus pandemic that has killed more than 3 million people worldwide. The key is to communicate to doctors and patients how to be on the lookout for a ‘one-million-side effect’.
“It made sense to interrupt it,” said Dr. Rishi Mehta, co-director of inpatient surgery at Keck Hospital at the University of Southern California in Los Angeles, said referring to the use of the J&J vaccine. “We have to say, ‘Listen that the side effects are rare, but there’s a possibility of getting them, and that’s what you need to look out for … We’re talking about headaches, abdominal pain, confusion.
The American Heart Association said Friday other possible symptoms, which can occur up to two weeks after vaccination, are blurred vision, fainting, sensory changes, seizures, leg pain or shortness of breath.
Doctors also need to be vigilant when it comes to treatment. Cases identified so far are of cerebral venous sinus thrombosis (CVST), or blood clots in the veins of the brain, rather than in the veins, which is the case in most strokes.
The U.S. Food and Drug Administration has said patients who develop lump-related symptoms after receiving the J&J vaccine should not receive heparin, a blood thinner commonly used to treat clotting disorders, at least until additional tests to fast state if they have low platelets count. The rare combination of clotting and low platelet count indicates a condition associated with thrombocytopenia, and heparin administration may cause damage.
The FDA has warned healthcare providers that using heparin in these cases can even be fatal, and advises them to consider non-heparin anticoagulants and high-dose intravenous immunoglobulin (IVIG).
“You will need to do some tests with anyone who has such symptoms, and based on these tests, you will be fairly positioned to treat it without endangering the person,” said Dr. Jeffrey Berger, a cardiologist who focuses on blood clotting disease at New York University.
According to the details published in the New England Journal of Medicine on Friday, a 48-year-old woman who had the J&J shot was transferred to the University of Nebraska Medical Center after being diagnosed with extensive blood clotting, or thrombosis . She was treated with heparin, but her condition worsened and she was switched to another anticoagulant and IVIG. The patient remained critically ill at the time of the report.
“Giving heparin can make things worse, so it’s a good reason to draw attention to this,” Fauci, director of the National Institute of Allergy and Infectious Diseases, told Reuters.
According to doctors, hospital systems can give time to update their own recommendations by interrupting J&J vaccinations.
“It is definitely a very serious condition, but there are recommendations for treatment,” says Dr. Annabelle de St. Maurice, Specialist in Infectious Diseases, University of California, Los Angeles. “Before this time, anyone who has had the vaccine and had a headache would be our first idea to consider CVST and order the labs and imaging to evaluate it.”
Officials from J&J and AstraZeneca did not immediately respond to requests for comment.
(Reporting by Deena Beasley in Los Angeles; additional reporting by Julie Steenhuysen in Chicago; editing by Michele Gershberg and Lisa Shumaker)
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