Image of gloved hand holding a vial of Johnson & Johnson's investigational COVID-19 vaccine
Johnson & Johnson’s COVID-19 vaccine

COVID-19 vaccinations are essentially at a standstill in U.S. nursing homes and assisted living communities due to federal officials’ call today for a pause on the use of the Johnson & Johnson vaccine, industry officials report.

Senior living and care industry leaders are calling on the Biden administration to “promptly” start supplying more Pfizer and Moderna vaccines to fill the eldercare gaps.

“Unfortunately, today’s development essentially halts vaccinations in long-term care, as the federal government was primarily allocating the Johnson & Johnson vaccine to nursing homes and assisted living communities,” said David Gifford, M.D., MPH, the chief medical officer for the American Health Care Association and the National Center for Assisted Living, in a Tuesday morning statement. “Without swift action to replace these vaccines, we could see tragic consequences.”

AHCA/NCAL said that last week it sent letters to White House Senior Adviser Andy Slavitt, White House Senior Policy Adviser for COVID-19 Equity Cameron Webb and the National Governors Association, requesting that long-term care residents and staff remain a priority for the vaccines as the next phase of distribution begins, opening up more to the general public. 

The federal government had begun to allocate primarily Johnson & Johnson vaccines to the long-term care population, but not at the levels necessary to ensure all facilities and pharmacies had consistent and immediate access, AHCA/NCAL said in its statement.

“There is this notion among some that vaccines were administered in long-term care, so we’re done, and that would be a perilous mistake,” Gifford said, reminding that there is a “constant flow” of new residents and employees who will need vaccinations.

Rare blood clots

U.S. health officials are recommending a pause on the use of Johnson & Johnson’s COVID-19 vaccine while they investigate rare cases of blood clots known to have arisen in six women among 6.8 million doses so far administered nationwide.

The announcement was made jointly Tuesday morning by the Food and Drug Administration and the Centers for Disease Control and Prevention “out of an abundance of caution,” the agencies said. 

The incidents in question involve a type of blood clot called cerebral venous sinus thrombosis in vaccine recipients between the ages of 18 and 48. Symptoms occurred six to 13 days after vaccination. Heparin, the usual anticoagulant treatment for many blood clots, may be dangerous when used in cases of CVST, and “alternative treatments need to be given,” the agencies said.  

The temporary action “is important, in part, to ensure that the healthcare provider community is aware of the potential for these adverse events and can plan for proper recognition and management due to the unique treatment required with this type of blood clot,” officials stated.

“Extremely rare”

The CDC plans to convene a meeting of its independent immunization advisory committee on Wednesday to scrutinize the reported blood clot cases, with the outcome to be reviewed by the FDA. 

While these cases appear to be “extremely rare,” people who have received the J&J vaccine and develop severe headache, abdominal pain, leg pain or shortness of breath within three weeks afterwards should contact their healthcare provider, according to Anne Schuchat, M.D., principal deputy director of the CDC, and Peter Marks, M.D., director of the FDA’s Center for Biologics Evaluation and Research.

Health officials in other countries have at various times put similar pauses on the use of a COVID-19 vaccine made by AstraZeneca over the past few months, also due to concerns over blood clots. The European Medicines Agency has concluded that blood clots should be listed as a very rare side effect of the drug, Vaxzevria. It is not yet approved in the United States.

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CDC safety panel: J&J vaccine benefits outweigh rare neuro risks seen in older adults