The Centers for Medicare & Medicaid Services has released brief, interim guidance for long-term care facilities while the Johnson & Johnson vaccine remains on pause. 

Although a few cases of blood clots following vaccination and the J&J shot have not yet been shown to be definitively linked, health officials have recommended holding off on administering the drug while they review those events. The “extremely” rare blood clot incidence appears to be limited only to J&J’s shot among vaccines approved for use in the United States, the agency noted. Nevertheless, it is encouraging providers to be aware of the following symptoms of clotting, along with additional updates: 

  • Signs of a blood clot after vaccination: If residents or staff members develop severe headache, abdominal pain, leg pain or shortness of breath within three weeks of receiving the J&J vaccine, seek medical care, the agency stated. Healthcare providers are advised to report the event to the Vaccine Adverse Event Reporting System at
  • Clotting events are rare: “We realize there may be concern among LTCF staff and residents who have received the J&J vaccine, but it’s important to note these adverse events appear to be extremely rare,” CMS stated. Six cases were reported among the more than 6.8 million doses administered in the U.S. All cases occurred in women aged 18 to 48, with symptom onset six to 13 days after vaccination.
  • No clotting linked to Pfizer, Moderna vaccines: The Centers for Disease Control and Prevention is not seeing blood clot events with the Pfizer-BioNTech or Moderna COVID-19 vaccines.
  • CDC is pursuing options to reduce vaccination interruptions in long-term care: The CDC has notified federal pharmacy partners about the recommendation to pause J&J COVID-19 vaccination and is “exploring options to minimize any potential interruption” in ongoing access to vaccines for long-term care facilities, CMS stated. 

The CDC’s Advisory Committee on Immunization Practices is scheduled to meet for a second time, on April 23, to further discuss the blood clot cases and whether the recommended pause on J&J vaccinations should continue. 

In related news:

Blood clot treatment guidelines needed to resume J&J COVID vaccination, doctors say  Clinicians and patients should look out for a “one-in-a-million” side effect in COVID-19 vaccines, doctors and scientists have told Reuters. “It made sense to pause [J&J shots],” Rishi Mehta, M.D., of Keck Hospital at the University of Southern California, Los Angeles, told the news outlet. “We should say: ‘Listen, the side effects are rare, but there is a potential for you to get them and these are what you should look out for… We are talking about headaches, abdominal pain, confusion.”