Advisers to the Centers for Disease Control and Prevention have released new clinical guidance regarding a rare blood clotting condition reported after vaccination with Johnson & Johnson’s shots.

Education and guidance are critical to the effort to resume use of the one-shot vaccine and  ensure flexibility, choice and improved access, wrote members of the Advisory Committee on Immunization Practices in a Tuesday web post.

After instituting a 10-day pause on the vaccine’s use, ACIP on April 23 advised that the benefits of resuming J&J vaccinations among adults outweighed the risks. Its original emergency use recommendation now includes a new warning for rare clotting events called thrombosis with thrombocytopenia syndrome, or TTS, among women aged 18 to 49 years old. Emergency Use Authorization fact sheets regarding the events have also been released.

Women ages 50 years old or younger should be made aware that, while very rare, they have an increased risk for TTS and that other COVID-19 vaccines are available, wrote Sara E. Oliver, M.D., CDC epidemic intelligence service officer, and colleagues. The EUA fact sheet should be provided to all vaccine recipients and their caregivers (as relevant) for careful review before vaccination with any authorized COVID-19 vaccine, they added. 

Vaccinators also should be sure to educate themselves on the preferred treatment for TTS, which may not align with the general presumed treatment for blood clots, the advisers said. 

“Notably, heparin should not be administered, and consultation with hematology specialists is strongly recommended.”

The advisers point clinicians to a Health Alert Network notification published on April 13, 2021 for additional information and recommendations concerning the identification and treatment of suspected cases after vaccination.

More clinical considerations involving the rare events are available here.