CDC vaccine advisers to hear about new blood clot cases linked with J&J coronavirus vaccine

Vaccine advisers to the US Centers for Disease Control and Prevention are scheduled to meet Friday to discuss how to move forward with the paused Johnson & J...

Posted: Apr 23, 2021 10:13 AM
Updated: Apr 23, 2021 12:00 PM

Vaccine advisers to the US Centers for Disease Control and Prevention are scheduled to meet Friday to discuss how to move forward with the paused Johnson & Johnson's coronavirus vaccine.

The Advisory Committee on Immunization Practices is scheduled to meet from 11 a.m. to 5 p.m. ET Friday and is expected to vote on updated recommendations for use of the vaccine, made by Janssen, J&J's vaccine arm. Use of the vaccine has been paused since April 13, after a small number of people experienced blood clots after taking the shot.

The meeting is being livestreamed.

During the meeting, a subcommittee of the vaccine advisers known as the working group will recommend continued use of the vaccine in the United States, an expert familiar with the situation said Friday. ​

Typically, the CDC accepts the recommendations of ACIP, which is made up of outside experts.

'They are not going to disallow the use of the vaccine -- that is off the table,' said the expert, who required anonymity because the subcommittee's deliberations have not yet been made public.

'And they are determined that the committee will make a recommendation of some kind will today. They are not going to kick this can further down the road.'

Late in the afternoon on Thursday, the working group was still debating whether to ​recommend adding a ​warning to the vaccine ​and whether to suggest that people under a certain age not receive the shot. ​

The blood clot cases that led to the pause were all in people under the age of 48. Six women experienced blood clots within 6 to 13 days after being given the shot, according to the CDC and the US Food and Drug Administration. One man experienced clots 21 days after getting the vaccine during the clinical trial last fall, according to J&J.

More cases of rare blood clots

The advisers will discuss whether the vaccinecauses a rare blood clotting syndrome they're calling thrombosis with thrombocytopenia syndrome (TTS). Other groups have called it vaccine-induced immune thrombotic thrombocytopenia or VITT, but ACIP is sticking with more neutral language that doesn't presume vaccines are causing the condition.

It's characterized by a rare type of blood clot in the brain -- and possibly other large blood clots -- along with a low number of blood clotting cells called platelets. Some blood specialists have said they believe it's caused by an unusual immune reaction that targets platelets, causing them to glob together into clots.

ACIP will hear about additional cases reported since their last meeting earlier in the month. At the time, ACIP members said they needed more time and more information before deciding on whether and how to change recommendations for giving the vaccine.

The expert CNN spoke with said there have been more cases since then, but declined to say how many.

Oregon health officials said Thursday night they were investigating the case of a woman in her 50s who died after having received the vaccine and who had symptoms of TTS.

'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.

They'll hear from a blood clot expert -- Dr. Michael Streiff of Johns Hopkins University, who is likely to brief on what's known how to treat TTS. Reports indicate blood thinners, with the exception of a commonly used blood thinner called heparin -- will help dissolve the clots, and use of an immune product called IVIG can help neutralize the mistaken immune response.

ACIP will also hear from two officials of Johnson & Johnson.

Members of ACIP will consider the potential risks of the vaccine as opposed to the risk of catching coronavirus. Blood clot specialists have told CNN the risk of developing blood clots of all sorts from coronavirus infection are much higher than the risks seen in people who got the vaccine.

AstraZeneca's vaccine has been linked to TTS as well. The World Health Organization and European medical regulators have said the benefits of the AstraZeneca vaccine, which is not yet authorized in the US, outweigh any potential risks.

Earlier this week, Dr. William Schaffner, a non-voting ACIP member and infectious diseases professor at the Vanderbilt University School of Medicine, told CNN that it was likely that ACIP will recommend that use of the vaccine resume with a warning about possible adverse effects -- and potentially, advice to the highest-risk populations to steer clear of this vaccine altogether.

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