April 13, 2021

stop and breathe for a minute

Today was a day to take a deep breath and pause. This time last year, we were afraid of a new virus that was causing hospitals to be overwhelmed, ICU’s to be full, and more deaths then we could imagine. None of us really imagined we would have more than 550,000 deaths in the US a year later, with the virus still raging in the country and the rest of the world.

Nor could we imagine that we would have more than one safe and effective vaccine a year later. The plan to development multiple vaccines options simultaneously was brilliant and worked, bringing a hint of relief after a long year. That fast track to vaccine approval cut red tape, but increased fear for many that corners were cut and safety of the vaccines would be compromised. Since the vaccine rollout in December, millions and millions have been vaccinated in the US. 143 million at least, a remarkable achievement.

One of our biggest obstacles to overcoming the pandemic is the hesitancy for many and the anti-vaxxer attitude in some. We have been making slow and steady progress with the vaccine hesitants. Hesitancy was steadily decreasing as people saw the vaccines to be effective and safe. In March, a poll showed that at least 62% of those asked had either gotten a vaccine or were planning to as soon as able. Another 17% took the attitude “Wait and See”. Another 20% were unlikely to be swayed. That number of 20% of people who will refuse the vaccine hasn’t budged for months, which means they are unlikely to change their minds. However, the “Wait and See” group has decreased from 39% to 17%, an optimistic change, with more opting for vaccines

The news today about the Johnson & Johnson vaccine being put on pause will start to roll back the gains we have made in the “Wait and See” group. This is why the decision to pause giving the vaccine was a challenging decision, with arguments on both sides. Ultimately transparency won out, which is as it should be. Even though the risk of this rare blood clot is low, being honest about findings may help some people view the process as more honest.

The big fear is that hesitancy will go way up, as it has in Europe with the Astra Zeneca vaccine which has a similar, rare side effect. This will slow our emergence from the pandemic. The hope is that this openness and transparency of this process will help some gain trust in the process. A big worry is that more are at risk from death from COVID-19 vs this rare cerebral venous sinus thrombosis.

The pause is also to give an alert to doctors and those in the medical field caring for people who may have this rare (6 cases out of almost 7 million doses) clot. Treatment is different than the more common DVT’s (deep vein thromboses) that people get if they sit for too long on a plane or are immobilized for some other reason. It seems to be caused by an immune system reaction because platelet counts go down. The treatment for the more common DVT is heparin but it can cause more harm in this particular clot.

The pause will give time to look for trends or other causes and similarities.

In the meantime, we can all explore what relative risk means. This story in The Washington Post has an excellent graphic that shows the number of vaccines given vs the number of these rare clots vs the likelihood of COVID-19 deaths. This shows how the risk of death from COVID 19 (real at 1.6 per 100 people) is still so much greater than risk from the vaccine (1 in 1.1 million)

I will write more about this as the week goes on. The bottom line today is that if you got the Johnson & Johnson vaccine, the risk is only about 1 in 1.1 million. It has only been 6 total women ranging in age from 18-48, with symptoms of severe headache, abdominal pain, leg pain, or shortness of breath occurring between 6 and 13 days post vaccination. If you have those symptoms then you need to be seen right away. Read the CDC health alert for good details. Remember that your risk of dying from COVID-19 is now greatly diminished after the vaccine and that your risk of this clot is exceedingly low .

Wash your hands, cover your nose, keep safe six. Take a deep breath and pause.

And finally, my caveat is that this is my experience and my opinions, which are subject to change as more information is available, and not related to the organization I work for. Thanks for reading.

https://www.kff.org/coronavirus-covid-19/poll-finding/kff-covid-19-vaccine-monitor-march-2021/

https://www.medpagetoday.com/infectiousdisease/covid19vaccine/91992

https://www.nytimes.com/2021/04/13/us/politics/johnson-johnson-vaccine-pause-states.html

https://www.nytimes.com/2021/04/13/health/blood-clots-johnson-vaccine.html

https://www.washingtonpost.com/politics/2021/04/13/risk-reward-calculus-johnson-johnson-vaccine-visualized/

https://emergency.cdc.gov/han/2021/pdf/CDC-HAN-00442.pdf

https://www.nytimes.com/2021/04/13/us/politics/johnson-vaccine-risk.html