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This email is being sent to local health officers, tribal health directors, COVID-19 vaccinators, COVID-19 vaccine stakeholders, HERC coordinators, and key DHS staff.
DHS Supports CDC Recommendation for Revised Use of the Johnson & Johnson (Janssen) COVID-19 Vaccine
The Wisconsin Department of Health Services (DHS) supports the Centers for Disease Control and Prevention’s (CDC) recommendation expressing a clinical preference for individuals to receive an mRNA COVID-19 vaccine over Johnson & Johnson’s COVID-19 vaccine, when possible and appropriate. On December 16, the CDC’s Advisory Committee on Immunization Practices (ACIP) members voted 15 to 0 and the CDC Director accepted the recommendation.
New data indicates that thrombosis with thrombocytopenia syndrome (TTS), a blood clotting syndrome, is still rare, but more common among people who received Johnson & Johnson’s COVID-19 vaccine than previously believed. As with any vaccine safety concern, researchers have followed this issue closely. TTS death rates are highest among females 30–39 years of age (1.93 per million doses) and 40–49 years of age (1.8 per million doses). There have been 54 cases of TTS out of about 14 million doses given overall, and the CDC’s risk-benefit analysis presented showed the vaccine still likely prevents far more hospitalizations from COVID-19 than is caused by TTS.
Administration
ACIP’s unanimous recommendation followed a robust discussion of the latest evidence on vaccine effectiveness, vaccine safety and rare adverse events, and consideration of the U.S. vaccine supply. The CDC analysis determined that the Pfizer and Moderna mRNA COVID-19 vaccines are safer than the Johnson & Johnson COVID-19 vaccine.
The ACIP reaffirmed that receiving any vaccine is better than being unvaccinated. Individuals who are unable or unwilling to receive an mRNA vaccine will continue to have access to Johnson & Johnson’s COVID-19 vaccine.
Some people may benefit from the Johnson & Johnson COVID-19 vaccine in these cases:
- When a person has a contraindication to mRNA COVID-19 vaccines (such as a severe allergic reaction after a previous dose or to a component of an mRNA COVID-19 vaccine),
- When a person would otherwise remain unvaccinated for COVID-19 due to limited access to mRNA COVID-19 vaccines, or,
- When a person wants to receive the Johnson & Johnson COVID-19 vaccine despite the safety concerns identified.
Vaccinators should discuss the CDC recommendation with patients who prefer the Johnson & Johnson COVID-19 vaccine to ensure that they are fully informed about the risks.
Booster Dose
Those who have received the Johnson & Johnson COVID-19 vaccine and have not experienced any symptoms of TTS (listed here) within 2 weeks are not at risk but do have protection against severe illness from COVID-19. It is recommended that all recipients of the Johnson & Johnson vaccine receive a booster at least 2 months after their initial vaccine – mRNA vaccines are preferred for the booster dose.
There is not yet sufficient data to determine or evaluate the risk of TTS in individuals who have received a booster dose of Johnson & Johnson COVID-19 vaccine.
Updated Clinical Considerations
The CDC Interim Clinical Considerations have been updated.
Note for Local Health Departments: DHS updated the Immunization Program's Policy and Procedure Manual and it is available on SharePoint.
Updated Emergency Use Authorizations Fact Sheets
CDC COCA Call
CDC held a Clinician Outreach and Communication Activity (COCA) Call on December 17, 2021: Updated Guidance for Clinicians on COVID-19 Vaccines.
This COCA Call presented the latest evidence on thrombosis with thrombocytopenia syndrome (TTS) after administration of the Johnson & Johnson/Janssen COVID-19 vaccine. Presenters discussed TTS and updated vaccine recommendations.
There is a web on-demand version of the call available.
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