Highly Anticipated CDC Vote on J&J Vaccine Likely Today

April 23, 2021

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Although there is no way to know how the vote will go when the CDC's Advisory Committee on Immunization Practices meets later today on the recommended pause in use of the Johnson & Johnson vaccine, many experts predict the panel to suggest the J&J vaccine rollout start back up..

Few additional cases of the rare, but serious blood clots that prompted the pause have emerged, which could increase the likelihood that vaccinations restart as early as this weekend.

The CDC and FDA initially recommended pausing the rollout on April 13 based on reports of six cases of rare blood clots. The 21 members of ACIP held a hastily called meeting the next day to evaluate the evidence. They decided that they needed more time to make a recommendation.

The panel also voted to keep the pause in place to give health care professionals and the public more time to learn about the most likely symptoms associated with the blood clots, known as central venous sinus thrombosis (CVST) and thrombocytopenia.

Fast forward 9 days to today, and the highly anticipated ACIP vote will be announced later this afternoon or early evening.

Likely Outcomes

The experts could vote to keep the pause in effect longer. They could decide to add a warning label about the blood clots as a potential rare serious adverse event, which is what the European Medicines Agency decided earlier this week. Johnson & Johnson

The panel could decide to just restart the rollout as business as usual.

They also might opt to recommend restrictions on who receives the Johnson & Johnson vaccine based on age, gender or other factors.

As one of three available COVID-19 vaccines, the Johnson & Johnson product increases the capacity for immunizations nationwide. It also offers specific advantages for the needle phobic and for outreach to rural and other underserved communities because of its single shot administration and less stringent storage requirements.

Experts Agree and Disagree

"I suspect the pause is going to be lifted," Amesh Adalja, MD, said during a media briefing April 22 sponsored by the Infectious Disease Society of America and the Institute for Health Metrics and Evaluation (IHME) at the University of Washington in Seattle.

Although he did not think a "blanket pause" was necessarily the right approach, "this shows that we are taking vaccine safety seriously that something that happens very rarely is picked up by our systems." added Adalja, senior scholar at Johns Hopkins University Center for Health Security in Baltimore.

"I totally agree with Dr. Adalja that we're going to go back to Johnson & Johnson," Ali H. Mokdad, PhD, Professor of Health Metrics Sciences at IHME said during the briefing. He predicted the panel will recommend a warning about the rare adverse events and a change in the target population that excludes people at highest risk for the blood clots.

Although he said he rarely disagrees with Dr. Adalja, Mokdad supported the pause as the appropriate thing to do. And they both agreed that the Johnson & Johnson product is essential.

"Johnson & Johnson is a game changer for all of us, especially among the marginalized communities and homeless people. I mean, this is our best line of defense and vaccine because you can get one shot and you can take it anywhere," Mokdad said.

"I want this vaccine back as soon as possible," Adalja said. "The longer the pause continues, the harder it's going to be to restart it."