WASHINGTON (Reuters) – Resumption of use of Johnson & Johnson’s COVID-19 vaccine in the United States will require clear guidelines for the medical community on how to better treat patients who develop a rare type of blood clot, as well as alert recipients note the revealing symptoms, according to heart doctors and other medical experts.
U.S. health regulators last week recommended a pause in the use of the J&J vaccine after six cases of rare cerebral blood clots, accompanied by low platelet levels, were reported in women after vaccination. , of about 7 million people who received the vaccine in the United States. States. A group of expert advisors to U.S. health agencies will meet later this week to determine whether the break should continue, with a decision scheduled as early as Friday.
“My calculation is that we will continue to use it in some way,” Dr. said Sunday. Anthony Fauci, chief medical adviser to President Joe Biden, in NBC’s “Meet the Press.” “I think there will probably be some kind of alert or restriction or risk assessment.”
Scientists have not yet established a direct link between the J&J vaccine and unusual blood clots, which have also been identified among a small fraction of people who received AstraZeneca Plc’s COVID-19 vaccine outside the United States. It is unclear how long it would take to determine if vaccines cause these symptoms.
Meanwhile, however, scientists say both vaccines remain important tools to help fight a coronavirus pandemic that has killed more than 3 million people worldwide. The key will be to tell doctors and patients how to look at the “one in a million” side effect.
“It made sense to take a break,” said Dr. Rishi Mehta, associate medical director of inpatient operations at Keck Hospital at the University of Southern California in Los Angeles, referring to the use of the J&J vaccine. “We should say, ‘Listen, side effects are rare, but you might get them and that’s what you have to keep in mind … We’re talking about headaches, abdominal pain, confusion.”
My estimate is that we will continue to use it in some way. I think there will probably be some kind of warning or restriction or risk assessment.
–Dr. Anthony Fauci, chief medical adviser to the prison. Biden
The American Heart Association said Friday that other potential symptoms, which could occur up to two weeks after vaccination, are blurred vision, fainting, sensory changes, seizures, leg pain or shortness of breath. of breath.
Doctors will also need to be vigilant when treating themselves. The cases identified so far are cerebral venous sinus thrombosis (CVST), or blood clots in the veins of the brain, rather than in the arteries, which is the case with most strokes.
The U.S. Food and Drug Administration has said that patients who develop clot-related symptoms after receiving the J&J vaccine should not be given heparin, an anticoagulant that is widely used to treat blood clotting disorders. coagulation, at least until additional tests to determine if they have low platelets. counts. The rare combination of clotting and low platelets indicates a condition called heparin-associated thrombocytopenia, and giving heparin can cause damage.
The FDA warned health care providers that the use of heparin in these cases could even be fatal and advised them to firmly consider non-heparin anticoagulants and high-dose intravenous immunoglobulin (IVIG).
“You should do some tests with anyone who has symptoms like this and, based on those tests, you will be reasonably positioned to treat without putting the person at risk,” Dr. at New York University.
According to details published Friday in the New England Journal of Medicine, a 48-year-old woman who received the J&J shot was taken to the University of Nebraska Medical Center after being diagnosed with extensive blood clotting or thrombosis. She was treated with heparin, but her condition worsened and she was replaced by a different anticoagulant and IVIG. The patient remained in critical condition at the time of the report.
“If they give heparin, they can make things worse, so that’s a good reason to draw attention to that,” Fauci, director of the National Institute of Allergy and Infectious Diseases, told Reuters.
Doctors said the pause in vaccines against J&J allows hospital systems to have time to update their own recommendations.
“It’s certainly a very serious condition, but there are recommendations for treatment,” said Dr. Annabelle of St. Louis. Maurice, infectious disease specialist at the University of California at Los Angeles. “Before that, someone who had the vaccine and had a headache, our first idea would not be to consider CVST and order labs and images to evaluate it.”
J&J and AstraZeneca officials did not immediately respond to requests for comment.
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