The vials labeled “COVID-19 coronavirus vaccine” and the syringe are seen in front of the Johnson & Johnson logo that appears in this illustration of February 9, 2021. REUTERS / Dado Ruvic / Illustration
Resuming the use of Johnson & Johnson (JNJ.N) 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. of the vaccine be aware of 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. A group of expert advisers from U.S. health agencies will meet later this week to determine if the break should continue, with a decision scheduled as early as Friday.
“My estimate is that we will continue to use it in some way,” Dr. said Sunday. Anthony Fauci, chief medical adviser to President Joe Biden, on 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 the unusual blood clots, which have also been identified among a small fraction of people who received the COVID-19 vaccine from AstraZeneca Plc (AZN.L). 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 hospital 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 should keep in mind … We’re talking about headaches, abdominal pain, confusion.”
The American Heart Association said Friday that other possible symptoms, which could appear up to two weeks after vaccination, are blurred vision, fainting, sensory changes, seizures, leg pain or lack of timely.
Doctors will also need to be vigilant when treating themselves. The cases identified so far are of 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 a low plaque. 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 healthcare 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 in a reasonable position to treat without putting the person at risk,” said Dr. Jeffrey Berger, a disease-focused cardiologist. of blood clotting 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 J&J vaccinations allows hospital systems 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.
Our standards: the principles of trust of Thomson Reuters.