Covering COVID-19 is a daily Poynter briefing of story ideas about the coronavirus and other timely topics for journalists, written by senior faculty Al Tompkins. Sign up here to have it delivered to your inbox every weekday morning.
The quick way to read this item is that a Centers for Disease Control and Prevention committee of experts says that Pfizer and Moderna’s COVID-19 vaccines are safer than Johnson & Johnson’s vaccine. The Johnson & Johnson vaccine is linked to rare cases of serious blood clots, especially in middle-aged women.
Before you read on, keep in mind that even in the most vulnerable populations, about one in 100,000 people who got the Johnson & Johnson vaccine developed a blood clotting problem. Of the 17 million people who got that shot, there were 54 cases of clotting. Women aged 40 to 49 had the highest incidence of clotting problems that may be linked to the Johnson & Johnson vaccine and, even then, it was two cases per 1 million people who took the vaccine.
But some people got very sick, and nine people died, so it is not a minor issue. And, of course, the other vaccines that are widely available do not raise clotting concerns.
The CDC’s Advisory Committee on Immunization Practices voted 15-0 in favor of a statement that says mRNA vaccines (Pfizer’s and Moderna’s) are preferred over the Johnson & Johnson vaccine. This was the wording of the motion the committee approved:
The Johnson & Johnson vaccine was conceived as a one-dose regimen but now is considered to be a two-dose vaccine. 16 million people in the United States took the Johnson & Johnson shot, compared to 113 million people who got the Pfizer vaccine and 73 million who got the Moderna vaccine.
The ACIP advisers’ vote is in line with a statement earlier this week from the Food and Drug Administration that warned people who have a clotting problem after the first dose not to get a second dose. ACIP said the Johnson & Johnson vaccine is still better than not taking a vaccine at all and that the Johnson & Johnson vaccine is still useful for people who have concerns about or allergies to the mRNA vaccines. And ACIP says where people cannot get access to multiple doses of an mRNA vaccine, the Johnson & Johnson vaccine offers an alternative to not getting vaccinated.
The FDA and CDC have been tracking the blood clot issue for some time.
You will remember that on April 13, the FDA paused the use of the Johnson & Johnson vaccine after the first reports of clots were documented. After a few days, the FDA said the vaccine was safe and effective. There were reports about similar issues with the AstraZeneca vaccine, which has not been approved for use in the United States. Three-fourths of the 54 known cases of thrombosis that followed a Johnson & Johnson vaccine happened before the April 13 pause.
The clotting condition is called Thrombosis with Thrombocytopenia, or TTS. This was part of the ACIP briefing:
Earlier this week, the FDA summarized:
- Cases of TTS following administration of the Janssen COVID-19 Vaccine have been reported in males and females, in a wide age range of individuals 18 years and older, with the highest reporting rate (approximately 1 case per 100,000 doses administered) in females ages 30-49 years; overall,
- Approximately 15% of TTS cases have been fatal.
- Currently available evidence supports a causal relationship between TTS and the Janssen COVID-19 Vaccine.
Notice that the FDA was not ready to say the vaccine caused the clots. The FDA still says the risks from the virus outweigh the risks from the Johnson & Johnson vaccine.
The reported increase in clotting problems has mainly shown up on the CDC’s Vaccine Adverse Event Reporting System, or VAERS, where anybody can post what they believe to be an adverse medical reaction to a vaccine without having to show a documented cause and effect. (Poynter has explained the importance and hazards of VAERS in previous articles.)
The CDC staff said in the days ahead it will have to find ways to tell the public that this vote does not mean the vaccines are unsafe, but that because there are alternatives available to the Johnson & Johnson shots, unvaccinated people have safe choices that have not raised concerns about clotting.
The CDC wants to remind people who have gotten the Johnson & Johnson shot that there is no known reason to be concerned. The small number of people who have developed clotting problems did so within two weeks after they got the vaccine.
Of the 54 people who did develop TTS after being vaccinated with the Johnson & Johnson vaccine, 36 ended up in the intensive care unit. Nine of them died.
Omicron update: 33 cases in 22 states
The CDC panel also saw new data on the spread of the omicron variant of COVID-19. A third of U.S. cases involved people who had traveled internationally, and eight out of 10 people infected with omicron were fully vaccinated (meaning two doses). About 14% of them had previously been infected with COVID-19 and may have had some level of “natural protection” that is normal when people get infected with a virus.
The CDC says Moderna is currently testing a “higher booster dosage” shot that could be used to prevent infection from the omicron variant, and Pfizer is working on an omicron-specific vaccine.
The CDC says this is its current recommendation for fighting omicron, which looks a lot like what CDC said you should do with the delta variant spreading fast:
Omicron is showing up in wastewater samples
The Associated Press says that in one Florida county where the wastewater is tested for viruses, the omicron variant is showing up prominently, even though infections are not yet.
Even though there have been practically no cases of clinical infection, wastewater samples show that the new omicron variant is now the dominant strain of COVID-19 in the Florida county that is home to the nation’s largest theme park resorts, officials said this week.
The omicron variant has quickly surpassed the delta variant in collections taken from wastewater sampling sites in Orange County, officials said.
A sampling this week showed that omicron represented almost 100% of the strains in the samples from the wastewater facilities, Orange County Utilities spokesperson Sarah Lux said in an email.
Dozens of NYC restaurants close this weekend due to new COVID cases
In the context of a city with hundreds of thousands of businesses, this may not seem like much — unless it is the canary in the coal mine. The New York Times reports, “At least a dozen businesses have temporarily shut this week in response to positive test results among their workers, and others are expected to follow.”
The Times added, “There have been restaurant closings in Massachusetts, Maryland, Virginia. New Mexico, Oregon, Hawaii and other states. The New York City closings, like those now occurring at several Broadway shows, come in the thick of the holiday season, normally one of the busiest times of the year for those businesses.”
Soaring COVID cases in UK
New COVID-19 cases are nearing all-time highs in the United Kingdom. Deaths are up, too, but most cases do not require hospitalization.
Prime Minister Boris Johnson said, “I’m afraid we’re also seeing the inevitable increase in hospitalizations up by 10% nationally, week-on-week, and up by almost a third in London.”
‘America is not ready for omicron’
Ed Yong is a Pulitizer Prize-winning journalist for The Atlantic. He has been asking front-line doctors how America will endure a new variant that is spreading fast. Here are his opening paragraphs:
America was not prepared for COVID-19 when it arrived. It was not prepared for last winter’s surge. It was not prepared for Delta’s arrival in the summer or its current winter assault. More than 1,000 Americans are still dying of COVID every day, and more have died this year than last. Hospitalizations are rising in 42 states. The University of Nebraska Medical Center in Omaha, which entered the pandemic as arguably the best-prepared hospital in the country, recently went from 70 COVID patients to 110 in four days, leaving its staff “grasping for resolve,” the virologist John Lowe told me. And now comes Omicron.
Will the new and rapidly spreading variant overwhelm the U.S. health-care system? The question is moot because the system is already overwhelmed, in a way that is affecting all patients, COVID or otherwise. “The level of care that we’ve come to expect in our hospitals no longer exists,” Lowe said.
COVID is forcing universities to move back to online learning
Princeton University is moving final exams online “so that students will be able to leave campus at their earliest convenience.”
New York University told students that it is canceling all nonacademic, nonessential gatherings because of a “considerable acceleration” in COVID-19 cases.
Cornell University reported 903 cases of Covid-19 among students between Dec. 7 and 13. The school closed its campus.
The times in which we live
I didn’t realise the noise I was hearing outside: the National Cathedral is tolling its bell 800 times to mark 800,000 deaths.
i don’t even know what to say right now and am going to just sit and listen. my heart goes out to everyone who has lost someone over the last two years
— Dr Alexandra Phelan (@alexandraphelan) December 15, 2021
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