Summit County has paused its use of the Johnson & Johnson vaccine. Here’s what you need to know.

Reporting, writing and photos by H.L. Comeriato

Two days after the U.S. Centers for Disease Control and Prevention and the Food and Drug Administration recommended a pause in administering the Johnson & Johnson COVID-19 vaccine, I sat down with Summit County Public Health Commissioner Donna Skoda to learn more about why the vaccine was halted, and what the pause will mean for Summit County’s mass vaccination site.

Because the Johnson & Johnson vaccine is the only single dose vaccination approved for emergency use by the FDA in the United States, it’s been an important part of vaccine rollouts in vulnerable, hard-to-reach communities across the country.

Why did the CDC and FDA recommend a pause?

On April 13, the CDC and FDA released a joint statement recommending the pause after six women between ages 18 and 48 developed a “rare and severe type of blood clot,” between six and 13 days after receiving the Johnson & Johnson vaccine.

The clot, called cerebral venous sinus thrombosis (CVST), forms in the brain’s venous sinuses. According to Johns Hopkins University, the clot may prevent blood from draining out of the brain. When blood builds up and enters the brain tissues, it can deprive the brain of oxygen, causing a hemorrhage or stroke. 

This type of blood clot is extremely rare, and only affects around 5 out of every  1 million people each year.

In all six reported cases of CVST, women also experienced low levels of blood platelets after receiving the vaccine.

Blood platelets help regulate blood clotting and stop bleeding from wounds or cuts. When a person’s blood platelet levels are low, they may bleed excessively.

Low blood platelets complicate treatment for CVST, because Heparin  — a blood thinner commonly used to treat blood clots — can’t be used to treat CVST in patients who also have low blood platelet levels.

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How will this pause affect vaccinations among Akron’s more vulnerable communities? 

Because the Johnson & Johnson vaccine requires only one dose, while the Pfizer and Moderna vaccines require two doses, Skoda says the pause may affect Summit County Public Health’s ability to vaccinate Akron’s most vulnerable communities — including new Americans, older adults and other residents with limited access to transportation services.

“It’s double the manpower,” Skoda says. “It’s double everything.”

I’ve heard that this type of blood clot is rare. How do officials gauge that risk?

Of the nearly 7 million doses of Johnson & Johnson administered worldwide, just 0.00086% of people who received the vaccine have been affected by CVST. 

“The incidence is so very, very low and the risk is so very, very low,” Skoda says. “You’re probably going to get struck by lightning before you would have [CVST]. But because there was a death, and there’s another person in serious condition, they’re not going to risk letting it continue until they make sure that this was something unique to these individuals.”

Public health officials have recommended a “pause.” Does that mean the vaccine will be used again?

Skoda says it’s likely the Johnson & Johnson vaccine will be cleared for use again after researchers determine why CVST occurred in the six women affected.

Right now, researchers still aren’t sure how CVST and low platelet levels are linked to the vaccine. Some individuals may have medical histories that heighten the risk of experiencing CVST and low platelet levels, including genetic factors.

“I think it’ll be back, and I don’t think it’ll be very long before it’s back,” Skoda says. “We’ve never vaccinated at this level in the world before. And so you’re going to have some adverse effects and you’re going to have, unfortunately, some bad outcomes. But overwhelmingly, it’s a safe vaccine.”

If you have already received a dose of the Johnson & Johnson vaccine and you’re worried or anxious, what symptoms should you look for?

“It’s normal right after a vaccine to have a slight temperature, not feel good, have achiness [or] a headache,” Skoda says. But those symptoms, often described as flu-like, should be gone 2-3 days after vaccination.

If you experience severe headaches, prolonged shortness of breath, pain in your legs or abdomen, blurred vision, confusion, difficulty speaking, loss of movement or seizures, you should seek medical attention as soon as you can.

In all six reported cases, symptoms have occurred between six and 13 days after receiving the vaccine.

What will this pause mean for Summit County’s mass vaccination site?

After the CDC and the FDA released their joint recommendation on April 13, Summit County’s mass vaccination site halted use of the Johnson & Johnson vaccine.

On Sunday, April 18, vaccinations at the site resumed using the Pfizer COVID-19 vaccination. Previously, the mass vaccination site at the Summit County Fairgrounds used Johnson & Johnson exclusively.

Pfizer is currently the only COVID-19 vaccination approved for people under the age of 18. All 16 and 17-year-olds who schedule a vaccination appointment will receive the Pfizer vaccine, and must be accompanied by a parent or guardian while the vaccine is administered.

Skoda says Summit County Public Health is also expecting a shipment of Moderna vaccines to be administered at the mass vaccination site.

What should I do if I don’t have a ride to and from my vaccination appointment? 

  • There are currently nine mass pick-up locations in operation across the city, in addition to sites in Cuyahoga Falls and Barberton.

To find a pick-up site in your neighborhood, click here for a full list of times and locations.

  • METRO will offer free rides to and from vaccination appointments to rides who can provide print or digital proof they have a vaccination appointment the same day they plan to ride.

To learn more about riding free with METRO, click here.

  • METRO will also run a free shuttle between the county’s mass vaccination site at Summit County Fairgrounds and the Independence Transit Center at 1280 Independence Ave.

To learn more about METRO’s shuttle site at the Independence Transit Center, click here.

  • If you are a Medicaid recipient, you may be eligible to receive free transportation to and from your vaccination appointment. 

To register for free transportation to and from vaccination appointments via Medicaid, call (330) 643-8200.

If you are already registered for free transportation, call (330) 376-5353 to request a ride to and from your vaccination appointment.

For more information on transportation support via Medicaid, click here.

How can Akronites help?

The Ohio Department of Health is currently recruiting volunteers to assist with the vaccination process. You do not have to have to have experience in healthcare or public health to volunteer, but healthcare professionals, veterinarians and pharmacists are all encouraged to register.

“We always use volunteers,” Skoda says. “You can do anything from direct traffic to help register. You can be a runner. You can help with the patient monitoring. We have EMS there, but we also have volunteers monitoring.”

To register as a volunteer, residents should register with Ohio’s Medical Reserve Corps.

The Ohio Responds Volunteer Registry tracks registered volunteers and notifies them when they’re needed to help with public health efforts like mass COVID-19 vaccination.

To register with the Ohio Department of Health and the Medical Reserve Corps as a volunteer, click here.

How do I schedule a vaccination appointment?

To schedule a vaccination appointment at Summit County’s mass vaccination site at the Summit County Fairgrounds, visit Ohio’s central vaccine portal: https://gettheshot.coronavirus.ohio.gov/

To schedule an appointment over the phone, call 1-833-4-ASK-ODH (1-833-427-5634).

If you have questions or concerns about vaccination, or have difficulty scheduling an appointment, call Summit County Public Health’s helpline at (330) 926-5795.

H.L. Comeriato covers public health at The Devil Strip via Report for America. Reach them at HL@thedevilstrip.com.

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