Health Department puts J&J vaccine on hold
Decision not expected to stall expanded rollout on Neighbor Islands
Federal agencies called for a pause on Johnson & Johnson vaccines on Tuesday, dealing a “setback” to Hawaii’s plans but not likely to impact rural Neighbor Island communities where the state hoped to use the one-dose vaccine, the health director said.
“It’s a setback just because it’s fewer doses of vaccine, and we in Hawaii had actually been hoping to get more and more,” state Department of Health Director Dr. Elizabeth Char said Tuesday. “We still have a really good demand for vaccine and we’re really thankful for that. So we’re going to keep marching forward. Most of the vaccine that we’re using out in our community pods and in the hospitals is Pfizer and Moderna anyway, so this will set us back a little bit but not a lot.”
On Tuesday, the Centers for Disease Control and Prevention and the Food and Drug Administration announced that they were reviewing data from “six reported U.S. cases of a rare and severe type of blood clot in individuals after receiving the J&J vaccine.” All were women between the ages of 18 and 48 who developed the symptoms 6 to 13 days after vaccination. The blood clot, known as cerebral venous sinus thrombosis, as also observed with low levels of blood platelets, the agencies said.
As of Monday, more than 6.8 million doses of the vaccine have been administered in the U.S.
“Right now, these adverse events appear to be extremely rare,” the CDC and FDA said in a joint statement. “COVID-19 vaccine safety is a top priority for the federal government, and we take all reports of health problems following COVID-19 vaccination very seriously. People who have received the J&J vaccine who develop severe headache, abdominal pain, leg pain or shortness of breath within three weeks after vaccination should contact their health care provider.”
In Hawaii, sites that had been planning to use Johnson & Johnson in the coming days will transition to Moderna or Pfizer, Char said.
The Johnson & Johnson vaccine, while less effective in clinical trials than Pfizer and Moderna, offered advantages for rural or hard-to-reach populations because it only requires one dose and does not need to be stored at the same ultra-low temperatures as Pfizer.
Hawaii received its first shipment of 11,900 doses of Johnson & Johnson vaccine in early March, with 5,900 doses going to Oahu and 2,000 doses each to Maui, Kauai and Hawaii counties.
So far, Hawaii has received 47,000 Johnson & Johnson doses and administered about 17,000, the Health Department said Tuesday. Since the rollout began in mid-December, the state has received 849,230 doses and administered 740,769, according to DOH data.
Char said Tuesday that the state had been divvying up the Johnson & Johnson vaccines based on population but that it also wanted to use the one-shot vaccine in rural and hard-to-reach areas.
“We were trying to use the Johnson & Johnson in situations where it would be harder to get to somebody for a second dose, or to get the appointment and set them up or transportation issues,” Char explained.
However, she said she didn’t think Neighbor Islands would be disproportionately impacted because the state “hadn’t really gotten a robust supply” of Johnson & Johnson yet.
“I don’t believe that any of the islands will be impacted more than any other,” Char said. “Again, we hadn’t received that much in the way of Johnson & Johnson, so it’s not going to affect us since the majority of our vaccine sites are using Moderna and Pfizer.”
Most clinics in Maui County have been offering the two earliest versions of the vaccine. Health care workers received Pfizer in the initial days of the vaccination rollout, while staff and residents of long-term care facilities received Moderna.
Maui Health, which operates clinics at Maui Memorial Medical Center and the Grand Wailea, only offers Pfizer.
The Health Department’s Maui District Health Office had been administering Moderna but held a clinic on Saturday at King Kekaulike High School offering Johnson & Johnson.
Providers on Molokai and Lanai, where more than half of the eligible population has already been vaccinated, have also been relying on Pfizer and Moderna.
Lanai Community Hospital, run by Maui Health, distributes Pfizer vaccines, while the Lana’i Community Health Center offers Moderna and had been planning to make Johnson & Johnson available before the CDC and FDA hit pause on Tuesday.
Molokai General Hospital offers Moderna, according to its vaccine registration forms, while the Molokai Community Health Center said last week that it has been giving out Moderna but planned to offer Johnson & Johnson at a future mass distribution event.
Char said that if any vaccine recipients start to feel symptoms or any unusual pain, they should get checked out by a health care provider. While the blood clots are “very serious and significant,” Char also pointed out that they were “very rare,” detected in just six cases out of more than 6.8 million doses.
She said that any sort of reaction to the vaccine is reported to the Vaccine Adverse Event Reporting System, a national database that allows federal officials to track potential patterns.
Until Hawaii receives further guidance from federal health agencies, the state plans to keep the 30,000 doses of Johnson & Johnson that it currently has “in safe storage at the proper temperature control.”
“We’re waiting for the guidance that will come out tomorrow regarding use of Johnson & Johnson, whether it’s a pause or whether it’s suited better for certain populations or not at all,” Char said. “We’ll wait for the science and we’ll wait for the data to come out and that will help guide us.”
* Colleen Uechi can be reached at firstname.lastname@example.org.