The Centers for Disease Control and Prevention on Thursday recommended favoring Covid vaccines other than Johnson & Johnson’s, after their advisers cited mounting evidence that the company’s injections could cause a rare blood clotting disorder that’s now linked to dozens of cases and at least nine deaths in the United States in the past year.
The decision took a recommendation from a panel of experts that effectively discouraged vaccine providers and adults from using Johnson & Johnson’s injection. New data showed that there was a higher risk of the blood clotting condition than previously known. The risk was greatest in women ages 30 to 49, estimated to be 1 in 100,000 who had received the company’s injection.
Johnson & Johnson’s vaccine will not be withdrawn from the market. It remains an option for those “unable or unwilling” to receive the more popular shots from Moderna or Pfizer-BioNTech, the agency said.
The recommendation is the latest setback for a vaccine that has largely fallen out of favor in the United States. The company’s vaccine has not lived up to its early promise as a traditional, one-time format that could be easily deployed in more isolated or rural communities, or among those timid about receiving two doses.
About 16 million people in the United States have received the Johnson & Johnson vaccine as their primary immunization, compared with 73 million fully immunized with Moderna’s vaccine and 114 million with the Pfizer-BioNTech injections. Of the Americans who received a booster, only 1.6 percent chose Johnson & Johnson.
This week, the Food and Drug Administration released updated guidance on the risks of the blood clotting disorder associated with Johnson & Johnson’s vaccine, but reiterated that the benefits outweighed the risks.
Dozens of countries have approved Johnson & Johnson’s vaccine and are using it as part of their immunization campaigns. But while it remains in high demand in some parts of the world, it has lost popularity in many countries due to safety concerns and relatively lower effectiveness against Covid.
Some governments have already taken steps to limit the Johnson & Johnson shot due to the risk of blood clotting. Finland, Denmark and Slovenia no longer use it, and several other countries have ranked it lower for use than the vaccines from Pfizer-BioNTech and Moderna. Some countries have also advised doctors to advise women under the age of 50 about the potential risk.
The CDC panel’s recommendation lands in the middle of a wave of virus cases, driven by the Delta coronavirus variant and Omicron, the latest version that has already become dominant in some countries and is rapidly spreading in Britain and the United States.
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Several lab experiments suggest that a single dose of Johnson & Johnson’s injection offers little protection against infection with Omicron. The company said late last month it was testing blood samples from clinical trial participants who had received the injection as a booster to see how their vaccine-induced antibodies fare against Omicron.
At Thursday’s meeting of the Advisory Committee on Immunization Practices, CDC officials went into detail about the clotting-related syndrome identified in 54 people in the United States who received the injection before the end of August. Overall, the number of cases of the condition was 3.8 cases per million people who received the vaccine.
People who received a Johnson & Johnson shot months ago are not expected to be at risk for the clotting disorder, as the onset of symptoms usually occurred about nine days after vaccination in the diagnosed cases.
An increased risk of the condition has also been associated with the injection of AstraZeneca, which is not allowed in the United States. It is not linked to the Moderna or Pfizer vaccines.
There is mounting evidence that one dose of Johnson & Johnson’s injection provides far less protection against infection than other vaccines. Federal health officials approved boosters in October for people who had received a single injection of the company’s vaccine at least two months earlier. They enabled a “mix and match” approach, which allowed people to have a second shot, but with a Pfizer or a Moderna vaccine.