Q & A: What’s going on with the Johnson & Johnson vaccine in S.C.?

One-on-One with Nick Davidson, senior deputy for public health, DHEC

MYRTLE BEACH, S.C. (WMBF) - The South Carolina Department of Health and Environmental Control placed an “immediate pause” on the distribution of its Janssen (Johnson & Johnson) vaccine on Tuesday.

This comes after the CDC and FDA made the recommendation due to concerns of rare instances of blood clotting.

“Our top priority is protecting the health and safety of the public,” DHEC said in a statement.

Nick Davidson, DHEC’s senior deputy for public health, spoke one-on-one with WMBF about what kind of impact the state foresees with this pause in the rollout of this vaccine.

How concerned are you all about how this may or may not derail a timeline of sorts that you would like for this vaccine to be rolled out to South Carolinians?

Davidson: There’s no doubt it will slow us somewhat. But the Janssen vaccine represents, as you can see in the numbers, a pretty small proportion of the vaccine that we receive each week. So we’re not worried about it derailing our efforts, but certainly, there were some individuals who were planning to get the vaccine as soon as today (Tuesday), so that’s not going to be possible.

It will prevent some individuals and some clinics from using the vaccine that they had planned to use. But if you look at our numbers, which we did (Tuesday) morning, most weeks we’ve been around 5,700 or so vaccines, up to 7,000 Janssen vaccines delivered each week, and most recently, our numbers from Moderna have been up above 50,000 and the numbers for Pfizer have been above 60,000 a week.

So really, when you look at 110, 120,000, the elimination of maybe five or seven or a bit more thousand is not going to derail our efforts.

So you don’t see it slowing us down as much as maybe if it had been Pfizer or Moderna?

Davidson: Oh yeah, no way. That would have had a drastic impact. But those two vaccines are unaffected by this.

Do you have any idea how long this pausing might continue?

Davidson: We don’t yet know. I know that the federal government and the vaccine manufacturers will have some work on their hands to determine what the cause is of it and therefore, what the remedy is going to be. But we don’t yet have an indication of the amount of time.

The Janssen (vaccine) was being used to help target some particular pockets that would be more easily met because of it being one shot - specifically our rural populations, and then more specifically, frequently people of color who live in our rural (areas). Are you all concerned about not being able to get the vaccine out to these particular groups, and losing that kind of equitability that we’ve been working towards so much?

Davidson: It’s going to require more effort to get it to all the places that we want. And certainly, Janssen is nice because it’s one-and-done. The Moderna and the Pfizer is going to mean that folks are going to have to come back, and that’s not as convenient for many people, particularly those in some rural communities. But we’re going to do our part to make vaccine one or the other available.

There have been some clinic events that were being planned over the next few weeks, and some of those were going to be using Janssen. So we are making sure we have alternate vaccines available for those clinic events, particularly those that were out in the rural community.

So we are going to take every action that we possibly can but I am certain that there will be some people who were maybe planning to make one trip to the clinic and get a vaccine, and we would urge them and emphasize, as we’ve said all along, that any vaccine that you can get is the vaccine for you. And so we would urge folks not to wait on Janssen coming back available to them, and go ahead and get the vaccine that they can get access to now.

Are you concerned that this is going to negatively impact those people who were already on the fence, and getting them to cross over onto the other side to be convinced to get the vaccine?

Davidson: I certainly hope that it won’t. I hope that people would be encouraged by the fact that there is a robust checks and balances system out there. There is a method for reporting instances of individuals that have problems with the vaccine, or alleged problems with the vaccine, and so that is indeed what caught this potential problem.

We have to remember the numbers are very, very small. I think that the CDC reported six individuals, and so in the whole scheme of the hundreds of thousands - millions - of people that have already been vaccinated now with Janssen - six individuals is pretty small.

But the electronic reporting system to report these problems is that sensitive to be able to pick up problems that could be occurring; and again, I think we should really emphasize - could be occurring. We just don’t know the details yet, or what might have caused it, if there were other underlying conditions or something that may have attributed to these potential problems that we’re seeing with these six individuals.

So, very small numbers. We’ve got some incredibly safe vaccines that’s been used in now well over 100 million people around the nation, and certainly, want to encourage people that those two vaccines are still available and are actively being used.

Some say they’re not going to be a guinea pig and they don’t trust the government. What would you say to that?

Davidson: These vaccines have been thoroughly tested. Again, if we’re talking about the fact that we’ve got six individuals around the nation for whom it may have caused problems - I think we need to understand again that well over 100 million people safely vaccinated, now protected against a virus that has killed thousands and thousands and thousands of people - tens of thousands of people around the nation; hundreds of thousands of people, millions of people actually around the world.

I certainly am very sympathetic to the plight of those six individuals, but we do need to understand the risks and weigh that - balance that with the benefits of the vaccine. The benefits of the vaccine, particularly the two vaccines that remain on the market in the U.S., seem well proven. And so I really encourage people to weigh the risks and understand the incredible benefits that, not only as an individual, but as a population, we get from getting vaccinated and getting vaccinated quickly.

What about people who say, ‘I think that there’s a lot more that’s happening that just isn’t being reported; that there’s a lot more than the six’?

Davidson: If people think that there’s some information that’s somehow being hidden or not being shared - I’ve alluded to the reporting system, the Vaccine Adverse Event Reporting System, or VAERS. That system is intended to pick up on any potential problems that are happening. All providers must report into that system. All manufacturers of the vaccine must report into that system if there is a problem. That system is just so sensitive and was able to pick up on six instances where there may have been a problem.

It’s a transparent system. It’s a system that nobody is somehow forced to use or use incorrectly. The system has been out there for years for all vaccines that are used in the United States. And that gives me confidence that indeed, there are systems that can pick up on problems if those occur.

We may investigate these and determine that it wasn’t a problem caused solely, or even at all, by the vaccine. Time will tell. But there’s a really incredible safety record that vaccine manufacturers have in the U.S. and that the U.S. medical community is going to ensure that we protect our citizens and our residents.

Do you think that they addressed this quickly enough - or do you think there might have been a lag?

Davidson: I know that the instances started in March. We have such a great sample size - the numbers of people getting vaccinated is so large that it does allow the CDC and Health and Human Services to closely examine and routinely see incredible numbers of vaccinations happening and looking for those problems so frankly, I’m quite impressed that we’re able to pick up on across the 100-plus million people in the U.S. that have been vaccinated - just six individuals. So it seems to be something that was detected vary rapidly, and I’m encouraged by that.

Does DHEC know of any cases in the state yet that have been severe. Throughout the rollout - are you aware of any - for Janssen, or Pfizer, or Moderna?

Davidson: No we’re not aware of any of these types of instances in South Carolina.

Certainly, there are vaccine adverse events that get reported routinely. If somebody complains to their physician, their physician thinks that it is something that is worthy to note, and put out there as a potential problem - so certainly, those do happen routinely, with all vaccines in the state. So simply a vaccine adverse event report is not something that we should be concerned with. But no, I’m not aware of any of these instances with any of these three vaccines.

DHEC later followed up with WMBF to say that at this time, they don’t know the states of residence of these rare type of blood clots in people who received the Johnson & Johnson vaccine.

What are the next steps now for DHEC?

Davidson: Here at DHEC and across the state, we’re going to work with our providers. We started (Tuesday) morning by notifying our providers to make sure that everybody knew to put an immediate stop to use of the Janssen vaccine, until we learn more. We communicated that to them electronically; we also started making phone calls (Tuesday) morning as well.

We asked them to just hold their vaccine - to mark it as ‘Do Not Use,’ but not to dispose of the vaccine, because that vaccine might indeed go right back into use as soon as these challenges are solved. So right now we’re going to wait. We’re going to continue to vaccinate tens of thousands of people everyday with the Moderna and the Pfizer vaccine. And as soon as we can put Janssen back to use, I promise you we’ll do that right away.

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