An expert panel to the Centers for Disease Control and Prevention voted on Thursday to recommend that Covid vaccines other than Johnson & Johnson's should be preferred, citing increasing evidence that the company's shots can cause a rare blood clot disorder.
The panel voted against vaccine providers and adults using Johnson & Johnson's shot. There was a higher risk for the blood clot condition. The risk was greatest for women in their 30s and 40s who had received the company's shot.
Panelists hoped that Johnson & Johnson's vaccine could still be used by people who did not have access to the more popular shots from Moderna or Pfizer-BioNTech, or who wanted the shot despite knowing of the elevated side effect risk.
The vaccine has largely fallen out of favor in the United States, and the recommendation that the C.D.C. must still decide whether to accept is the latest blow. The company's vaccine has not fulfilled its promise as a traditional, one-and-done format that would be easy to deploy in more isolated or rural areas.
The Johnson & Johnson vaccine has been given to 16 million people in the United States, compared to 73 million fully immunized with Moderna's vaccine and 114 million with the Pfizer-BioNTech shots. Only 1.6 percent of Americans who received a booster chose Johnson & Johnson.
The benefits of the vaccine outweigh the risks, as the Food and Drug Administration stated earlier this week.
Dozens of countries have authorized Johnson & Johnson's vaccine and have been using it in their immunization campaigns. It has lost popularity in many countries because of safety concerns and its less effectiveness against Covid.
Some governments have put restrictions on the shot because of the risk of blood clot. Several nations have ranked it lower for use than Pfizer-BioNTech and Moderna's vaccines. Doctors in some countries have been told to counsel women under 50.
The C.D.C. panel recommended that the government take action against the Delta coronaviruses variant and Omicron, the newest version that has already begun spreading in Britain and the United States.
A single dose of Johnson & Johnson's shot may not be enough to protect against Omicron. The company said late last month that it was testing blood samples from clinical trial participants who have received its shot as a booster to see how their vaccine-generated antibodies fare against Omicron.
C.D.C. officials told the Advisory Committee on Immunization Practices about the 54 people in the United States who received the Johnson & Johnson shot before the end of August. The rate of the condition was 3.8 cases per million people given the vaccine.
People who received a Johnson & Johnson shot months ago are not thought to be at risk for the clotting condition since the symptoms typically occur about nine days after the vaccine is given.
An increased risk for the condition, which is known as thrombosis with thrombocytopenia syndrome and can cause internal bleeding, has also been linked to the shot from AstraZeneca, which is not authorized in the United States. It has not been associated with any of the vaccines.
The doctor who steered families away from the Johnson & Johnson vaccine was a panelist.
One dose of Johnson & Johnson's vaccine offers less protection against infections than other vaccines. Federal health officials in October authorized boosters for people who had received a single shot of the company's vaccine at least two months earlier. People could get a second shot of a Pfizer or Moderna vaccine if they wanted to.
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There are many vaccines that have been tested in humans.
The New York Times has an interactive tracker for the coronaviruses vaccine.
Most Johnson & Johnson recipients who have gotten a booster have turned to other shots, and hardly any people who were originally immunized with other shots have opted for Johnson & Johnson as a booster.
Panelists said it was important to keep Johnson & Johnson's vaccine available.
Goldman is an assistant professor of clinical biomedical science at Florida Atlantic University.
The vaccine is making a crucial difference in the response to the Pandemic. The vaccine has a positive benefit-risk profile. She said that it is saving lives around the globe.
The vaccine was temporarily halted by federal officials because of concerns about the risk of blood clot. Cases have continued to accumulate.
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The U.S. has over one million deaths. The United States has the highest known number of covid deaths. 75 percent of the deaths have involved people 65 or older. One in 100 older Americans have died from the disease.
The longest hospital stay for Johnson & Johnson vaccine recipients was 132 days, and 36 of them were admitted to an intensive care unit. Eight of them died. There have been nine deaths since September.
The C.D.C. official said that they were struck from reviewing the cases because of how quickly the status deteriorated.
The people who died ranged in age from 28 to 62. All but seven of the women were white. Obesity was the most common underlying medical condition. Two of the people who died did not have medical problems.
The rate at which the general population would expect a condition is not known.
Dr. See said there had been more cases identified since the earlier C.D.C. meetings.
C.D.C. reported on side effects among children who have received the Pfizer vaccine in the last few weeks. The C.D.C. confirmed eight cases of myocarditis, or swelling of the heart muscle, and has an additional case under review. There are five more cases it is following up on.
The risk of myocarditis was reported to be higher for males between 16 and 29 years old. A few days after being fully vaccined, nearly 11 out of every 100,000 of them developed the condition. The C.D.C. said that the shots would cause an estimated 70 myocarditis cases but prevent 5,700, 215 hospitalizations and two deaths. Most recovered in a short period of time.
Five of the six cases in younger children with known outcomes recovered from the myocarditis symptoms. The eight confirmed cases were evenly split between males and females.
Children younger than 16 who had been exposed to Covid-19 were 37 times more likely to get myocarditis than other children. The study was done before children started getting vaccines.
The F.D.A. warned that Johnson & Johnson's vaccine could increase the risk of Guillain-Barré syndrome, a rare neurological condition.
The Johnson & Johnson vaccine prevented thousands of Covid hospitalizations compared to a few cases of the clotting syndrome, according to a C.D.C. presentation. The people over 64 avoided hospital stays the most. The agency said that like those who were immunized, thousands avoided hospitalization.
