Doctors Say Clot Treatment Tips Key to US Resuming J&J COVID Vaccines

The vials labeled “COVID-19 Coronavirus Vaccine” and the syringe are seen in front of the Johnson & Johnson logo shown in this illustration taken on February 9, 2021. REUTERS / Dado Ruvic / Illustration

Resuming use of Johnson & Johnson’s (JNJ.N) COVID-19 vaccine in the United States will require clear guidance from the medical community on how to best treat patients who develop a rare type of blood clot, in addition to alerting the Over-vaccine recipients be aware of telltale symptoms, according to cardiologists and other medical experts.

US health regulators recommended last week that the use of the J&J vaccine be stopped after six cases of rare brain blood clots, accompanied by low platelet levels, were reported in post-vaccination women from about 7 million people who received the injection in the United States. State. A panel of expert advisers from US health agencies will meet later this week to determine whether the hiatus should continue, with a decision expected Friday. read more

“My guess is that we will continue to use it in some form,” Dr. Anthony Fauci, chief medical adviser to President Joe Biden, said Sunday on NBC’s “Meet the Press.” “I think there will probably be some kind of warning, restriction or risk assessment.”

Scientists have yet to establish a direct link between the J&J vaccine and unusual blood clots, which have also been identified among a small fraction of people who received the COVID-19 vaccine from AstraZeneca Plc (AZN.L) outside the states. United. It is not clear how long it would take to determine if vaccines cause such symptoms. read more

Meanwhile, however, scientists say both vaccines remain important tools to help fight a coronavirus pandemic that has killed more than 3 million people worldwide. The key will be to tell doctors and patients how to look for a “one in a million” side effect.

“It made sense to pause,” said Dr. Rishi Mehta, associate medical director of inpatient operations at Keck Hospital at the University of Southern California in Los Angeles, referring to the use of the J&J vaccine. “We should say: ‘Listen, side effects are rare, but there is a possibility that you will get them and here is what you should be aware of … We are talking about headaches, abdominal pain, confusion.”

The American Heart Association said Friday that other potential symptoms, which could occur up to two weeks after vaccination, are blurred vision, fainting, sensory changes, seizures, leg pain or shortness of breath.

Doctors will also need to be vigilant when it comes to treatment. The cases identified so far are cerebral venous sinus thrombosis (CVST) or blood clots in the veins of the brain, rather than in the arteries, which is the case in most strokes.

The U.S. Food and Drug Administration has said that patients who develop clot-related symptoms after receiving the J&J vaccine should not receive heparin, a blood thinner widely used to treat bleeding disorders, at least until Have additional tests done to determine if they have low platelet counts. The rare combination of clotting and low platelets indicates a condition called heparin-associated thrombocytopenia, and giving heparin can cause harm.

The FDA warned healthcare providers that heparin use in these cases could even be fatal and advised them to seriously consider non-heparin anticoagulants and high-dose intravenous immunoglobulin (IVIG).

“I would need to do some tests on anyone who has symptoms like this and based on those tests, I would be in a reasonable position to treat without putting the person at risk,” said Dr. Jeffrey Berger, a cardiologist who specializes in blood clotting diseases. . at New York University.

According to details published in the New England Journal of Medicine on Friday, a 48-year-old woman who received the J&J injection was transferred to the University of Nebraska Medical Center after being diagnosed with extensive blood clotting or thrombosis. She was treated with heparin, but her condition worsened and she was switched to a different anticoagulant and IVIG. The patient was still seriously ill at the time of the report.

“If they give heparin they can make things worse, so that’s a good reason to draw attention to this,” Fauci, director of the National Institute of Allergy and Infectious Diseases, told Reuters.

Doctors said the hiatus in J&J vaccines gives hospital systems time to update their own recommendations.

“It’s certainly a very serious condition, but there are treatment recommendations,” said Dr. Annabelle de St. Maurice, an infectious disease specialist at the University of California, Los Angeles. “Before this, someone who had the vaccine and had a headache, our first idea would not be to consider CVST and order the labs and imaging to evaluate that.”

Officials at J&J and AstraZeneca did not immediately respond to requests for comment.

Our Standards: The Thomson Reuters Trust Principles.


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