Doctor: Pause of J&J vaccine could teach us lessons but hurt vulnerable populations

A decision on the future of the Johnson & Johnson vaccine could still be weeks away.

A CDC panel is trying to figure out the best way to handle resuming the use of the vaccine after a handful of people developed blood clots and low platelet counts.

The pause is meant to increase vaccine confidence and safety, but some fear it could harm the most vulnerable populations.

“The initial pause was a very sensible thing to do because there was a lot we needed to explore,” said Dr. Ross McKinney, chief scientific officer with the Association of American Medical Colleges.

He said keeping the J&J vaccine paused for the next several days gives health care providers time to look for more cases of blood clots and low platelet counts so we know exactly what we’re dealing with.

But he acknowledges the decision also undermines public confidence and puts certain populations at risk.

“It’s too bad that this has happened; there are lots of people who would benefit. The one and done is useful for people who are very reluctant; you can talk somebody into getting one vaccine, but talking them into two is tough.”

“We have certain harder-to-reach populations,” said Richard Carpiano, Ph.D., a public health scientist and sociologist with UC Riverside. “One in particular that I’m thinking about is in terms of vaccinating homeless populations.”

“This is very much a case study in ‘damned if you do, damned if you don’t’ sort of decision making for public health practice and for public policy.”

Carpiano said the decision impacts vaccine goals in the present and future.

“We don’t know to what degree how impactful that might be, if that’s something that we can recover from, or even if that can spill over to perceptions about the other vaccines as well,” he said.

“People sign up for appointments, they know that they’re going to get the Johnson & Johnson vaccine, and maybe they don’t go to that appointment. Or maybe we start to see backlogs in locations where there is definitely going to be the other vaccines.”

It will slow down the system at a time when we need speed to beat mutations in the virus.

Carpiano said if we look at the federal government’s recommendations, rationally we would see that the pause is proof that the system is working to protect patients and that should actually increase our confidence in the process.