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CDC advisers recommend limiting the use of the J&J vaccine due to rare blood clots

MARY LOUISE KELLY, HOST:

A committee of advisers to the Centers for Disease Control and Prevention voted today to recommend that the Pfizer-BioNTech and Moderna COVID vaccines be used instead of Johnson & Johnson's This vote came over concerns about rare blood clots. NPR's Pien Huang is here to tell us more. Hey, Pien.

PIEN HUANG, BYLINE: Hey, Mary Louise.

KELLY: All right. So the Johnson & Johnson vaccine's been out for many months. I know a lot of people have gotten it. It was authorized in February. Sixteen million people in the U.S. have gotten it. So why is the CDC making this move now?

HUANG: Well, it's because there's new information about a known side effect from the J&J vaccine, which is rare but is potentially lethal. This issue of large blood clots, combined with low platelet counts, was first raised back in April. And based on the information that was available then, it was considered a rare condition that mostly affected younger women. Now, after months of surveillance, researchers are finding that it's still rare in women between 30 and 50. It's happening about 1 in 100,000 shots, but it's now been observed across all age groups and in men as well. There have been more than 50 cases in the U.S., and at least nine people have died from it.

KELLY: So given all that, given the safety concerns, what exactly has the CDC and its advisers recommended?

HUANG: Well, the panel today considered a few options, including unrecommending the vaccine altogether or limiting it to older people where the risk is lower. But ultimately, they agreed to keep it available to everyone but to strongly steer people towards getting a Pfizer or Moderna vaccine instead, which don't have that clotting problem. Dr. Beth Bell, a committee member from the University of Washington, put it this way.

BETH BELL: I would not recommend a Janssen vaccine to my family members. On the other hand, I think we do have to recognize that different people make different choices, and if they are appropriately informed, I don't think we should remove that option from them.

HUANG: Now, that was reflective of how people generally felt about the Janssen or Johnson & Johnson vaccine. But there was a long debate over the wording of the recommendation, whether it was strong enough. Many panelists felt that the vaccine should only be used if there were really no other options. Eventually, the CDC's Melinda Wharton said that the committee, called the Advisory Committee for Immunization Practices, needed to move it along.

MELINDA WHARTON: The ACAP makes recommendations. We don't make strong recommendations and weak recommendations. We make recommendations. We have heard your comments. They will be incorporated in our communications and our guidance and our implementation for this.

HUANG: Ultimately, the committee voted to say mRNA vaccines are preferred over the J&J for all of those greater or equal to 18 years of age. And the vote did end up being unanimous - 15 yeas and zero nays.

KELLY: That's quite a needle they're trying to thread there, keeping it available to everyone but strongly steering people away from it and towards other vaccines. How often is the J&J vaccine being used right now anyway?

HUANG: Well, it's a lot less popular than the Pfizer or Moderna vaccines. Just 8% of fully vaccinated people here have gotten the J&J vaccine. Still, around 200,000 doses are being administered every week. And it's an option in airports, homeless shelters, correctional facilities, places where people may not easily get a second shot on schedule. The panel is also very aware that what happens in the U.S. influences what's - how the vaccine is seen and used in other countries. So, you know, since the vaccine - since the Johnson & Johnson vaccine is easier to store and transport, it may be the only option in some places.

KELLY: Better than getting no shot at all. NPR's Pien Huang, thank you so much.

HUANG: Thanks for having me. Transcript provided by NPR, Copyright NPR.

Pien Huang is a health reporter on the Science desk. She was NPR's first Reflect America Fellow, working with shows, desks and podcasts to bring more diverse voices to air and online.