Alliance for Pandemic Preparedness

April 27, 2021

Updated Recommendations from the Advisory Committee on Immunization Practices for Use of the Janssen (Johnson & Johnson) COVID-19 Vaccine After Reports of Thrombosis with Thrombocytopenia Syndrome Among Vaccine Recipients — United States, April 2021

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  • The Advisory Committee on Immunization Practices (ACIP) reaffirmed its interim recommendation for use of the Johnson & Johnson vaccine in all persons aged ≥18 years on April 23, 2021 and recommended including a warning that rare clotting events may occur in female vaccine recipients aged 18-49 years. The updated recommendations follow the recommended pause by the FDA and CDC on April 13, 2021 after reports of thrombosis with thrombocytopenia (TTS) among a small number of vaccine recipients, including central venous sinus thrombosis. As of April 21, 2021, 15 reports of TTS have been reported among approximately 8 million Johnson & Johnson vaccine doses. 
  • A risk-benefit analysis model that guided ACIP recommendations suggested that over 6 months, resuming vaccine use among persons aged ≥18 years (at 50% of administration rate before the pause) could prevent 3,926 to 9,395 COVID-19-related hospitalizations, 928 to 2,236 ICU admissions, and 586 to 1,435 deaths compared with 26 expected cases of TTS. For every 1 million doses administered to women aged 18-49 years, 297 COVID-19-related hospitalizations, 56 ICU admissions, and six deaths could be prevented, compared with 7 expected TTS cases.

MacNeil et al. (Apr 27, 2021). Updated Recommendations from the Advisory Committee on Immunization Practices for Use of the Janssen (Johnson & Johnson) COVID-19 Vaccine After Reports of Thrombosis with Thrombocytopenia Syndrome Among Vaccine Recipients — United States, April 2021. MMWR. https://doi.org/10.15585/mmwr.mm7017e4