An advisory committee for the U.S. Centers for Disease Control and Prevention voted unanimously December 16 to recommend mRNA COVID-19 vaccines over Johnson & Johnson’s shot.
When there is a choice, people seeking a COVID-19 shot should be told that the mRNA vaccines, made by Moderna and by Pfizer and its German partner BioNtech, are safer and more effective and are the preferred option.
But people who have allergies to ingredients in the mRNA vaccines and those who want the single-dose vaccine can still opt to get J&J’s vaccine. The benefits of that shot, authorized for those 18 and older, still outweigh the risks. And as a single-shot vaccine, it’s been a crucial tool for getting vaccines to people who are incarcerated or transitory, such as the homeless.
The recommendation followed new data indicating that a blood-clotting side effect of J&J’s shot, while rare, affects more than just young women. Of the 14.1 million people in the United States who got the J&J jab from March 2 through August 31, 54 developed a blood-clotting condition known as thrombosis with thrombocytopenia, or TTS (SN: 4/23/21). Nine have died, including one person vaccinated after August 31. Blood clots following the vaccine are suspected in two other deaths as well.
The blood clotting problem is most common in women 30 to 49 years old, with about 10 cases and 2 deaths per million doses given. But men ages 40 to 49, and women 18 to 29 and 50 to 64 also develop about 4 to 5 cases for every million doses of the vaccine. The U.S. Food and Drug Administration had previously changed its guidance to say that anyone with a prior history of this kind of blood clot should not get the J&J shot.
In addition, a neurological side effect called Guillain-Barré syndrome is more common with the J&J vaccine than with mRNA vaccines. J&J’s single-shot vaccine is also less effective than the mRNA vaccines (SN: 10/19/21).
Taken together, the risks and benefits of the mRNA vaccines outweigh those of the J&J jab. For instance, for every million women 18 to 49 years old vaccinated with the J&J shot, 3,729 hospitalizations from COVID19 would be prevented. But nine cases of TTS and five cases of Guillain-Barré syndrome would be expected. The mRNA vaccines in women in that age group would avert 4,700 hospitalizations and produce two cases of myocarditis, a usually mild inflammation of the heart muscle (SN: 12/15/21).While the benefits of Johnson & Johnson’s COVID-19 vaccine outweigh the risks, mRNA vaccines are preferred because they’re more effective with fewer serious side effects, a federal advisory committee said.
Millions of people who got Moderna’s or Johnson & Johnson’s COVID-19 vaccines will soon be lining up for another dose.
On October 20, the U.S. Food and Drug Administration authorized a third dose of Moderna’s mRNA vaccine for select groups. The groups include people age 65 and older as well as 18- to 64-year-olds who have underlying conditions that put them at higher risk for severe disease, or who live or work in conditions that put them at high risk of exposure or complications from falling ill. The agency also authorized a second dose of the J&J one-shot vaccine for everyone who got that jab. And FDA said the additional shots could come from any of the authorized or approved vaccines in a mix-and-match strategy.
On October 21, an advisory panel for the U.S. Centers for Disease Control and Prevention also gave the thumbs up for boosters for people in those groups. Soon after, CDC director Rochelle Walensky gave the official OK, paving the way for Moderna and J&J shot recipients to join the millions more who received Pfizer’s COVID-19 vaccine and became eligible for boosters in September (SN: 9/21/21).
These shots may be especially important for older people whose immune systems have weakened with age, and for those with medical conditions that put them at higher risk of serious complications of the disease. While the vaccines greatly reduce the chance of being hospitalized and dying, there are some chinks in the armor that still leave millions of such people vulnerable to the disease. Fully vaccinated people can get COVID-19 and die from it, though at much lower rates than unvaccinated people. le.
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