The Johnson & Johnson vaccine is now recommended for all Canadians 30 years of age and older, but officials say to weigh the risk of rare but potentially serious blood clots that can occur from the vaccine with COVID-19 levels in the community — or hold out for another shot altogether.
The National Advisory Committee on Immunization (NACI) said Monday that while the Johnson & Johnson vaccine will soon be distributed across Canada, it’s up to Canadians in that age group to decide whether they should take it or wait for an mRNA vaccine such as Pfizer-BioNTech or Moderna.
Health Canada approved the Johnson & Johnson vaccine in March and updated its labelling last week to acknowledge the risk of a rare but serious blood-clotting condition connected to the shot known as vaccine-induced immune thrombotic thrombocytopenia (VITT).
“NACI weighed the benefits of the Janssen vaccine in saving lives and protecting populations against serious complications of COVID-19 against the risk of developing VITT,” said NACI vice-chair Dr. Shelley Deeks said during a news conference Monday.
“At this time, based on the current evidence, NACI recommends that similar to the AstraZeneca vaccine, the Janssen vaccine may be offered to individuals 30 years of age and over without contraindications if the individual prefers an earlier vaccine rather than waiting for an mRNA vaccine and if the benefits outweigh the risks.”
The move followed a brief pause of the Johnson & Johnson vaccine in the U.S. to investigate reports of clots, which NACI officials said Monday have occurred in 17 of the roughly eight million Americans who have received the shot.
VITT has also been reported with the AstraZeneca-Oxford COVID-19 vaccine in Canada, and like the J&J vaccine, it uses a similar adenovirus vector technology, which has led to unproven speculation that the rare condition could be connected to the vaccine platform.
“What we’re saying, and what we’ve been saying all along, is that the mRNA vaccines are the preferred vaccines,” said Deeks. “Yet given the epidemiology, the viral vector vaccines are very effective vaccines, but there is a safety signal, a safety risk.”
NACI says VITT occurs at a rate of about one in 100,000 people vaccinated with the AstraZeneca vaccine, with a mortality rate of about 40 per cent, although more research is needed — and that number is subject to change.
Though extremely rare, VITT is much more severe than a typical blood clot because it can cause cerebral venous sinus thrombosis (CVST), where veins that drain blood from the brain are obstructed and can potentially cause fatal bleeding.
Canada has reported seven confirmed cases of VITT following the AstraZeneca vaccine out of more than 1.1 million doses administered. One death was reported in Quebec on Saturday, when a 54-year-old woman died of CVST in a Montreal hospital after receiving the AstraZeneca shot on April 9.
NACI also announced Monday that mRNA vaccines, such as Pfizer-BioNTech and Moderna, are preferred in pregnant women and that Canadians who have previously been infected with COVID-19 should still receive two doses of a vaccine rather than one, which was previously recommended.
More to come