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CDC panel recommends resuming use of Johnson and Johnson vaccine

185 points by rafaelc 5y ago

ardit33 5y ago
Damage is done... NYC saw a drop in vaccine appointments right after the original ban on J&J happen. They could have issued a warning first, with the group ages/sex that they were seeing the clots (it was mostly women). Now they are scaring the 'indecisive' part of the population, and just making sure the pandemic will keep going. Both the CDC and the FDA have completely dropped the ball during this pandemic. They are acting like typical bureaucrats, with the 'you don't fired if you buy IBM' type of mentality, and instead of being aggressive, they are just acting in a way so they don't get fired. They should have done challenge trials back in April last year, and ask for military style of mobilization on productions, instead of just doing the normal/usual trails. It would have speedup the vaccine rollout even more, and perhaps save at least 200k lives or more. (mask requirements on the Federal level, would have saved another 100-200k people).
- Vecr 5y ago
  I think a mask mandate on the federal level would have required using more emergency presidential powers than most people would have been comfortable with. A president exercising martial law or something similar that would allow increased power over the states during a presidential election might not be helpful for people's view of the procedures and result.
  - ghaff 5y ago
    It's unclear that federal mandates would even have been constitutional and compliance, even in blue states in situations like people walking at comfortable distances outside are pretty spotty. There's a lot of faith in the idea that different top-level policies would have made a big difference short of truly sealing borders and having them totally shut even now.
- sp332 5y ago
  Polling shows that pausing the J&J vaccine did not make people more hesitant to get vaccinated. https://arstechnica.com/science/2021/04/poll-shows-jj-pause-has-not-increased-vaccine-hesitancy/ https://arstechnica.com/science/2021/04/poll-shows-jj-pause-... It might have made the locations and times less convenient, or people might be waiting for a one-shot vaccine.
- elliekelly 5y ago
  Doesn't a drop in vaccine appointments make sense given the (presumably) reduced supply of total available vaccines when J&J was paused?
- shadowofneptune 5y ago
  Vaccines take multiple years to develop normally. How much faster can you get for vaccine development? I certainly did not expect there to be more than one, or any, good options for vaccination by the beginning of this year. The trials also helped make it clear that the Pfizer–BionTech and Moderna vaccines were safe, something that will help convince people to take the vaccine in the long term.
  - thrower123 5y ago
    The rapidity of vaccine development is one of those things that makes me look at the lab-leak hypothesis and raise an eyebrow exaggeratedly.
joe_the_user 5y ago
Excellent news. The unfortunate thing is the level of ignorance today mistakes a very careful effort make sure the vaccine is safe with a wanton ignoring of some danger. Beyond talking about the fact that they determined this was safe, at some point educating people on danger in statistical terms is going to be necessary. But I'm not sure how that happens - addiction to headline-logic and single-heart-pulling-events is a huge part of the news industry.
- andrew_v4 5y ago
  I think it's a direct consequence of media and government trying to remove free will from the equation and present taking the vaccine as the only choice people have. If you're going to essentially force people to do it, a statistically meaningless side-effect becomes more important as reason for people to push back (and the media to drum up false fears). If you treat people like adults and let them consult their doctors and make their own decisions, the bar is much lower for safety (by lower I mean from impossibly high to reasonable). People willingly take much more risky medicines and treatments all the time and are fine with it. But if you try and force something in them, it's not surprising they push back on anything that isn't guaranteed to be perfect. (So my point is, I think demand would be higher and concerns lower if you just made it available and let people make their own choice. But the whole pandemic has been more about forcing people to do things than about trying to do things that actually solve the problem) [Edit- it's funny how any presence of giving people control over their bodies evaporates in a situation like this. And re the strawman that "nobody is forcing you" - if the consequence is severe limits on what you are allowed to do, that doesnt really hold up]
  - jdavis703 5y ago
    No one is being forced to take vaccines. It’s already announced there will be no federal vaccine passport, and many states are banning passports.
    - option 5y ago
      at least here, in California, you can not chose which one you get when making the appointment or when arriving at the vaccination site. Also CSU and UC will require vaccinations for return to on-campus. (Though I'm not sure that they will be able to do so until vaccines are under "emergency use" authorization, not a regular one)
hn_throwaway_99 5y ago
I just read the linked Axios article, so perhaps there is more in the CDC decision, but seems like it would make the most sense to just recommend against the J&J vaccine for anyone at higher risk of clot (e.g. all 6 of the people who had clots were women of childbearing age). With 3 good vaccines available, seems like there is plenty (or shortly will be plenty) to go around even if the J&J vaccine only goes to those at low clot risk.
- sp332 5y ago
  I don't think the usual risk factors for clotting apply here. These cases were rare enough to stand out at just 1 per million. The clotting seems to be a specific immune response similar to some people who clot when given heparin.
  - lholoubek 5y ago
    FWIW, the ACIP meeting today shared that another ~7 cases were discovered. In a particular group - women between 30-39 - the numbers were more like 1 in 100k. Still very small odds, but greater than the "one in a million" widely quoted, particularly for certain age groups. Good coverage of the updated data today here: https://twitter.com/kakape/status/1385661019494699010 https://twitter.com/kakape/status/1385661019494699010
- bpodgursky 5y ago
  God the downvotes on this site piss me off so much. They are SO mindless. This is what the UK is doing with AstraZeneca, for the exact same problem! Only suggesting it to people over 30! Stop downvoting the suggestion which is literally expert advice!
- InitialLastName 5y ago
  It's worth noting that young-to-middle-aged women are also over=represented (relative to the general public) among healthcare workers, who have been a primary target for the early rounds of vaccination.
  - 5y ago
sjm 5y ago
Just makes sense. The benefits far outweigh the risks at six cases of blood clots out of over 6.8 million doses, especially when there's a high risk of blood clots following COVID-19 hospitalization. Not to mention rates of blood clots caused by the pill are more like 1 in 3000. Hopefully if anything the pause has shown anti-vax folks that the safety of these vaccines is being taken seriously.
- Sebguer 5y ago
  >Hopefully if anything the pause has shown anti-vax folks that the safety of these vaccines is being taken seriously. The vast majority of skeptics will not be convinced by this, because their skepticism is not rooted in the science.
  - passivate 5y ago
    I think it should fall under basic common sense, not science. In reality, only a handful of people in the world understand in detail all the intricacies of the various ways our body interacts with drug substances. This group varies based on the drug in question. The rest of us are just parroting them. Yes you can try to be informed and read-up but at the end of the day they're still a layperson. I work in biotech (vaccines), and outside of my little niche, I'm just your average lay person, just slightly more informed.
    - benchaney 5y ago
      > In reality, only a handful of people in the world understand in detail all the intricacies of the various ways our body interacts with drug substances. That is not science, and it is not what is meant when people talk about trusting the science. Science is empiricism. The science that supports the efficacy of vaccination is the data from the trials that shows a reduction in cases. The science supporting safety is similar. This data is something anyone can understand with sufficient knowledge about probability and statistics. That level of knowledge is somewhat rare, but nowhere near as uncommon as the theoretical knowledge you are describing.
passivate 5y ago
This is great news! I'm holding out for the J&J shot myself :) I find it to be a better product than the others.
- servercobra 5y ago
  Can you explain why you think it's a better product? Genuinely curious as I haven't done much comparison myself.
  - dmitrygr 5y ago
    Adenovirus-based vaccines have existed a while, so it is not as new as mRNA vaccines are. That is my reason. Why the downvotes? it is a legit answer to the OP's question
    - deleted 5y ago
      [deleted]
  - raphlinus 5y ago
    Speaking for myself (team J&J), single dose is definitely more convenient. Anecdotally, reactions seem to be less severe than for the mRNA vaccines. And, while it's only a minor speed bump to our gold-plated healthcare delivery system, the fact that it doesn't need an extreme cold chain means it's logistically much easier to handle.
  - passivate 5y ago
    Because of their confidence (and the FDAs confidence) in their single-dose immunogenicity data, and also the fact that they ran trials in regions (brazil, SA, US) at times when new variants were prevalent.
- neither_color 5y ago
  I was holding out too but the opportunity to get Pfizer part 1 came up this week and I figured "this indefinite suspension could take months might as well get this out of the way now." Oh well. Im always wrong about these things. Either way in three more weeks I'll be done doing the "needful." No side effects for me besides my arm sore to the touch the day after, but not painful. Similar to the day after a weightlifting workout.
grej 5y ago
Both my wife and I got the J&J shot before it was cancelled. We both had a period about 12 hours afterwards where we felt like we had a mild flu for about another 12 hours, then it was over and we’ve felt fine. Very happy with this decision.
- deleted 5y ago
  [deleted]
- hcurtiss 5y ago
  If we're doing anecdata, I too had the J&J shot right before it was cancelled. Literally no symptoms whatsoever. Very happy with the "one and done" relative to my wife who will go in next week for the second Pfizer shot, which has clobbered everyone else in our neighborhood who took it.
  - rel2thr 5y ago
    My anecdote is that I got the JJ and kinda regret it, this blood clot thing made me realize it’s pretty untested , I feel like they should be recommending everyone get a full panel blood test a week after to add more data. After the AZ issues there should have been more scrutiny of the early clot cases
    - deleted 5y ago
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      - deleted 5y ago
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    - ggm 5y ago
      Kind of untested: sorry that's just wrong. All these shots are tested by 40,000 or more people. The problems emerging now are in the one in 100,000 or more. Do the maths on the odds.
      - 5y ago
medicineman 5y ago
.03%
mancerayder 5y ago
Pausing like that causes, not prevents, vaccine skepticism. In an era of declining public trust of institutions (across both political aisles, even if unequally), I argue this pause was poor politics. Science doesn't enter much into it, unfortunately.
- Fomite 5y ago
  Personally, I prefer drug safety protocols be based on science, not what people feel, or whether or not it's "good politics".
  - mancerayder 5y ago
    This is what I am arguing above. In light of this, would you say the pause was good science and not politics?
    - Fomite 5y ago
      Yes. The pause was exactly what should have been done, and every single vaccine specialist I know was both supportive and unsurprised.
      - mancerayder 5y ago
        Your confidence is unwarranted, and we don't know who you are or the significance of "every single vaccine specialist [you] know"? Just moments ago a Bloomberg summary popped into my inbox and a link from "The pause of the J&J vaccine was not without its controversy" and a link from there has this as the last sentence of the article: In the meantime, health officials will need to convince the public to take J&J’s shot. Americans’ confidence in Covid-19 vaccines continues to rise, according to a poll from the de Beaumont Foundation, an advocacy group focused on public health. But it has taken a toll on trust in J&J’s shot, specifically, with nearly one-third of respondents saying they’d never take the single-dose vaccine. (https://www.bloomberg.com/news/articles/2021-04-23/five-things-to-watch-as-j-j-covid-vaccine-gets-cdc-panel-review?cmpid=BBD042321_BIZ&utm_medium=email&utm_source=newsletter&utm_term=210423&utm_campaign=bloombergdaily https://www.bloomberg.com/news/articles/2021-04-23/five-thin...)
LatteLazy 5y ago
I got confused as the same thing was reported in Oxford Astrozenica vaccine recipients. I wasn't sure if they're the same vaccine (they're not). So I read up a bit. The same sort of clots occur in people who have been given heparin (a blood thinner). It's even called "heparin induced" in people using heparin. https://en.wikipedia.org/wiki/Post-vaccination_embolic_and_thrombotic_events https://en.wikipedia.org/wiki/Post-vaccination_embolic_and_t... People on either vaccine have been found to have an immune response to "platelet factor 4" (PF4). PF4s job is to moderate substances like heparin. I wonder if PF4 is similar to spike protein somehow? I wonder how long the immune response lasts? I guess it's not super useful as it wouldn't make sense to give people a blood thickener (a coagulant?) prophylacticly. Maybe we need to consider whether this is appropriate for people on Heparin or similar medications? I'm no doctor so don't take this as discouragment, I'm just musing. I have Oxford AZ (1 dose so far) and it was fine.
- jrochkind1 5y ago
  Even the experts still don't know what could be causing these side effects, or why it would be similar between the two vaccines. However, when they want to investigate it, what they'll be looking at is that both the Astrozenica and J&J vaccines use adenovirus vaccine technology, and the Moderna and Pfizer do not, so there could be something in common there that leads to the side effects. I think people only have guesses they aren't super confident in as to what that could be at present.
- thro1 5y ago
  > I wonder if PF4 is similar to spike protein somehow? it may be not only PF4: ..of 2,688 human proteins. In some of his own covid patients he found antibodies targeting 30 other important signaling agents besides interferon, Antibodies which: can somehow be created by covid itself , have the potential to last a lifetime. https://news.ycombinator.com/item?id=26915143 https://news.ycombinator.com/item?id=26915143 I guess that the spike another function could be a trap for the immune system and antibodies - resulting in production of autoantibodies - and that's very wise choice, which parts of that trap/virus are used in vaccines.
loceng 5y ago
In-depth talk with a virologist who believes that all of these vaccines currently be dangerous - and that we should perhaps stop all of them, please watch it before you assume you understand the reasoning: https://www.youtube.com/watch?v=BNyAovuUxro https://www.youtube.com/watch?v=BNyAovuUxro - DarkHorse Podcast with Geert Vanden Bossche & Bret Weinstein
- root_axis 5y ago
  Can you summarize the argument? The video is almost 2 hours.
- Igelau 5y ago
  I googled him to see if I could find the gist of his claims. I can't find a single thing from him, but I can find a ton of takedown pieces tearing apart this episode. (Bret Weinstein is leaning hard into the IDW thing. DarkHorse? Really?)
  - hammock 5y ago
    His open letter to the WHO: https://37b32f5a-6ed9-4d6d-b3e1-5ec648ad9ed9.filesusr.com/ugd/28d8fe_266039aeb27a4465988c37adec9cd1dc.pdf https://37b32f5a-6ed9-4d6d-b3e1-5ec648ad9ed9.filesusr.com/ug... The gist: Mass infection prevention and mass vaccination with leaky Covid-19 vaccines in the midst of the pandemic can only breed highly infectious variants Source: the top of the home page of his website, which is the first result on a google search of his name (How hard did you try?)
- seriousquestion 5y ago
  It's worth a watch. Bret Weinstein was a year early on the lab leak hypothesis, when it was taboo to even ask the question. Only now are scientists able to discuss it somewhat openly; https://news.ycombinator.com/item?id=26750452 https://news.ycombinator.com/item?id=26750452
  - loceng 5y ago
    Just don't try to discuss it on HN or you'll get downvoted by people who probably don't even look at the counter narrative content.
clarkevans 5y ago
J&J is starting a 2-dose clinical study (https://clinicaltrials.gov/ct2/show/NCT04614948 https://clinicaltrials.gov/ct2/show/NCT04614948), perhaps to see if it could have comparable effectiveness as the 2-dose mRNA Moderna and Pfizer protocols. Unfortunately, the control arm for this study is a placabo instead of a single dose, which I would expect to be the standard of care.
nostromo 5y ago
Now maybe the US can finally approve the AstraZeneca vaccine and put our 20 million (!) doses on hand to good use. Or not! But if we’re not going to use them, we should send them to another country like Canada or Mexico or Australia or the UK or EU, all of which have approved it and administered millions of doses. Sitting on 10s of millions of vaccines during a pandemic is inexcusable.
- deleted 5y ago
  [deleted]
- dawnerd 5y ago
  100% agree we should send them elsewhere. It seems we’ve reached the point where we’re manufacturing enough to just about meet demand and our neighbors are struggling.
- sxcurry 5y ago
  Just a reminder that AstraZeneca has not applied yet to the FDA for emergency use authorization.
  - lukeboi 5y ago
    Companies generally don’t apply for FDA authorization unless they’re confident they’ll pass. From my limited experience in the bio/med industry companies are usually in contact with the FDA and it’s a really bad look if you get a rejection.
    - refurb 5y ago
      The US trial of AZ was supposed to read out this month and was pivotal to US approval.
- ggm 5y ago
  Africa or India or south America need them more than G8 economies
  - 5y ago
_wldu 5y ago
I had Covid in March 2020. It almost did me in. Was in ICU for a while. Had the J&J shot three weeks ago. Did not feel a thing. My arm was slightly sore at injection site. Nothing else. I guess my body was used to it and just sort of shrugged it off. Some of my friends who got J&J were sick for a few days, but rebounded quickly after that.
- JamesBarney 5y ago
  Usually previous covid infection will make vaccine reactions worse not better. (due to an increased immune reaction)
- hammock 5y ago
  What prompted you to get a vaccine when you have already developed immunity?
  - _wldu 5y ago
    Unspoken workplace requirement. Sort of peer pressure, too, I guess. Also, I did not want to make others (around me) uncomfortable.
    - hammock 5y ago
      Thanks for your honesty
  - gher-shyu3i 5y ago
    Immunity is not permanent. We know people who got infected more than once.
    - hammock 5y ago
      Even taking the data least charitable to my postulate, a study[1] (which there are issues with that I will not mention) using a sample of 63 million medical records found a reinfection rate of 0.48% compared to 2.2% infection rate for the previously uninfected. This study therefore estimated protection against reinfection was 78.8%. That's higher than the 72% efficacy offered by the J&J vaccine. [1]https://www.eurekalert.org/pub_releases/2021-03/l-tls031821.php https://www.eurekalert.org/pub_releases/2021-03/l-tls031821....
jollybean 5y ago
This is great, but a gigantic Public Communications disaster. I had a vax-sceptic friend send me an article from a reputable source, quoting claims from the National Health Agencies and WHO etc. about the 'blood clots' which essentially conclude that 'they are rare and treatable' ... but my friends 'interpretation' was that the vax was 'unsafe'. She literally couldn't grasp that the data in the article was supposed to make her conclude it was 'safe'. She just read 'fear'. 40% of developed world people are either 'not very literate' or 'not paying attention' or have 'reading comprehension' problems whereing they are not going to engage with the material to derive conclusions. While the public health agencies decisions are a little cautious, they are reasonable, but the 'communications' of it via random articles with bits of 'facts' is a complete disaster from a Public Communications perspective and is causing probably measurable harm. If there is a 'marginal risk' of 4 in 1 million of 'blood clotting' and it's entirely treatable, then this information should be made available and transparent during the official conferences, but it should not be headline news. Whenever material information is presented regarding concerns, they have to be contextualized, and if the conclusion is effectively 'the vax is perfectly safe, this is just an administrative thing' then this has to be repeated over and over. From the FDA: "Out of every 10,000 women taking birth control pills, 3 to 9 of them will develop a blood clot". That is about 100x greater than clotting from AstraZeneca Vaccine, and 10's of millions of American women are taking it daily. Now that's context. Every single story about COVID needs to start and end with the 'Net reality facts' about vaccination, which as of today is: 'It's utterly safe, basically for everyone, and it will help stop the spread and keep other safe'. When messaging critical information for the masses it needs to be simple, clear, consistent, repetitive, words need to be chosen very carefully, and assume you're dealing with a 'Grade 8' audience in terms of net comprehension/attention/understanding. Almost all intelligent professionals live in bubbles, we tend to have no grasp of how it is out there for a large swath of the population. Even public health agencies web-sites are overloaded with information, literally with critical information in 'downloadable PDFs' (???), it's not good, I hope we develop a new approach but I don't think we will.
- quickthrowman 5y ago
  > From the FDA: "Out of every 10,000 women taking birth control pills, 3 to 9 of them will develop a blood clot". > That is about 100x greater than clotting from AstraZeneca Vaccine, and 10's of millions of American women are taking it daily. Now that's context. More context: the vaccine clots have been in the brain, birth control clots tend to occur in the legs (and rarely in the lungs). You can use heparin to treat the latter, but heparin could make the brain clot from the vaccine worse. I’m no medical professional, so I’ll let this article do the heavy lifting: https://www.usatoday.com/story/news/factcheck/2021/04/23/fact-check-birth-control-vaccine-blood-clot-comparison-lacks-nuance/7256800002/ https://www.usatoday.com/story/news/factcheck/2021/04/23/fac... Despite that, the odds seem to favor using the J&J vaccine based on numbers. The reported clot cases and total vaccines are 6 in 6.7 million with 1 death. If those odds are extrapolated, this means approximately 1150 people would die if everyone on earth received the J&J vaccine, and 6600 would have blood clots. All of the cases were in women of roughly child-bearing age, give them an option/priority for the mRNA vaccines, see if clots occur in other demographic groups. I had the J&J shot, and would do so again.

185 points by rafaelc 5y ago

Damage is done... NYC saw a drop in vaccine appointments right after the original ban on J&J happen. They could have issued a warning first, with the group ages/sex that they were seeing the clots (it was mostly women). Now they are scaring the 'indecisive' part of the population, and just making sure the pandemic will keep going. Both the CDC and the FDA have completely dropped the ball during this pandemic. They are acting like typical bureaucrats, with the 'you don't fired if you buy IBM' type of mentality, and instead of being aggressive, they are just acting in a way so they don't get fired. They should have done challenge trials back in April last year, and ask for military style of mobilization on productions, instead of just doing the normal/usual trails. It would have speedup the vaccine rollout even more, and perhaps save at least 200k lives or more. (mask requirements on the Federal level, would have saved another 100-200k people).

Vecr 5y ago
I think a mask mandate on the federal level would have required using more emergency presidential powers than most people would have been comfortable with. A president exercising martial law or something similar that would allow increased power over the states during a presidential election might not be helpful for people's view of the procedures and result.
- ghaff 5y ago
  It's unclear that federal mandates would even have been constitutional and compliance, even in blue states in situations like people walking at comfortable distances outside are pretty spotty. There's a lot of faith in the idea that different top-level policies would have made a big difference short of truly sealing borders and having them totally shut even now.
sp332 5y ago
Polling shows that pausing the J&J vaccine did not make people more hesitant to get vaccinated. https://arstechnica.com/science/2021/04/poll-shows-jj-pause-has-not-increased-vaccine-hesitancy/ https://arstechnica.com/science/2021/04/poll-shows-jj-pause-... It might have made the locations and times less convenient, or people might be waiting for a one-shot vaccine.
elliekelly 5y ago
Doesn't a drop in vaccine appointments make sense given the (presumably) reduced supply of total available vaccines when J&J was paused?
shadowofneptune 5y ago
Vaccines take multiple years to develop normally. How much faster can you get for vaccine development? I certainly did not expect there to be more than one, or any, good options for vaccination by the beginning of this year. The trials also helped make it clear that the Pfizer–BionTech and Moderna vaccines were safe, something that will help convince people to take the vaccine in the long term.
- thrower123 5y ago
  The rapidity of vaccine development is one of those things that makes me look at the lab-leak hypothesis and raise an eyebrow exaggeratedly.

joe_the_user 5y ago

Excellent news. The unfortunate thing is the level of ignorance today mistakes a very careful effort make sure the vaccine is safe with a wanton ignoring of some danger. Beyond talking about the fact that they determined this was safe, at some point educating people on danger in statistical terms is going to be necessary. But I'm not sure how that happens - addiction to headline-logic and single-heart-pulling-events is a huge part of the news industry.

andrew_v4 5y ago
I think it's a direct consequence of media and government trying to remove free will from the equation and present taking the vaccine as the only choice people have. If you're going to essentially force people to do it, a statistically meaningless side-effect becomes more important as reason for people to push back (and the media to drum up false fears). If you treat people like adults and let them consult their doctors and make their own decisions, the bar is much lower for safety (by lower I mean from impossibly high to reasonable). People willingly take much more risky medicines and treatments all the time and are fine with it. But if you try and force something in them, it's not surprising they push back on anything that isn't guaranteed to be perfect. (So my point is, I think demand would be higher and concerns lower if you just made it available and let people make their own choice. But the whole pandemic has been more about forcing people to do things than about trying to do things that actually solve the problem) [Edit- it's funny how any presence of giving people control over their bodies evaporates in a situation like this. And re the strawman that "nobody is forcing you" - if the consequence is severe limits on what you are allowed to do, that doesnt really hold up]
- jdavis703 5y ago
  No one is being forced to take vaccines. It’s already announced there will be no federal vaccine passport, and many states are banning passports.
  - option 5y ago
    at least here, in California, you can not chose which one you get when making the appointment or when arriving at the vaccination site. Also CSU and UC will require vaccinations for return to on-campus. (Though I'm not sure that they will be able to do so until vaccines are under "emergency use" authorization, not a regular one)

hn_throwaway_99 5y ago

I just read the linked Axios article, so perhaps there is more in the CDC decision, but seems like it would make the most sense to just recommend against the J&J vaccine for anyone at higher risk of clot (e.g. all 6 of the people who had clots were women of childbearing age). With 3 good vaccines available, seems like there is plenty (or shortly will be plenty) to go around even if the J&J vaccine only goes to those at low clot risk.

sp332 5y ago
I don't think the usual risk factors for clotting apply here. These cases were rare enough to stand out at just 1 per million. The clotting seems to be a specific immune response similar to some people who clot when given heparin.
- lholoubek 5y ago
  FWIW, the ACIP meeting today shared that another ~7 cases were discovered. In a particular group - women between 30-39 - the numbers were more like 1 in 100k. Still very small odds, but greater than the "one in a million" widely quoted, particularly for certain age groups. Good coverage of the updated data today here: https://twitter.com/kakape/status/1385661019494699010 https://twitter.com/kakape/status/1385661019494699010
bpodgursky 5y ago
God the downvotes on this site piss me off so much. They are SO mindless. This is what the UK is doing with AstraZeneca, for the exact same problem! Only suggesting it to people over 30! Stop downvoting the suggestion which is literally expert advice!
InitialLastName 5y ago
It's worth noting that young-to-middle-aged women are also over=represented (relative to the general public) among healthcare workers, who have been a primary target for the early rounds of vaccination.
- 5y ago

sjm 5y ago

Just makes sense. The benefits far outweigh the risks at six cases of blood clots out of over 6.8 million doses, especially when there's a high risk of blood clots following COVID-19 hospitalization. Not to mention rates of blood clots caused by the pill are more like 1 in 3000. Hopefully if anything the pause has shown anti-vax folks that the safety of these vaccines is being taken seriously.

Sebguer 5y ago
>Hopefully if anything the pause has shown anti-vax folks that the safety of these vaccines is being taken seriously. The vast majority of skeptics will not be convinced by this, because their skepticism is not rooted in the science.
- passivate 5y ago
  I think it should fall under basic common sense, not science. In reality, only a handful of people in the world understand in detail all the intricacies of the various ways our body interacts with drug substances. This group varies based on the drug in question. The rest of us are just parroting them. Yes you can try to be informed and read-up but at the end of the day they're still a layperson. I work in biotech (vaccines), and outside of my little niche, I'm just your average lay person, just slightly more informed.
  - benchaney 5y ago
    > In reality, only a handful of people in the world understand in detail all the intricacies of the various ways our body interacts with drug substances. That is not science, and it is not what is meant when people talk about trusting the science. Science is empiricism. The science that supports the efficacy of vaccination is the data from the trials that shows a reduction in cases. The science supporting safety is similar. This data is something anyone can understand with sufficient knowledge about probability and statistics. That level of knowledge is somewhat rare, but nowhere near as uncommon as the theoretical knowledge you are describing.

passivate 5y ago

This is great news! I'm holding out for the J&J shot myself :) I find it to be a better product than the others.

servercobra 5y ago
Can you explain why you think it's a better product? Genuinely curious as I haven't done much comparison myself.
- dmitrygr 5y ago
  Adenovirus-based vaccines have existed a while, so it is not as new as mRNA vaccines are. That is my reason. Why the downvotes? it is a legit answer to the OP's question
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- raphlinus 5y ago
  Speaking for myself (team J&J), single dose is definitely more convenient. Anecdotally, reactions seem to be less severe than for the mRNA vaccines. And, while it's only a minor speed bump to our gold-plated healthcare delivery system, the fact that it doesn't need an extreme cold chain means it's logistically much easier to handle.
- passivate 5y ago
  Because of their confidence (and the FDAs confidence) in their single-dose immunogenicity data, and also the fact that they ran trials in regions (brazil, SA, US) at times when new variants were prevalent.
neither_color 5y ago
I was holding out too but the opportunity to get Pfizer part 1 came up this week and I figured "this indefinite suspension could take months might as well get this out of the way now." Oh well. Im always wrong about these things. Either way in three more weeks I'll be done doing the "needful." No side effects for me besides my arm sore to the touch the day after, but not painful. Similar to the day after a weightlifting workout.

grej 5y ago

Both my wife and I got the J&J shot before it was cancelled. We both had a period about 12 hours afterwards where we felt like we had a mild flu for about another 12 hours, then it was over and we’ve felt fine. Very happy with this decision.

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hcurtiss 5y ago
If we're doing anecdata, I too had the J&J shot right before it was cancelled. Literally no symptoms whatsoever. Very happy with the "one and done" relative to my wife who will go in next week for the second Pfizer shot, which has clobbered everyone else in our neighborhood who took it.
- rel2thr 5y ago
  My anecdote is that I got the JJ and kinda regret it, this blood clot thing made me realize it’s pretty untested , I feel like they should be recommending everyone get a full panel blood test a week after to add more data. After the AZ issues there should have been more scrutiny of the early clot cases
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  - ggm 5y ago
    Kind of untested: sorry that's just wrong. All these shots are tested by 40,000 or more people. The problems emerging now are in the one in 100,000 or more. Do the maths on the odds.
    - 5y ago

medicineman 5y ago

.03%

mancerayder 5y ago

Pausing like that causes, not prevents, vaccine skepticism. In an era of declining public trust of institutions (across both political aisles, even if unequally), I argue this pause was poor politics. Science doesn't enter much into it, unfortunately.

Fomite 5y ago
Personally, I prefer drug safety protocols be based on science, not what people feel, or whether or not it's "good politics".
- mancerayder 5y ago
  This is what I am arguing above. In light of this, would you say the pause was good science and not politics?
  - Fomite 5y ago
    Yes. The pause was exactly what should have been done, and every single vaccine specialist I know was both supportive and unsurprised.
    - mancerayder 5y ago
      Your confidence is unwarranted, and we don't know who you are or the significance of "every single vaccine specialist [you] know"? Just moments ago a Bloomberg summary popped into my inbox and a link from "The pause of the J&J vaccine was not without its controversy" and a link from there has this as the last sentence of the article: In the meantime, health officials will need to convince the public to take J&J’s shot. Americans’ confidence in Covid-19 vaccines continues to rise, according to a poll from the de Beaumont Foundation, an advocacy group focused on public health. But it has taken a toll on trust in J&J’s shot, specifically, with nearly one-third of respondents saying they’d never take the single-dose vaccine. (https://www.bloomberg.com/news/articles/2021-04-23/five-things-to-watch-as-j-j-covid-vaccine-gets-cdc-panel-review?cmpid=BBD042321_BIZ&utm_medium=email&utm_source=newsletter&utm_term=210423&utm_campaign=bloombergdaily https://www.bloomberg.com/news/articles/2021-04-23/five-thin...)

LatteLazy 5y ago

I got confused as the same thing was reported in Oxford Astrozenica vaccine recipients. I wasn't sure if they're the same vaccine (they're not). So I read up a bit. The same sort of clots occur in people who have been given heparin (a blood thinner). It's even called "heparin induced" in people using heparin. https://en.wikipedia.org/wiki/Post-vaccination_embolic_and_thrombotic_events https://en.wikipedia.org/wiki/Post-vaccination_embolic_and_t... People on either vaccine have been found to have an immune response to "platelet factor 4" (PF4). PF4s job is to moderate substances like heparin. I wonder if PF4 is similar to spike protein somehow? I wonder how long the immune response lasts? I guess it's not super useful as it wouldn't make sense to give people a blood thickener (a coagulant?) prophylacticly. Maybe we need to consider whether this is appropriate for people on Heparin or similar medications? I'm no doctor so don't take this as discouragment, I'm just musing. I have Oxford AZ (1 dose so far) and it was fine.

jrochkind1 5y ago
Even the experts still don't know what could be causing these side effects, or why it would be similar between the two vaccines. However, when they want to investigate it, what they'll be looking at is that both the Astrozenica and J&J vaccines use adenovirus vaccine technology, and the Moderna and Pfizer do not, so there could be something in common there that leads to the side effects. I think people only have guesses they aren't super confident in as to what that could be at present.
thro1 5y ago
> I wonder if PF4 is similar to spike protein somehow? it may be not only PF4: ..of 2,688 human proteins. In some of his own covid patients he found antibodies targeting 30 other important signaling agents besides interferon, Antibodies which: can somehow be created by covid itself , have the potential to last a lifetime. https://news.ycombinator.com/item?id=26915143 https://news.ycombinator.com/item?id=26915143 I guess that the spike another function could be a trap for the immune system and antibodies - resulting in production of autoantibodies - and that's very wise choice, which parts of that trap/virus are used in vaccines.

loceng 5y ago

In-depth talk with a virologist who believes that all of these vaccines currently be dangerous - and that we should perhaps stop all of them, please watch it before you assume you understand the reasoning: https://www.youtube.com/watch?v=BNyAovuUxro https://www.youtube.com/watch?v=BNyAovuUxro - DarkHorse Podcast with Geert Vanden Bossche & Bret Weinstein

root_axis 5y ago
Can you summarize the argument? The video is almost 2 hours.
Igelau 5y ago
I googled him to see if I could find the gist of his claims. I can't find a single thing from him, but I can find a ton of takedown pieces tearing apart this episode. (Bret Weinstein is leaning hard into the IDW thing. DarkHorse? Really?)
- hammock 5y ago
  His open letter to the WHO: https://37b32f5a-6ed9-4d6d-b3e1-5ec648ad9ed9.filesusr.com/ugd/28d8fe_266039aeb27a4465988c37adec9cd1dc.pdf https://37b32f5a-6ed9-4d6d-b3e1-5ec648ad9ed9.filesusr.com/ug... The gist: Mass infection prevention and mass vaccination with leaky Covid-19 vaccines in the midst of the pandemic can only breed highly infectious variants Source: the top of the home page of his website, which is the first result on a google search of his name (How hard did you try?)
seriousquestion 5y ago
It's worth a watch. Bret Weinstein was a year early on the lab leak hypothesis, when it was taboo to even ask the question. Only now are scientists able to discuss it somewhat openly; https://news.ycombinator.com/item?id=26750452 https://news.ycombinator.com/item?id=26750452
- loceng 5y ago
  Just don't try to discuss it on HN or you'll get downvoted by people who probably don't even look at the counter narrative content.

clarkevans 5y ago

J&J is starting a 2-dose clinical study (https://clinicaltrials.gov/ct2/show/NCT04614948 https://clinicaltrials.gov/ct2/show/NCT04614948), perhaps to see if it could have comparable effectiveness as the 2-dose mRNA Moderna and Pfizer protocols. Unfortunately, the control arm for this study is a placabo instead of a single dose, which I would expect to be the standard of care.

nostromo 5y ago

Now maybe the US can finally approve the AstraZeneca vaccine and put our 20 million (!) doses on hand to good use. Or not! But if we’re not going to use them, we should send them to another country like Canada or Mexico or Australia or the UK or EU, all of which have approved it and administered millions of doses. Sitting on 10s of millions of vaccines during a pandemic is inexcusable.

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dawnerd 5y ago
100% agree we should send them elsewhere. It seems we’ve reached the point where we’re manufacturing enough to just about meet demand and our neighbors are struggling.
sxcurry 5y ago
Just a reminder that AstraZeneca has not applied yet to the FDA for emergency use authorization.
- lukeboi 5y ago
  Companies generally don’t apply for FDA authorization unless they’re confident they’ll pass. From my limited experience in the bio/med industry companies are usually in contact with the FDA and it’s a really bad look if you get a rejection.
  - refurb 5y ago
    The US trial of AZ was supposed to read out this month and was pivotal to US approval.
ggm 5y ago
Africa or India or south America need them more than G8 economies
- 5y ago

_wldu 5y ago

I had Covid in March 2020. It almost did me in. Was in ICU for a while. Had the J&J shot three weeks ago. Did not feel a thing. My arm was slightly sore at injection site. Nothing else. I guess my body was used to it and just sort of shrugged it off. Some of my friends who got J&J were sick for a few days, but rebounded quickly after that.

JamesBarney 5y ago
Usually previous covid infection will make vaccine reactions worse not better. (due to an increased immune reaction)
hammock 5y ago
What prompted you to get a vaccine when you have already developed immunity?
- _wldu 5y ago
  Unspoken workplace requirement. Sort of peer pressure, too, I guess. Also, I did not want to make others (around me) uncomfortable.
  - hammock 5y ago
    Thanks for your honesty
- gher-shyu3i 5y ago
  Immunity is not permanent. We know people who got infected more than once.
  - hammock 5y ago
    Even taking the data least charitable to my postulate, a study[1] (which there are issues with that I will not mention) using a sample of 63 million medical records found a reinfection rate of 0.48% compared to 2.2% infection rate for the previously uninfected. This study therefore estimated protection against reinfection was 78.8%. That's higher than the 72% efficacy offered by the J&J vaccine. [1]https://www.eurekalert.org/pub_releases/2021-03/l-tls031821.php https://www.eurekalert.org/pub_releases/2021-03/l-tls031821....

jollybean 5y ago

This is great, but a gigantic Public Communications disaster. I had a vax-sceptic friend send me an article from a reputable source, quoting claims from the National Health Agencies and WHO etc. about the 'blood clots' which essentially conclude that 'they are rare and treatable' ... but my friends 'interpretation' was that the vax was 'unsafe'. She literally couldn't grasp that the data in the article was supposed to make her conclude it was 'safe'. She just read 'fear'. 40% of developed world people are either 'not very literate' or 'not paying attention' or have 'reading comprehension' problems whereing they are not going to engage with the material to derive conclusions. While the public health agencies decisions are a little cautious, they are reasonable, but the 'communications' of it via random articles with bits of 'facts' is a complete disaster from a Public Communications perspective and is causing probably measurable harm. If there is a 'marginal risk' of 4 in 1 million of 'blood clotting' and it's entirely treatable, then this information should be made available and transparent during the official conferences, but it should not be headline news. Whenever material information is presented regarding concerns, they have to be contextualized, and if the conclusion is effectively 'the vax is perfectly safe, this is just an administrative thing' then this has to be repeated over and over. From the FDA: "Out of every 10,000 women taking birth control pills, 3 to 9 of them will develop a blood clot". That is about 100x greater than clotting from AstraZeneca Vaccine, and 10's of millions of American women are taking it daily. Now that's context. Every single story about COVID needs to start and end with the 'Net reality facts' about vaccination, which as of today is: 'It's utterly safe, basically for everyone, and it will help stop the spread and keep other safe'. When messaging critical information for the masses it needs to be simple, clear, consistent, repetitive, words need to be chosen very carefully, and assume you're dealing with a 'Grade 8' audience in terms of net comprehension/attention/understanding. Almost all intelligent professionals live in bubbles, we tend to have no grasp of how it is out there for a large swath of the population. Even public health agencies web-sites are overloaded with information, literally with critical information in 'downloadable PDFs' (???), it's not good, I hope we develop a new approach but I don't think we will.

quickthrowman 5y ago
> From the FDA: "Out of every 10,000 women taking birth control pills, 3 to 9 of them will develop a blood clot". > That is about 100x greater than clotting from AstraZeneca Vaccine, and 10's of millions of American women are taking it daily. Now that's context. More context: the vaccine clots have been in the brain, birth control clots tend to occur in the legs (and rarely in the lungs). You can use heparin to treat the latter, but heparin could make the brain clot from the vaccine worse. I’m no medical professional, so I’ll let this article do the heavy lifting: https://www.usatoday.com/story/news/factcheck/2021/04/23/fact-check-birth-control-vaccine-blood-clot-comparison-lacks-nuance/7256800002/ https://www.usatoday.com/story/news/factcheck/2021/04/23/fac... Despite that, the odds seem to favor using the J&J vaccine based on numbers. The reported clot cases and total vaccines are 6 in 6.7 million with 1 death. If those odds are extrapolated, this means approximately 1150 people would die if everyone on earth received the J&J vaccine, and 6600 would have blood clots. All of the cases were in women of roughly child-bearing age, give them an option/priority for the mRNA vaccines, see if clots occur in other demographic groups. I had the J&J shot, and would do so again.