Science

I Got the J&J Vaccine & I Support the Pause!

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Two weeks ago, I was delighted to receive my COVID-19 vaccine. By random chance, I got the single dose Johnson & Johnson shot, which I was totally happy with: lower chance of bad side effects, only one round of side effects, no need to schedule a second shot, and an equal protection against being hospitalized or dying of COVID-19.

And then, a week later, I opened up my laptop to the news that US officials were temporarily pausing distribution of Johnson & Johnson while they evaluated some rare blood clots that occured in a handful of people in the weeks after their vaccine. Those people were all women between the ages of 18 and 48. You know. Like me.

And as I had my coffee and started processing all that, my social media feed was rife with takes. Most of the takes were “what the heck, why would they pause the vaccine over literally six people getting blood clots out of about 6 million total shots given??” And it’s understandable, considering the risks that we take every day. Medications get approved every day with much worse risks, including blood clots: according to the FDA, out of 100,000 people who are not on birth control or pregnant, 1 to 5 will develop a blood clot. Out of 100,000 people taking oral contraception, 5-9 will develop a blood clot. But hey, we don’t stop doctors from prescribing birth control, right? So why would we stop them from giving a vaccine that only causes 1 in a million blood clots?

Let me briefly tell you why this is, in fact, a bad argument. For a start, we are actually talking about different kinds of blood clots — the condition linked to the Johnson & Johnson vaccine is thrombotic thrombocytopenia, which research shows is most likely due to the patient’s immune system overreacting (remember last week’s video where I said you don’t want a “strong” immune system? Yeah.). Conflating this type of blood clot with those from birth control actually helps spread a misconception — the vaccine does NOT stack blood clot risks, so women on birth control do NOT need to exercise extra caution with this vaccine.

For another reason, we are not actually comparing 1 in a million to 9 in 100,000. 6 million is the total number of J&J vaccines that had been delivered to that point, to everyone. But all the people with blood clots fit in a specific demographic: women under the age of 48. The number of people in that demographic who got the vaccine was 1.4 million doses. So it’s not a 1 in a million risk for everyone, it’s MAYBE 1 in 150,000. Still way fewer than birth control, but not as stark as the inaccurate number. (That said, experts say we still don’t know how rare this really is, and it may be much rarer than these numbers suggest. There’s not enough data, but there are more cases being found and there’s another public meeting happening this Friday to go over new information.)

Finally, it’s not a fair comparison because of relative risk and consent. Why do we expect women to be okay with birth control that gives them a blood clot risk of 5-9 out of 100,000? For one reason, it’s because that risk is MASSIVELY lower than the risk of developing a blood clot during and after pregnancy. Out of 100,000 pregnant women, 5-20 will develop a blood clot, and another 40-65 will develop a blood clot in the 3 months after giving birth.

And when we are prescribed that birth control, we are told about the elevated risk of blood clots and are told to reduce other activities that can further raise that risk (like smoking) and to consider stopping that kind of birth control when we get into our 40s and 50s.

That’s informed consent, and the 6 women who developed thrombotic thrombocytopenia from the Johnson & Johnson vaccine did not have that. They were told about the risk of an allergic reaction, the possible pain, fever, muscle aches, and other side effects they may experience the day after their shot, but they were not informed they may develop blood clots, and that is a problem. They didn’t know to look out for the symptoms, which are severe headaches, abdominal pain, leg pain or shortness of breath. And one of them died. 

So personally I’m absolutely fine with the pause, and I’ll go through some of the objections I’ve seen and rebut them.

“COVID carries a higher risk of blood clots, plus it’s literally killing people, and the most important thing is getting everyone vaccinated as soon as possible.” 

I agree that vaccinating everyone trumps rare side effects. But here in the United States, we do not have a shortage of vaccine supply. Everyone who wants a vaccine can now get one, from one of the other two manufacturers with approved vaccines. We do not currently need the Johnson and Johnson vaccine to achieve herd immunity.

“This is just going to rile up the anti-vaxxers and scare more people away from the vaccines.”

Okay, it is absolutely true that this news riled up the anti-vaxxers. Absolutely. The number one news story on Facebook about the pause was from a batshit conspiracy theorist. But let’s imagine what would have happened if they hadn’t paused that vaccine. Later on, we find out that authorities knew this vaccine caused a deadly blood clot and did nothing. (And by the way, the research has been done: it’s not just a coincidence. The vaccine causes this disorder.)

Would the anti-vaxxers suddenly start trusting medical professionals? No! They would RIGHTLY demand to know why the public wasn’t informed and why this vaccine continued to be distributed.

Even if doctors informed the public but didn’t pause the vaccine, they would be shamed for caving to Big Pharma.

Unfortunately, there simply is no way to negotiate with conspiracy theorists. They will NEVER be happy, and they will ALWAYS spin news to support their worldview. Like…they think the COVID vaccine killed Prince Philip because he got it 4 months before he died. HE WAS 99

The response isn’t to get angry at doctors for being overly cautious — it’s to fight back against the conspiracy theorists by saying, “Holy shit, authorities are SO concerned with the safety of these vaccines that they hit the brakes after only six known cases.” Because that demonstrates incredible attention to detail and a very speedy response.
So as a woman in the affected demographic who got the Johnson & Johnson vaccine, I am absolutely fine with this pause and grateful that I and my loved ones around me know what symptoms to look out for. I have another week of being in that “danger” zone, and while I know that my risk is extremely low, I feel better going into this week armed with more information than I had before. I’m hopeful that once the data is in, authorities will reapprove Johnson & Johnson, at least for people outside of the risky demographic, and that regardless we will continue our current pace of vaccination in the US and start shipping our extra vaccines to other countries that desperately need them.

Rebecca Watson

Rebecca is a writer, speaker, YouTube personality, and unrepentant science nerd. In addition to founding and continuing to run Skepchick, she hosts Quiz-o-Tron, a monthly science-themed quiz show and podcast that pits comedians against nerds. There is an asteroid named in her honor.

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