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Use of one shot J&J jab under threat for under 30s in UK, as vaccinations paused worldwide

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Henry Bodkin
·4 min read
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A man receives the Johnson & Johnson Covid-19 vaccine in Chicago - KAMIL KRZACZYNSKI / AFP
A man receives the Johnson & Johnson Covid-19 vaccine in Chicago - KAMIL KRZACZYNSKI / AFP
Coronavirus Article Bar with counter
Coronavirus Article Bar with counter

The use of the one-shot Johnson & Johnson vaccine for under-30s is under threat after the United States and other countries suspended their rollouts due to blood clotting concerns.

The deputy chair of the UK’s Joint Committee on Vaccination and Immunisation (JCVI) last night said there were “implications” for younger age groups, and that the group would have to review the latest safety data “very carefully”.

It followed reports of six dangerous but very rare blood clots with low platelet in women aged 18 to 48 in America. One has died and another is in a critical condition, said the US regulator.

Any similar decision to pause in the UK could potentially hamper the smooth execution of phase two of the rollout, which started on Tuesday.

The UK government has ordered 30 million doses of “jab and go” J&J vaccine, which reportedly had been due to achieve regulatory approval as early as this week.

It is thought that planners had been lining up the jab - which could be available by around July - particularly for those aged 18 to 29, after the JCVI last week recommended they avoid the Oxford-AstraZeneca vaccine due to a possible link to cerebral clotting.

Latest UK vaccine numbers: rollout figures
Latest UK vaccine numbers: rollout figures

They were told to seek an alternative jab because the risk from Covid in that age group does not outweigh the potential harm from clots. However, some experts now fear the J&J jab, which uses the same adenoviral vector platform technology, is also causing the condition.

Some 6.8 million doses of the single shot jab have been administered in America, but the US Food and Drug Administration (FDA) announced on Tuesday that the vaccine’s rollout there would be temporarily paused out of an “abundance of caution”.

As the US news broke, J&J announced it would also “proactively delay” the jab’s rollout across Europe, where the first deliveries of the vaccine arrived only this week. The European Medicines Agency is already investigating a possible link to clotting.

Professor Anthony Harnden, JCVI deputy chair, on Tuesday evening said: “The observation of cases of thrombosis and thrombocytopenia in those receiving the Jansen vaccine in the US will need to be carefully reviewed – depending on outcomes of any review there may be implications for the recommendation of the Janssen vaccine in the younger age groups in the UK where the risk from severe Covid is much less than in older age groups and in those with underlying illnesses.”

Professor Jeremy Brown, another JCVI member, told The Telegraph that the news “obviously isn’t a good thing”, but added: “We were pretty much expecting it because it's an adenoviral vector”.

He said it was too soon to tell whether the issue would hamper the UK’s wider vaccine rollout.

Dr Peter Marks, director of the FDA’s centre for biologics evaluation and research, said he would “hesitate to call it a class effect” - an effect common to all adenovirus vaccines.

But he added: “It's plainly obvious to us already that what we're seeing with the [J&J] vaccines looks very similar to what is being seen with the AstraZeneca vaccine.”

Meanwhile Prof Eleanor Riley, professor of immunology and infectious disease at the University of Edinburgh, said that while a link between the vaccines and the blood clots has not yet been confirmed, “the index of suspicion is rising that these rare cases may be triggered by the adenovirus component”.

However, Dr Peter English, a past chairman of the British Medical Association's public health medicine committee, described the move as “highly precautionary”.

“Even if all of the cases were caused by the vaccine, the risk of less than one in a million would have to be set against the benefits of protection from Covid-19 disease - a disease which, in itself, causes clotting in many cases,” he said. “The call for a pause may dent confidence in vaccination.”

US officials indicated that the temporary suspension would be relatively short. “The timeframe will depend obviously on what we learn in the next few days, however we expect it to be a matter of days,” said Janet Woodcock, acting FDA commissioner.

In Europe, which was just about to start using the vaccine, the paused rollout apparently caught some off-guard. While J&J said it was acting “proactively” and “reviewing these cases with European health authorities”, a European Union official told Reuters that the US announcement was “completely unexpected”.

Belgium indicated it would not stop its rollout of the vaccine at this stage, while the Dutch drug regulator said the benefits of the vaccine outweighed possible risks.

Meanwhile South Africa has decided to temporarily suspend the rollout of the jab, though the health minister said there have not been reports of blood clots post-vaccination in the country.

The Prime Minister's spokesman said: “On Johnson & Johnson, it's for the MHRA to make a ruling - obviously they are independent so I'm not going to prejudge their decision. It's right that the independent safety watchdog looks at this and gives a ruling.”

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