The Johnson & Johnson vaccine ‘has become critically important’: Doctor

Dr. Manish Garg, Emergency Medicine Physician & Co-Founder of World Academic Council of Emergency Medicine, joins Yahoo Finance’s Sibile Marcellus and Alexis Christoforous to discuss the latest on the coronavirus.

Video Transcript

ALEXIS CHRISTOFOROUS: I want to bring in Dr. Manish Garg now, an emergency medicine physician and co-founder of World Academic Counsel of Emergency Medicine. Doctor, thanks so much for being with us. I actually want to begin with something we're expecting President Biden to announce later this week. He's going to be talking tomorrow about new guidelines from the CDC when it comes to mask wearing.

Apparently we're expecting the CDC to update those guidelines, especially for people who have been fully vaccinated. If they do indeed lift the mandate to wear masks or the recommendation to wear masks outside, what's your feeling on that, given the fact that we are still very far away from herd immunity?

MANISH GARG: So thank you, Alexis, Sibile, and Anjalee. The opinions expressed are my own. My-- my feel on it is I guess I approach it with caution. I think it's important that we are able to get to a point where we can resume our normal activities of daily living. However, the cases of what we're seeing happen in India and certainly what we're seeing in Michigan that's happening right now are a little bit troubling.

And I know outside, and I think we all know outside, from a public health perspective, how important it is to have ventilation and that the risk transmission is really, really low. However, if you take a look at Michigan, there's some real concern there. There's a number of 20 to 40-year-olds that they're finding that are requiring oxygen, that are getting admitted, that are put on life support.

And, you know, the CDC has shown slight increases in-- in infections from the people who are in their ages 30 to 40. So a lot of this is coming from the UK variant. And I think that what we're starting to see in a number of these different countries is the mutation of that UK variant is there. So I think it is important that we're able to get to a good place with vaccines and with-- a good place with these recommendations about masks. But, I mean, I don't know. I guess I approach it very cautiously.

SIBILE MARCELLUS: Doctor. I wanted to touch on the Johnson & Johnson vaccine. So now officials are saying, it's safe. You can use it. But fewer than one in four Americans who have not been vaccinated would actually consider taking that vaccine, even though it's just one shot. Do you think officials have more explaining to do to build trust in explaining? I know it's just a few cases where there were the blood clots, but explain why that happened at all.

MANISH GARG: Yeah, I think that one of the challenges with the blood clots-- so as we've seen in the numbers that have come out, it's kind of at a rate of seven per 1 million vaccinations in women ages 18 to 49, and then basically 0.9 per 1 million in women that are ages 50 and older.

And I think they've been able to identify 15 cases of these rare blood clots. And it's important to note that this is a combination of blood clots plus the fact that platelets that we have in our body, which are used to cause clotting, that those numbers have come down. So it's an entity that's new. I think it was good that the CDC and the FDA did this investigation.

I think one of the challenges that people are having is just the phrase the overabundance of caution. We saw what happened in Europe with AstraZeneca, how blood clots and how, you know, a pause really-- really compromised the approach for vaccination in the country. The Johnson & Johnson vaccine is critically important to this effort. They have a single-dose vaccine, as we know, that they don't require the same sort of refrigeration.

So for people that are in hard-to-reach areas, this has become a really, really critically important vaccine. I think it's important that we acknowledge that, you know, science is not 100%. And I think that when I talk to community leaders and when I talk to patients about what they're going through, they feel a sense of distrust about what happened. They feel like, you know, you've been touting this vaccine, and now we're finding out that there's problems. So is it safe? Is it not safe?

And they don't often want to hear the numbers, but the numbers are actually very important. The risk of getting a blood clot is actually very, very small. As we said, in this particular case, it's about seven per 1 million. If you take a look at the birth control pills, that's 1,000 in 1 million. If you're a cigarette smoker, you have about 2,000 in 1 million chance of getting blood clots. And if you have COVID-19 infection, it's 165,000 in 1 million, so a 16.5% chance.

So I know why the CDC and the FDA have now kind of said that it's OK now for us to get this as we look at it. But it's important to acknowledge to-- to the people that all of these lives and all of these people that have been compromised by these blood clots, that their lives are important. So it's important that we do that from a health care and public-- public health standpoint, that we acknowledge that this is happening and we care for these people, but at the same time, we are really promoting these vaccines because it is really our best chance and best defense to get out of this pandemic.

ALEXIS CHRISTOFOROUS: You know, I'd like to ask, doctor, your thoughts on the younger set being vaccinated. I know that Pfizer is now looking at, I believe, people 15 and under for getting the vaccine. Do you have any idea on a timeline? And also, how can we best protect those young people, especially, for instance, in my family? We're vaccinated except for our youngest because she's not yet able to get the vaccine. So what can we do to protect them?

MANISH GARG: So, yeah, thanks, Alexis. I think families are very interesting moment in this pandemic because you have some family members that are at higher risk, i.e., that some are vaccinated. Some have kids. I'm in a similar boat. I have three kids who are under the age for vaccination.

As they continue to study, as we're seeing with the Pfizer and Moderna, they keep studying-- are able to study younger age groups. I think as time goes forward, we'll start to see that the vaccine will be safe in children as well. They often have good-- really good antibody responses as well.

And it's-- I know maybe vaccine deliberators might say, well, the risk of a child getting COVID-19 or a serious case of COVID-19 is small, but there is this multi-inflammatory syndrome that happens in children, which is also small but not trivial. And so I think it's important.

And we still don't know how-- what long-term effects are going to happen with kids. So, you know, advice that we would give-- the CDC just came out with recommendations for children for summer camp. They're recommending, you know, kids should be outside, ventilated as much as possible, that they should be 3 feet from one another, and masked most of the time.

And I still think that what you'll see with a number of families is that they'll have all of these different situations and circumstances compared to the person across the street, but they need to know what the community prevalence rate is, and then they need to protect themselves accordingly.

SIBILE MARCELLUS: And, Doctor, speaking of the situation in India, what is the US doing in terms of helping, and do you expect that eventually they'll be able to contain the COVID outbreak in the country?

MANISH GARG: Well, this is really-- Sibile, this is a really concerning thing. COVID internationally is at a real flashpoint. In my roles on the World Academic Council of Emergency Medicine and the American College of Academic and International Medicine, we're speaking to our colleagues around the globe on a weekly basis to understand what's happening on the ground.

If you look at how India got there, they had fewer than 10% of the population having received one dose of the vaccine and about 1.6% fully vaccinated. They began to relax measures. They had intersecting bubble events, like political and religious holidays. That confluence could easily happen here as well in this country, depending on the community, because we have a large amount right now circulating of the UK variant.

When you look at the skyrocket that's happened in India, it's the B1617 variant that's there. It has a couple different mutations. These mutations are requiring more antibody to protect against infection. Now, we know that a person who has been vaccinated has a much higher level of antibody than even somebody with natural infection. So it's really imperative that we get vaccines out to the different countries.

And I think it's really wonderful that the United States is providing oxygen, ventilators. But what's really, really critical is the vaccine supplies and also making sure-- and maybe this is, I think, a moral obligation-- there's the recipes for the vaccines and the patents that I think the rest of the world could really benefit from. And so, you know, India has the Serum Institute. They're able to produce tons of vaccines.

I think what's lost in this is that India also provides vaccines for a lot of the rest of the world. And so Africa will not get vaccines because India, right now, will not be able to deliver vaccines to them. And so I think it's really important because we've learned that if we have mutations and we end up having these variants, that if that happens in one part of the world, it's just as easily to be able to come over to us in the United States.

So I think it's not just a strategic response but a moral imperative to be able to do that. And I think that what we've learned from this process is that if we can help out these other places, we can actually save ourselves, both-- both time in quarantine, as well as money, and as well as just, you know, the livelihood of the rest of the world. This is a global problem.

ALEXIS CHRISTOFOROUS: Indeed, it is. Dr. Manish Garg, thanks so much for being with us and for those insights today. We appreciate it.