In this March 25 file photo, a box of the Johnson & Johnson COVID-19 vaccine is shown in a refrigerator at a clinic in Washington state. (AP Photo/Ted S. Warren)

In this March 25 file photo, a box of the Johnson & Johnson COVID-19 vaccine is shown in a refrigerator at a clinic in Washington state. (AP Photo/Ted S. Warren)

Single-dose COVID shot on pause

Six severe blood clots were reported in relation to Johnson & Johnson/Janssen vaccine.

State health officials said Tuesday that Alaska is canceling upcoming appointments scheduled for the single-dose Johnson & Johnson COVID-19 vaccine, after a federal recommendation to pause distribution of the vaccine.

DHSS is currently reaching out to make sure more clinics have the Pfizer BioNTech and Moderna vaccines, according to Kelsey Pistotnik, an official with the Alaska Immunization Program. She said there is “plenty of stock” of both Pfizer and Moderna.

Anyone who has a Johnson & Johnson vaccine appointment should contact their health care provider to either schedule a Pfizer or Moderna vaccine or cancel the appointment until further notice.

The U.S. Centers for Disease Control and Prevention and the Food and Drug Administration announced on Tuesday that they are recommending a pause in the distribution of the Johnson & Johnson vaccine, also known as the Janssen vaccine, after severe blood clots were reported in six people who had taken the vaccine.

As of Monday, more than 6.8 million Johnson & Johnson vaccines had already been administered in the United States, including more than 11,000 to Alaskans.

People who have recently received the Johnson & Johnson vaccine should be cautiously monitoring their symptoms, state official said.

Alaska State Epidemiologist Joe McLaughlin said all six reported clots appeared in women between the ages of 18 and 48, within six and 13 days after vaccination. The symptoms include headaches, abdomen and leg pain, shortness of breath and decreased motor skills.

Dr. Lisa Rabinowitz, staff physician at the Department of Health and Social Services, said that the reported blood clot is classified as cerebral venous sinus thrombosis and is very rare.

“I’ve only seen a couple in my career of 19 years,” she said.

There’s an area of blood collection and circulation in the brain from which, if a clot occurs, the blood has no exit point. This can cause internal bleeding in the brain, Rabinowitz said.

“There are some syndromes that this is very similar to … so we’ll be using some of that information and knowledge as we move forward,” she said.

Doctor of Pharmacy Coleman Cutchins compared the side-effect risks of the Johnson & Johnson vaccine with other prescription drugs. He said with any new drug that receives FDA approval, the fourth round of clinical trial occurs after the medication makes it to market. That means adverse events aren’t usually reported until after a large group — much larger than the Johnson & Johnson clinical trial — actually takes the new product.

“I could name 15 examples of drugs that this has happened with in the last 10 years and it shows us that the FDA process works,” Cutchins said. “It’s part of the reason we have the safest drug approval process in the world.”

Cutchins added that there are labels on many over-the-counter medications, like ibuprofen and Aleve, warning consumers about the risks of blood clots and other medical conditions.

“Everything [we do] is with a certain degree of risk,” he said. “So it’s just important to balance the benefit and the risk.”

DHSS officials still emphasized the importance of patients contacting health care providers with severe symptoms after taking any of the three available COVID vaccines.

The CDC reporting systems and the Vaccine Adverse Event Reporting System are resources for documenting negative vaccine side effects.

“Vaccine safety is really our top priority,” Rabinowitz said. “This pause gives us a chance to talk about the clinical side of this.”

According to the FDA, most blood clots are treated with an anticoagulant drug called heparin. With these CVST cases in particular, however, the FDA and CDC speculate heparin could actually cause more damage, so alternative treatments will likely be administered.

Similar blood clotting has occurred in patients after receiving Britain’s Oxford-AstraZeneca vaccine, which is currently not approved by the CDC and the FDA in the U.S. According to BBC News, out of the 20 million AstraZeneca doses administered in the European Union by the end of March, 79 people — around 66% of them women — experienced clotting. Nineteen of them died.

Multiple European countries have suspended the use of the AstraZeneca vaccine for younger people, or for all their citizens.

Rabinowitz said she and her team will use the American College of Physicians’ analysis of the AstraZeneca reporting to better understand the cause of the Johnson & Johnson blood clotting.

McLaughlin said he hopes the Johnson & Johnson pause won’t increase vaccine hesitancy.

“In terms of how we counter that, I think the biggest thing is just to relay information,” he said. “It’s really important to be as transparent as we possibly can.”

By the numbers

The DHSS announced 156 new COVID-19 cases on Tuesday night, bringing the statewide total to 62,681. Alaska remains at high-alert level, with 22.55 cases per 100,000 people.

The new case count includes six on the Kenai Peninsula. Kenai reported four and Soldotna reported two.

Alaska also reported 48 new cases in Anchorage, 33 in Wasilla, 18 in Palmer, nine in Fairbanks, three each in Eagle River and North Pole, two each in Ketchikan, Wrangell and the Yukon-Koyukuk Census Area, and one each in Bristol Bay/Lake and Peninsula, the Copper River Census Area, the Dillingham Census Area, Healy, Houston, Juneau, Sitka, Tok, and Unalaska.

There were 15 new hospitalizations reported on Tuesday, bringing the statewide total to 1,404, with seven patients on ventilators. The DHSS reported no new COVID-related deaths.

Over one quarter — 25.4% — of the Kenai Peninsula population across all ages are fully vaccinated against COVID-19, according to state data updated on Tuesday. This compares to the U.S. vaccination percentage of 22.3% reported by NPR. Public health officials estimate 75% to 80% of the U.S. population will need to be vaccinated before stopping the virus spread.

Getting vaccinated

More than 70 COVID-19 vaccination appointments were available across multiple central peninsula clinics as of Tuesday, according to PrepMod, the online portal through which appointments can be scheduled. PrepMod can be accessed at myhealth.alaska.gov.

Appointments are available at locations including the Nikiski Senior Center, the Sterling Community Center and Soldotna Prep School.

A map of vaccine providers can be found on DHSS’ COVID-19 vaccine website at covidvax.alaska.gov. Many providers are using the state’s program to schedule appointments, which can be accessed at myhealth.alaska.gov. Instructions on how to schedule an appointment through alternative entities can be found on the map by clicking the icon of the preferred provider. Appointments at Walmart can be scheduled at walmart.com/covidvaccine.

People who would like assistance with scheduling a vaccination appointment can call the Kenai Peninsula Borough Office of Emergency Management call center. The center operates Monday through Friday from 9 a.m. to noon. The central peninsula call center can be reached at 907-262-4636. The Homer call center can be reached at 907-235-4636. The Seward call center can be reached at 907-224-4636.

The City of Kenai is offering transportation to and from vaccine clinics located in Kenai in partnership with CARTS and Alaska Cab. Rides will be offered on a first-come, first-served basis until the budgeted funds run out. In order to participate in the program, people must be going from an address located in Kenai to a clinic in Kenai and will need to provide proof of vaccination.

Testing locations on the peninsula

On the central peninsula, testing is available at Capstone Family Clinic, K-Beach Medical, Soldotna Professional Pharmacy, Central Peninsula Urgent Care, Peninsula Community Health Services, Urgent Care of Soldotna, the Kenai Public Health Center and Odyssey Family Practice. Call Kenai Public Health at 907-335-3400 for information on testing criteria for each location.

In Homer, testing is available from 9 a.m. to 6 p.m. daily at the lower level of South Peninsula Hospital’s Specialty Clinic as well as through SVT Health & Wellness clinics in Homer, Seldovia and Anchor Point. Call ahead at the hospital at 907-235-0235 and at the SVT clinics at 907-226-2228. Testing is also available at Homer Public Health Center daily from 8:30 a.m. to 5 p.m.

In Ninilchik, NTC Community Clinic is providing testing on Monday, Wednesday and Friday. The testing is only for those traveling, symptomatic, needing testing for medical procedures, or with a known exposure after seven days. Only 20 tests will be offered per day. To make an appointment to be tested at the NTC Community Clinic, call 907-567-3970.

In Seward, testing is available at Providence Seward, Seward Community Health Center, Glacier Family Medicine and North Star Health Clinic.

Reach reporter Camille Botello at camille.botello@peninsulaclarion.com.

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