A CDC panel recommends that other vaccines be preferred over J. & J.

An expert panel at the Centers for Disease Control and Prevention voted Thursday to recommend that Covid vaccines other than Johnson & Johnsons be preferred, citing growing evidence that the company’s shots could trigger a rare thrombotic disorder that is now linked to dozens of cases. and at at least nine deaths in the United States in the past year.

The panel is unanimous vote effectively discourages vaccine providers and adults from using the Johnson & Johnson syringe. New data showed that there was a higher risk of blood clots than previously known. The risk was highest in women aged 30 to 49 years, and the problem appeared in about 1[ads1] in 100,000 recipients in that group.

Nevertheless, some panelists expressed hope that Johnson & Johnson’s vaccine can still be used in cases where people do not have access to the more popular shots from Moderna or Pfizer-BioNTech, or want the shot despite being informed of the increased risk of side effects.

The recommendation, which the CDC still has to decide whether to accept, is the latest setback for a vaccine that has largely fallen out of favor in the United States. The shot has not fulfilled its early promise as a traditional one-and-done format that would be easy to distribute in more isolated or rural communities, and among people who are intimidated into receiving two doses.

Approximately 16 million people in the United States have received the Johnson & Johnson vaccine as their primary vaccination, compared with 73 million fully immunized with Moderna’s vaccine and 114 million with Pfizer-BioNTech syringes. Among Americans who have received an extra shot, only 1.6 percent chose Johnson & Johnson.

People who received a Johnson & Johnson shot months ago are not considered to be at risk for coagulation, as the symptoms usually occurred about nine days after vaccination in the diagnosed cases.

Earlier this week, the Food and Drug Administration issued updated guidelines on the risk of blood clotting disorders associated with Johnson & Johnson’s vaccine, but reiterated that the benefits outweighed the risks.

Dozens of countries have authorized Johnson & Johnson’s vaccine and used it as part of their vaccination campaigns. However, although it is still in demand in some parts of the world, it has lost popularity in many countries due to security concerns and its relatively lower efficiency.

Some governments have already moved to put restrictions on Johnson & Johnson’s shots because of the risk of blood clots. Finland, Denmark and Slovenia stopped using it, and several other nations have rated it lower for use than Pfizer-BioNTech and Moderna’s vaccines. Some countries have also advised doctors to advise women under the age of 50 on the potential risk.

The CDC panel’s recommendation comes amid a global increase in virus cases driven by the Delta coronavirus variant and Omicron, the latest version that has already become dominant in some countries and is spreading rapidly in the UK and US.

Several laboratory experiments suggest that a single Johnson & Johnson shot may offer little defense against Omicron infection. The company said late last month that it was testing blood samples from participants in clinical trials who have been shot as a booster to see how their vaccine-induced antibodies perform against Omicron.

At Thursday’s meeting with the panel, the Advisory Committee on Immunization Practice, CDC officials went into detail about the coagulation-related syndrome identified in 54 people in the United States who received the shot before the end of August. In total, the frequency of the condition was 3.8 cases per one million people who were given the vaccine.

The rate at which the condition would normally be expected in the general population is not known.

An increased risk of the condition is also associated with the shot from AstraZeneca, which is not authorized in the United States. It has not been linked to Moderna or Pfizer’s vaccines.

A panelist, Dr. Pablo Sanchez, a pediatrician at Ohio State University, said he had driven families away from the Johnson & Johnson vaccine.

Evidence has increasingly shown that one Johnson & Johnson dose provides much less protection against infection than other vaccines. In October, federal health authorities approved boosters for people who had received a single shot of the company’s vaccine at least two months earlier. They allowed a “mix and match” approach, so that people could get a new shot with Pfizer or Modern’s vaccine.

So far, most Johnson & Johnson recipients who have received a booster have turned to other shots, and hardly any people originally immunized with other shots have chosen Johnson & Johnson as a booster.

Despite their recommendation, a number of panelists said it was important to keep Johnson & Johnson’s vaccine available as an alternative.

“However, it is very important that we do not completely eliminate this vaccine,” said Dr. Jason Goldman, assistant professor of clinical biomedical science at Florida Atlantic University.

Dr. Penny Heaton, CEO of Johnson & Johnson, said the vaccine makes a “crucial difference” in the pandemic response. “We are confident in the positive benefit-risk profile of our vaccine. It saves lives here in the United States today and on all continents around the world,” she said.

A CDC presentation showed that despite concerns about coagulation, the Johnson & Johnson vaccine prevented thousands of US Covid hospitalizations compared to three to a dozen cases of coagulation syndrome, depending on the age group. Those over 64 avoided most hospital stays. Like those vaccinated with other vaccines, thousands avoided hospitalization, the agency said.

In April, shortly after Johnson & Johnson’s vaccine began being administered in the United States, federal officials briefly stopped using the shot because of concerns about the risk of blood clots. Things are still piling up.

Of all 54 Johnson & Johnson vaccine recipients diagnosed with the condition before the end of August, 36 were admitted to the intensive care unit and the longest hospital stay was 132 days. Eight of them died. Since September, a ninth person has died.

“We have been struck by these cases of how quickly the status deteriorates and results in death,” said Dr. Isaac See, a CDC official.

The people who died ranged in age from 28 to 62. Seven were women, and all were white. Obesity was the most common underlying medical condition. Two of the people who died did not have known medical problems, Dr. See said.

Dr. See said that several cases had been identified since previous CDC meetings due to delays in reporting and delays in identifying and confirming diseases related to the vaccine.

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