To federal health officials, asking states on Tuesday to suspend use of the Johnson & Johnson coronavirus vaccine until they could investigate six extremely rare but troubling cases of blood clots was an obvious and perhaps unavoidable move.
But where scientists saw prudence, public health officials saw a delicate trade-off: The blood clotting so far appears to affect just one out of every million people injected with the vaccine, and it is not yet clear if the vaccine is the cause. If highlighting the clotting heightens vaccine hesitancy and helps conspiracy theorists, the “pause” could ultimately sicken — and even kill — more people than it saves.
“It’s a messaging nightmare,” said Rachael Piltch-Loeb, an expert in health risk communications at the N.Y.U. School of Global Public Health. But officials had no other ethical option, she added. “To ignore it would be to seed the growing sentiment that public health officials are lying to the public.”
The one-dose Johnson & Johnson vaccine was just beginning to gain traction among doctors and patients after its reputation took a hit from early clinical trials suggesting its protection against the coronavirus was not as strong as that from the vaccines made by Pfizer-BioNTech and Moderna. Before Tuesday’s pause, some patients were asking for it by name.
But amid the blizzard of news and social media attention around the pause, those gains may well be lost, especially if the rare blood clotting feeds politically driven conspiracy theorists and naysayers, who seemed to be losing ground as the rate of vaccinations rose.
The problem is explaining relative risk, said Rupali J. Limaye, who studies public health messaging at the Johns Hopkins Bloomberg School of Public Health. She noted that the potential rate of blood clotting in reaction to the vaccine is much smaller than the blood clotting rate for cigarette smokers or for women who use hormonal contraception, although the types of clots differ.
And officials are not “pulling” the vaccine. They are simply asking for a timeout, in effect, to figure out how best to use it.
Vaccinators were already fielding questions from worried patients on Tuesday.
Maulik Joshi, the president and chief executive of Meritus Health in Hagerstown, Md., which has given 50,000 doses of all three vaccines without any reported major reactions, said he had a simple message to calm patients’ fears: “It’s a great thing that they have paused it, and this is science at work.”
Jennifer Steinhauer, Madeleine Ngoand Hailey Fuchs contributed reporting.