Triangle doctors discuss rare clots found in handful of J&J COVID-19 vaccine recipients

Wake County News

RALEIGH, N.C. (WNCN) — Dr. Anthony Fauci said he expects the United States to resume the use of the Johnson & Johnson COVID-19 vaccine, potentially with warnings or restrictions.

Last week, federal health officials paused use of the shot after a rare type of blood clot was reported in 6 of the 6.8 million people who received the vaccine.

CBS 17 asked three local experts in blood clotting to explain more about this rare condition.

Dr. Thomas Ortel, Duke’s chief of hematology, explained where the clots occur.

“You have a series of veins that kind of line the skull and all come together and drain out of the jugular vein,” he said. “These are called cerebral sinus veins, and those are the ones that people are getting clots inside of, in the six cases that have been described that raised the red flag with the FDA and CDC.”

He added that low platelet counts associated with these clots make the cases highly unusual.

“Usually, if your platelet count is low, you have bleeding symptoms, not clotting symptoms, so it’s a paradoxical connection,” Ortel said.

Dr. Nigel Key, the director of UNC’s Blood Research Center says the cases share some similarities with ones that may be linked to the AstraZeneca vaccine in Europe. Scientists are working to figure out whether and how vaccines could potentially lead to this condition in a very small number of recipients.

“The best model we have for it is that some individuals who get the vaccine develop an antibody that activates the platelets. They get angry, they get sticky and they cause blood clots, and because they are all involved in doing that, the numbers in the blood actually go down,” said Key.

Doctors emphasize it’s very important not to treat this condition with the anticoagulant, heparin, like a typical clot.

“Giving heparin will put you at more risk for complications, but that’s okay because there are many alternative medicines that we can use,” explained WakeMed’s Dr. Graham Snyder, who is the director of education for Wake Emergency Physicians.

Dr. Snyder noted that ensuring the right treatment is why it’s so important that doctors are aware of this potential issue, no matter how rare it is.

“We can check your blood and, within minutes, find out if you have thrombocytopenia, the low platelet count,” he added.

While people should be aware of this condition, all three doctors say people who received the Johnson & Johnson vaccine should not worry.

“It is extremely, extremely rare,” emphasized Dr. Key. “The chance of a young woman dying from taking oral contraceptive pills is probably higher than that. Do they worry about taking oral contraceptives? No.”

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