Johnson & Johnson vaccinations on hold in Sonoma County

Several Sonoma County clinics suspended vaccinations Tuesday or pivoted to a different product as the state Department of Public Health directed providers to pause the use of the Johnson & Johnson coronavirus vaccine due to a handful of incidents involving potentially deadly blood clots.

“We really want to make sure everyone is kept safe in our community, and this gets in the way of that,” said Cheryl Fox, president of Fox Home Health, which is among Sonoma County’s many vaccination partners.

Locally, the suspension disrupted West County Health’s scheduled clinic at Guerneville School on Tuesday and forced the replacement of about 100 doses of Johnson & Johnson with the Moderna vaccine at a drive-through clinic at the Santa Rosa Veterans Memorial Building, an operation managed by 1Care Diagnostics.

The event in Guerneville was West County Health’s first planned use of Johnson & Johnson.

“I happened to be up at 4 in the morning when I first saw the news,” said Jason Cunningham, the health center’s CEO. “I thought, ‘This is something we’d better pay attention to.’ ”

West County, which had 100 doses of J&J lined up for Tuesday’s clinic, took steps to offer the Pfizer-BioNTech vaccine to anyone who was left wanting, Cunningham said. But he cautioned that allotments from the state and county are finite, and that any doses used unexpectedly early in the week might produce a shortfall later.

Cunningham also noted that his clinic is preparing to immunize members of the Sonoma Coast’s commercial fishing fleet. Many of those fishers, he said, are due to ship out May 1. The one-dose J&J would allow them to depart fully vaccinated. Moderna and Pfizer, each of which calls for two doses, will not.

Fox Home Health, which has contracted with the county in part to deliver the vaccine to hard-to-reach populations, is temporarily suspending its efforts to immunize the homeless, Cheryl Fox said. The Santa Rosa-based health provider would continue to take doses of Moderna to homebound residents, she added.

Those less accessible populations have been targeted for Johnson & Johnson because of its one-dose application, and because it can be stored at normal refrigeration temperatures. Getting to those people may be harder during this delay.

“What it’s going to do is the exact same thing that’s happened with COVID from the beginning, and that is every time you think you have something in place that works, it changes,” Fox said. “We won’t stop doing vaccine for the homeless, but we’ll have to be creative. If we can’t use J&J, we’ll have to figure out how to make it attractive for the homeless to show up for vaccinations.”

The U.S. Food and Drug Administration and the Centers for Disease Control and Prevention recommended a “pause” in using the single-dose Johnson & Johnson COVID-19 vaccine Tuesday to investigate reports of rare but potentially dangerous blood clots, setting off a chain reaction worldwide and dealing a setback to the global vaccine campaign.

The agencies are investigating unusual clots that occurred six to 13 days after vaccination. The acting FDA commissioner, Dr. Janet Woodcock, said she expected the pause to last a matter of days.

The FDA, the CDC’s Advisory Committee on Immunization Practices and the Western States Scientific Safety Review Workgroup, of which California is a member, all will convene in the next couple days to discuss strategies.

As of Monday, 10,826 doses of Johnson & Johnson, also referred to as Janssen, had been administered in Sonoma County, accounting for about 3% of the 362,000 doses delivered in the county. Just over 4,000 of those had been put into arms within the past 13 days, the window of concern identified by the CDC and FDA. Sonoma County received about 400 doses of J&J this week, a small allotment that was affected by production delays on the East Coast, according to Dr. Urmila Shende, the county’s vaccine chief.

“We do not believe this precautionary interruption will have a significant impact on our vaccination efforts here in Sonoma County,” Shende said in a statement.

It is harder to gauge the supply of J&J currently being held by local hospitals. The three largest providers in Sonoma County — Kaiser Permanente, Sutter Health and Providence St. Joseph Health — all said they were following federal and state guidance and suspending J&J vaccinations.

Providence does not expect to cancel any first- or second-dose appointments at this time, said Dr. Chad Krilich, the group’s chief medical officer in Sonoma County. He stressed the safety of coronavirus vaccines, and the need for widespread immunization in the face of proliferating variants.

“A pause like this does indicate the process we have in place to monitor the side effects of COVID-19 vaccine is working,” Krilich said. “As we get more information on what we’re actually seeing in these six cases, it will help us to gauge a better response.”

Sutter patients scheduled to receive J&J this week may need to be placed on a standby list and rescheduled for Moderna or Pfizer, and Kaiser expects this pause to decrease overall vaccine supply and the number of appointments it can offer, according to separate statements issued by the two providers.

The FDA and CDC recommend that people who were given the J&J vaccine should contact their doctor should they experience severe headache, abdominal pain, leg pain or shortness of breath within three weeks of receiving their shot. Flu symptoms in the 24 hours or so after getting vaccinated are considered normal, harmless reactions to the coronavirus vaccines.

The clots occurred in veins that drain blood from the brain and occurred together with low platelets, the fragments in blood that normally form clots. All six identified cases were in women between the ages of 18 and 48. One person died, and all of the cases remain under investigation.

The narrow range of age and gender spurred Fox, a registered nurse with 53 years of experience, to speculate. “The commonalities, that’s childbearing age,” she said. “I wonder about the possibility these women were using a similar type of birth control.”

More than 6.8 million doses of the J&J vaccine have been given in the U.S., the vast majority with no or mild side effects. Authorities stressed they have found no signals of clot problems with the Moderna and Pfizer vaccines.

FDA officials emphasized that Tuesday’s action was not a mandate. Doctors and patients could still use J&J’s vaccine if they decide its benefits outweigh its risks for individual cases, said Dr. Peter Marks. But the CDPH framed its guidance as a directive.

The Associated Press contributed to this story. You can reach Phil Barber at 707-521-5263 or phil.barber@pressdemocrat.com. On Twitter @Skinny_Post.