Did the Costs of Pausing the J&J Vaccine Outweigh the Benefits?
Americans in states across the country started getting vaccinated with the Johnson & Johnson/Janssen Covid vaccine again yesterday, after regulators ended a suspension of the vaccine that had lasted almost two weeks. The FDA and the CDC decided to halt the use of the J&J vaccine on April 13 over concerns about a rare blood-clotting disorder that had been found in six people who had received it, one of whom had died. (AstraZeneca’s Covid vaccine, which is in wide use in the U.K. and Europe, has also been linked to blood clots). On Friday, ACIP, the CDC advisory panel on vaccines, after looking at all the data, concluded that the risks imposed by the vaccine were very low, and recommended that it be put back into general use, with a warning label attached.
Now, you might look at this story and assume that, as they say, “The system worked.” But it’d be more accurate to say that the system worked as it’s designed to work, and not as we might want it to work. While the initial decision to pause the vaccine was praised by many as evidence of the seriousness with which regulators were taking safety, that doesn’t mean the decision to extend the pause for almost two weeks represented a sensible balancing of costs and benefits. Instead, as medical ethicists Govind Persad and William Parker put it in The Washington Post last weekend, “slowing down vaccinations was a deadly mistake.” It was also, in some sense, a predictable one.
The decision to extend the pause was effectively made last week. The ACIP panel met a couple days after the suspension began, having had the chance to look at the available data. It could have decided then that the benefits of the vaccine outweighed the risks for all potential recipients, or, since all the people who had suffered the clotting disorder were women under the age of 50, it could have recommended administration of the vaccine come with age or gender restrictions until more data was available. Instead, it chose to kick the can down the road.
This was described at the time as the panel choosing to make no decision about whether the vaccine was safe. But as Dr. Nirav Shah, Maine’s CDC director, said at that first meeting, making no decision was a decision. While the U.S. has plentiful supplies of the Pfizer and Moderna mRNA vaccines, the J&J…