4/26/21 – Health Advisory: Johnson & Johnson COVID-19 Vaccine Update for Providers

Hand full of cloth face masks

Requested actions

  • Be aware, Johnson & Johnson (J&J) COVID-19 vaccine is again authorized for use in people 18 years or older in Washington starting April 24. Discard any J&J Emergency Use Authorization (EUA) Fact Sheets you have on hand. Use the new J&J EUA Fact Sheet.
  • Monitor and properly treat patients who develop signs and symptoms of thrombosis with thrombocytopenia syndrome (TTS)—severe headache, abdominal pain, leg pain or shortness of breath—within 3 weeks of receiving J&J vaccine.
  • If a patient is concerned about the increased risk associated with J&J vaccine, offer Moderna or Pfizer vaccine.
  • Vaccinate all people 16 years or older for COVID-19. Direct patients to vaccinelocator.doh.wa.gov to find vaccine providers nearby and to our COVID-19 vaccine page for vaccine events and regularly updated resources.
  • Be aware, on April 21, Washington State Department of Health (DOH) released its SARS-CoV-2 sequencing and variants in Washington report.
  • Be aware, manufacturers extended the expiration dates of the BinaxNOWCareStart and EverlyWell COVID-19 at-home test kits the Health Department distributed.


On April 13, the Centers for Disease Control and Prevention (CDC) and the Food & Drug Administration (FDA) recommended a pause in administering J&J vaccine. The pause was out of an abundance of caution after 6 women under the age of 50 developed a severe and rare blood clotting disorder, TTS, within 6 to 13 days of receiving J&J vaccine. As of April 23, about 8 million doses of J&J vaccine have been administered in the United States and 15 cases of TTS have been confirmed. Of these 15 cases, 3 people died.

Following a thorough safety review weighing the benefits and risks, the Advisory Committee on Immunization Practices (ACIP) voted to recommend the ongoing use of J&J vaccine under a revised EUA. ACIP recommended the Food and Drug Administration (FDA) include a warning statement and J&J include an information sheet at vaccination informing people about the increased risk of TTS. On April 27, CDC will issue a related Morbidity and Mortality Weekly Report (MMWR). Discard any J&J EUA Fact Sheets you have on hand. Use the new J&J EUA Fact Sheet. 

Starting April 24, providers may begin using J&J vaccine they have on hand. Washington State should receive J&J vaccine again in next week’s allocation.

These adverse events appear to be extremely rare, especially beyond 1 month after vaccination. The FDA and CDC will remain vigilant in continuing to investigate the risk. Educate patients who receive J&J vaccine to report to their healthcare provider any symptoms of severe headache, abdominal pain, leg pain or shortness of breath within 3 weeks of vaccination. All providers should report these symptoms to the Vaccine Adverse Event Reporting System (VAERS) at vaers.hhs.gov/reportevent.html.

Additional information

Changes to Moderna and Pfizer shipments

In May, Moderna will begin to distribute 15-dose-maximum vials. Starting next week, providers can order both 11-dose-maximum vials and 15-dose-maximum vials. Eventually, 11-dose maximum vials will be phased out. Also beginning in May, Pfizer will reduce its shipment size to 440 doses. Watch for these changes when using the Immunization Information System to order.

Additional resources

COVID-19 test processing

Labs report varying amounts of time to process COVID-19 tests. To support faster turnaround, we encourage providers to use in-state labs. The table below shows COVID-19 test processing times for in-state private labs.

FidaLab 24-48 hours 500
Kaiser 24 hours 600-700
LabCorp 48 hours Unknown
Northwest Pathology 24-48 hours 20,000
Quest 24-48 hours 700
UW Virology 24-48 hours 6,000-8,000
Atlas Genomic 16 hours 10,000

Patient education

Share the following materials with patients.

Additional resources