Requested actions
- Be aware, on May 5, 2022, because of the risk of thrombosis with thrombocytopenia syndrome (TTS) after getting Johnson & Johnson COVID-19 vaccine (J&J), Food and Drug Administration (FDA) limited its authorized use to people 18 years or older:
- For whom other COVID-19 vaccines are not accessible or clinically appropriate.
- Who want only J&J and would not otherwise get COVID-19 vaccine.
- Be aware, on May 6, 2022, Washington State Department of Health (DOH) removed its standing order for J&J. Providers may continue, under their own standing orders, to give J&J to the people listed above.
- Counsel those who get J&J of the risk of developing TTS 1–2 weeks after vaccination.
- Do not give J&J to those with a history of TTS following J&J or any other adenovirus-vectored COVID-19 vaccine.
- Report COVID-19 vaccine reactions to Vaccine Adverse Events Reporting System (VAERS) to maintain our nation’s robust vaccine safety surveillance system.
- Continue to encourage people to get up to date on COVID-19 vaccination. Research continues to show COVID-19 vaccine saves lives.
- Be aware, FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) will meet June 7, 2022 to discuss emergency use authorization (EUA) for Novavax’s protein-based COVID-19 vaccine. VRBPAC will meet later in June to discuss EUA for Moderna and Pfizer COVID-19 vaccine for younger populations.
Background
FDA limited the authorized use of J&J to people age 18 years and older:
- For whom other COVID-19 vaccines are not accessible or clinically appropriate.
- Who want only J&J and would not otherwise get COVID-19 vaccine.
This decision came after FDA analyzed, evaluated and investigated reported cases of TTS after getting J&J. TTS is rare and includes potentially life-threatening blood clots in combination with low levels of blood platelets. Symptoms typically start 1–2 weeks after getting J&J.
In December 2021, Advisory Committee on Immunization Practices (ACIP) recommended mRNA COVID-19 vaccines over J&J for all people 18 years or older in the United States. Centers for Disease Control and Prevention (CDC) endorsed continuing to offer J&J to people with a contraindication to mRNA COVID-19 vaccines or who would otherwise remain unvaccinated.
As of March 18, 2022, FDA and CDC have identified 60 confirmed cases of TTS after getting J&J; 9 cases were fatal.
- Rate of reported TTS cases: 3.23 per million doses of J&J.
- Rate of reported TTS deaths: 0.48 per million doses of J&J.
In their analysis, FDA found rates of reported TTS and TTS deaths after J&J are not appreciably lower than previously reported. Furthermore, factors that put a person at risk for TTS after getting J&J remain unknown. FDA also considered:
- People with TTS may rapidly deteriorate, despite prompt diagnosis and treatment.
- TTS can lead to long-term and debilitating health consequences.
- TTS has a high death rate.
FDA also considered the availability of other authorized and approved COVID-19 vaccines that provide protection from COVID-19 and have not been shown to present a risk for TTS.
FDA determined the known and potential benefits of J&J vaccine outweigh the known and potential risks for those 18 years or older who want only J&J and would not otherwise get COVID-19 vaccine or for whom other COVID-19 vaccines are not accessible or clinically appropriate.
More information
COVID-19 vaccine
- Clinical considerations for the use of COVID-19 vaccine, CDC.
- Clinician outreach and communication activity (COCA) call slides, CDC.
- Booster dose updates, FDA.
- EUA and FDA-approved vaccine information:
- COVID-19 vaccine locator, DOH.
- COVID-19 vaccine provider toolkit and resources, DOH.
- COVID-19 vaccination for providers, CDC.
- Clinical considerations for COVID-19 vaccination and guidance for managing anaphylaxis, CDC.
- COVID-19 vaccine quick reference guide for healthcare professionals, CDC.
- COVID-19 vaccine training module on best practices for providers, CDC.
COVID-19 Therapeutics
Department of Health and Human Services (HHS) allocates monoclonal antibodies and oral antivirals to each state. DOH distributes doses to enrolled providers. Providers must enroll to order therapies in Healthcare Partner Ordering Portal (HPoP) to manage COVID-19 therapies. Email mcm@doh.wa.gov for support enrolling.
- COVID-19 therapeutics locator for providers, HHS.
- Therapeutics for providers page, DOH.
- Our COVID-19 treatment information for providers page.
- COVID-19 therapeutics resources, HHS.
- COVID-19 treatment guidelines, National Institutes of Health (NIH).
COVID-19 prevention
Share with patients:
- What to do if you test positive for COVID-19, DOH.
- What to do if you were exposed to someone with COVID-19, DOH.
COVID-19 reporting
We ask that you notify us of patients being tested who are hospitalized or have contact with a confirmed case, and not wait for the lab confirmation. Fax the COVID-19 Report Form to 360-778-6103. You can leave us a non-urgent confidential report on our 24-hour Communicable Disease Report Line, 360-778-6150.
Additional resources
- CDC COVID-19 health equity resources.
- Washington COVID-19 risk assessment dashboard.
- CDC guidance for healthcare providers and facilities.
- DOH COVID-19 data dashboard.
- DOH COVID-19 page.
- CDC COVID-19 page.
- SARS-CoV-2 sequencing and variants in Washington.
Contacting the Health Department
360-778-6100 Main Call Line – available M-F 8:30am to 4:30pm
360-715-2588 Afterhours Answering Service – available after 4:30pm and weekends
360-778-6150 Communicable Disease Report Line – 24 hours a day 7 days a week
360-778-6103 Confidential Communicable Disease Fax – 24 hours a day 7 days a week
1500 N State Street, Bellingham WA 98225