Have you been vaccinated yet? At this point, most people either can’t wait to get a booster, are still waiting to be convinced it’s safe, or they have decided to roll the dice and forgo taking the COVID-19 vaccine altogether.

If you’re still thinking about getting vaccinated, here’s some helpful information around a vaccination concern that came up earlier this year.

What still has some people worried is the possibility of blood clots developing – a condition called thrombosis with thrombocytopenia syndrome (TTS) – with the one-shot Johnson & Johnson (Janssen) vaccine.

Back in April, U.S. federal health regulators recommended a pause in Johnson & Johnson distribution while they investigated reports of the rare side effect impacting women ages 18 to 48.

A subsequent review of available data showed that the Johnson & Johnson vaccine’s known and potential benefits outweighed its known and potential risks. However, the CDC and FDA did advise women younger than 50 to be aware of the risk, noting that it had not been seen in the Pfizer and Moderna vaccines. 

Still the numbers are small. As of Sept. 1, more than 14.3 million doses of the Johnson & Johnson vaccine have been given in the United States, and the CDC and FDA have identified 45 confirmed reports of people who later developed TTS.

Dr. Asif Wahid
Dr. Asif Wahid

In fact, one study determined that people were eight to 10 times more likely to develop blood clots in the brain from COVID-19 itself rather than from receiving either of the Pfizer or Moderna vaccines.

While additional research is ongoing, Dr. Asif Wahid, a cardiologist at Novant Health Cardiology in Thomasville and Lexington, recently answered some of the most pressing questions.

Let’s start from the top: What is a blood clot?

Blood clots are blood-formed blockages in the vein that can affect circulation. Depending on the type and severity, they can be mild and require little treatment, or they can lead to serious injury or even death. Deep vein thrombosis (DVT) is one of the most common types of blood clots, and it typically develops in the patient’s leg or arm. If left untreated, the clot can break free and travel to the lungs.

Blood clots in general are fairly common and affect an estimated 900,000 Americans each year. Anyone can be affected by a blood clot. Risk factors increase if patients are hospitalized, pregnant or have cancer. A long drive or long flight can also put you at risk for blood clots.

Can COVID-19 cause blood clots?

Yes. Research is currently underway to investigate how COVID-19 can affect the blood. Some COVID-19 patients have developed blood clots in multiple places throughout the body, and patients that have diabetes or high blood pressure are at a higher risk.

We believe this clotting is caused by increased levels of inflammation in the body. As a result, patients are at a higher risk for heart attack, stroke and organ damage.

In children, this condition is called multisystem inflammatory syndrome (MIS-C), and can damage the heart to such an extent that some children will need lifelong monitoring. 

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What kind of blood clot has been associated with the Johnson & Johnson vaccine?

TTS is a rare condition in which blood clots are accompanied by a low level of platelets, the colorless blood cells that help blood to clot. When working properly, platelets stop bleeding after injuries. However, if platelets drop below normal levels, patients are at increased risk of cerebral venous sinus thrombosis (CVST), a blood clot in the brain that can be life-threatening.

Patients that have developed the rare TTS after receiving the Johnson & Johnson vaccine typically develop symptoms within two weeks. Symptoms may include severe headache, trouble speaking or breathing and swelling. Similar occurrences of TTS were observed following the rollout of the AstraZeneca COVID-19 vaccine in Europe. AstraZeneca has not been approved in the United States.

If patients notice any of these symptoms, they should seek help right away. While blood clots are normally treated with a blood thinner medication, patients that develop TTS as a result of the vaccine may require a different treatment regimen.

When speaking to patients, I like to remind them that the temporary pause in the Johnson & Johnson vaccine back in April should give us all increased confidence in the overall safety and efficacy process. Before coming to market, each vaccine had to go through a strict approval process, and the CDC and FDA continue to monitor for possible side effects.

Bottom line: Ultimately, the data showed that the likelihood of developing TTS from the Johnson & Johnson vaccine was very rare. And the benefits, especially associated with a one-shot vaccine, outweigh the risk.

You also have the option of getting a Pfizer or Moderna vaccine.

Novant Health resources

  • Nearly 100 Novant Health clinics are administering vaccines to their patients. Established patients can call their primary care clinic to see if it is offering the vaccine.
  • Novant Health still has mass vaccination clinics in Winston-Salem, Charlotte and Salisbury. For more information or to schedule an appointment, visit GetVaccinated.org. Walk-ins are also accepted.
  • Novant Health is offering third doses for immunocompromised patients in both physician clinics and mass vaccination sites.

Those seeking a COVID-19 test can visit NovantHealth.org/coronavirus for a list of COVID-19 testing locations. Please don’t go to the emergency room for a test.