AHA Supports CDC Preference for mRNA COVID-19 Vaccines

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

In a scientific statement issued today, the American Heart Association (AHA) says it fully supports updated federal guidance regarding COVID-19 vaccines and boosters and implores all eligible Americans to get vaccinated as soon as possible.

Late last week, the US Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) voted unanimously (15-0) to state a preference for the Pfizer and Moderna mRNA vaccines over those from Johnson & Johnson after hearing a safety update on cases of thrombosis with thrombocytopenia syndrome (TTS).

TTS, also known as vaccine-induced thrombocytopenia with thrombosis (VITT), causes large clots that deplete the blood of platelets, resulting in uncontrolled bleeding.

Cases of TTS have occurred several days after receipt of the J&J COVID-19 vaccine.

From March 2 through August 31, 2021, there were 54 cases of hospitalized patients with TTS in the US, out of 14.1 million doses of the J&J vaccine administered, representing a case rate of 3.8 cases per million doses.

The 54 documented cases of TTS were in adults aged 28 to 62 years, with 37 in women. To date, there have been no reports of TTS occurring after receipt of a J&J booster shot.

“The mRNA vaccines are the preferred vaccines for most adults, given the latest data on the rare, yet serious possible side effect of TTS after receiving the Johnson & Johnson COVID-19 vaccine,” reads the statement from AHA president Donald Lloyd-Jones, MD, immediate past president Mitchell Elkind, MD, president-elect Michelle Albert, MD, MPH, chief science and medical officer Mariell Jessup, MD, and chief medical officer for prevention Eduardo Sanchez, MD, MPH.

“Despite the rare risk of TTS, the benefits of any of the three COVID-19 vaccines approved in the US outweigh the risks of remaining unvaccinated,” they emphasize.

The J&J COVID-19 vaccine is recommended for people who cannot receive one of the mRNA vaccines because of an allergy or other medical reason, or anyone who does not want to receive an mRNA COVID-19 vaccine.

“It is also a good option for people who have limited access to receive the two required doses of the mRNA vaccines, including people with difficulty accessing healthcare, such as those who are homeless, living in remote areas, or in countries with fewer healthcare resources,” Lloyd-Jones and colleagues say.

The AHA recommends that people who receive the J&J vaccine be monitored for symptoms of TTS and seek immediate treatment.

In April, as reported by Medscape Medical News, the AHA published a special report, Diagnosis and Management of Cerebral Venous Sinus Thrombosis with Vaccine-Induced Immune Thrombotic Thrombocytopenia, that provides important guidance about the signs and symptoms of TTS and the best treatment options.

“With the Omicron variant rapidly spreading throughout the US, we urge everyone 5 and older to get vaccinated against COVID-19 and get a booster dose as soon as they are eligible,” Lloyd-Jones and colleagues advise.

“Boosters are particularly important for adults ages 50 and older who have underlying medical conditions or any adult living in a long-term care facility,” they add.

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