Public health officials this week implored people to get a shot to protect themselves and others against COVID-19 as the spread of new, more deadly variants has caused a fresh spike in some cases.
Those entreaties to get the shot came in the face of news that the Johnson and Johnson, one-shot vaccine might cause one in a million, but potentially dangerous, blood clots.
Doctors and the health department have administered a limited number of Johnson and Johnson vaccines in Navajo and Apache counties. Most states have heeded a federal call to pause use of the Johnson and Johnson vaccine while experts investigate reports that six women developed blood clots within three weeks of receiving the vaccine. It’s unclear if the blood clots were connected to the vaccine. However, the finding mirrors reports of an equally rare problem with blood clots after receiving a similar vaccine manufactured by AstroZenica, which is not yet approved for use in the US.
Even if the blood clots in the six women all younger than 48 do prove connected to the vaccine, COVID-19 poses a far greater risk. One of the women died — which at this point amounts to a 1 in 7 million chance of death even if it was caused by the vaccine. By contrast, COVID has a 1% or 2% death rate among people who test positive for the virus.
The reports have complicated the effort to get enough people vaccinated to blunt the spread of new, more lethal COVID virus variants.
Navajo County Health Director Janelle Linn this week told the board of supervisors, “we advised our health partners to suspend giving this vaccine temporarily.”
She noted that the six cases out of the seven million shots administered “is a minimal number.”
Nonetheless, she said anyone who has received the Johnson and Johnson vaccine in the past three weeks who has developed signs of clotting including a headache or abdominal pain to contact their health provider.
In the meantime, she urged people to continue getting the Moderna vaccine, which has not been linked to any serious side effects. The Johnson and Johnson and AstraZenica vaccines use a harmless version of the virus that causes the common cold to deliver the distinctive spike protein of the COVID virus. Use of a similar vaccine design has in the past produced an immune system response that combines blood clots and low platelet counts consistent with the reported problems. However, the Pfizer and Moderna vaccines use a new, messenger-RNA technology — to deliver the spike protein in an oily molecule rather than a whole virus.
Linn noted that 36% of the county’s population has been fully vaccinated and another 30% have recovered from an infection. This suggests 66% of the population is currently well protected from an infection. However, she said protection after an initial infection wanes after about 90 days as antibody levels drop.
“We are pleading with our community,” she said, “especially those who have contracted COVID-19 in the past, to please consider being vaccinated. We’re at risk for a third surge. If you have concerns, speak to your healthcare provider. The blood clot issue is not a concern with the Pfizer and Moderna products — and those are readily available.”
Anyone in the county can now make an appointment for a shot. Even the first shot provides about 80% protection from infection and boosts the immune system protection even for people who have recovered from an infection.
The surge in new cases, hospitalizations and deaths in states like Michigan have been driven by the spread of several new, more deadly, more infectious variants. States that have lifted restrictions, eased back on mask wearing and seen a spread of the new variants have experienced rapid increases in recent weeks — after two months of decline.
So far, Arizona cases have remained relatively low compared to the peaks in December and January. Apache County has the highest per-capita rate of spread in the state. Navajo County’s doing better, but could still suffer a fresh spike as the new variants spread.
The federal Centers for Disease Control currently reports that assorted variants account for about half of the new infections in Arizona. That includes the B.1.1.7 variant that forced England into a fresh lockdown after rise in cases overwhelmed hospitals. A unique California variant that also spreads faster accounts for more than a third of new cases in Arizona, according to the CDC. The South African variant that not only spreads faster and causes more serious illness but can lessen the protection of the vaccine, accounts for about 1% of new Arizona cases, according to the CDC.
In the states with the fastest rising caseloads, the variants account for 70 to 90% of new cases.
Public health officials say the spread of the variants and the lapsing of most restrictions in states like Arizona make it critical that people continue wearing masks in public until we get 70 to 90% of the population vaccinated.
Early in the week, Apache County had vaccinated 43% of its population — including 70% of those over 65 — who account for most of the deaths from the pandemic. Navajo County had vaccinated 32% of its residents — including 58% of those over 65.
Nonetheless, Navajo County remained at “very high risk” for infection, according to national tracking data. New cases have declined by 7% in the past two weeks, but hospitalizations have risen by 94 %. About 5% of COVID tests are still coming back positive.
Apache County remains at “extremely high risk,” thanks to a 161% increase in new cases as a daily average over the past two weeks. Hospitalizations have increased 99% in that time. Fortunately, the latest surge in Apache County may have already passed its peak, with only 1% of tests coming back positive in the past two weeks and both new cases and hospitalizations declining in recent days.
However, the rapid spread of the variants could wipe away that progress if the vaccination efforts falter as people once again begin mixing in public places, often without masks.