United States health officials lifted their recommended pause on the Johnson and Johnson (J&J) vaccine April 23, after 11 days of the hold. After conducting a review of available data and reaching out to healthcare providers across the U.S., the U.S. Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) agreed to end the pause and continue recommending the J&J vaccine for COVID-19 prevention. 

The agencies initially recommended the pause after six reported cases of blood clots attributable to the vaccine. During the pause, the two agencies worked to determine if the J&J vaccine was safe for continued use in the U.S.

In so doing, they conducted an outreach program to U.S. hospitals and healthcare providers across the nation. They found evidence of nine more cases of blood clots linked to the J&J vaccine, bringing the overall total to 15. This total is out of almost eight million administered doses of the vaccine since it was first authorized. Looking at available data, the agencies found that the occurrence of blot clots and other related issues is exceedingly rare. 

While vowing to maintain vigilance, the agencies lifted the pause. Information on the risks of blood clots will now appear in a fact sheet and will be handed out with the vaccine. 

The end of the pause comes as a welcome sign to the U.S. vaccination effort. Prior to the pause, J&J was featured in U.S. vaccination plans because, unlike the Moderna and Pfizer vaccines, J&J is a single-dose vaccine and does not have to be stored at subzero temperatures. 

Those qualities made the J&J vaccine particularly useful in plans to vaccinate vulnerable populations of the U.S. – including those that are homebound and the homeless. Before the pause, when given the option, the J&J vaccine was preferred in many instances by the homeless population. 

On Feb. 27, the United States Food and Drug Administration (FDA) issued another emergency use authorization for a coronavirus vaccine developed by Johnson & Johnson. This is the third COVID-19 vaccine that has been approved by the FDA for emergency use. With the approval, hopes rise for expanded vaccine outreach.

While Moderna and Pfizer used a new technology called mRNA to create their vaccines, the Johnson & Johnson vaccine uses viruses to deliver a piece of DNA that creates a replica of a spike protein of the SARS-CoV-2 virus. 

The body is able to make these spike proteins for a short amount of time after receiving the vaccine, which allows the immune system to react defensively and produce an immune response against the SARS-CoV-2 virus. This is a tried and true method in vaccines for other viruses that presents several advantages to the Johnson & Johnson vaccine.

The most notable difference between the Johnson & Johnson vaccine and the other COVID-19 vaccines is that it only requires one dose instead of two. Unlike the other vaccines that must be stored at extremely low temperature, the Johnson & Johnson vaccine can be stored at normal refrigeration temperatures for up to three months. This will make the Johnson & Johnson vaccine easier to distribute and store, making it a good option for remote areas and drive-through mass vaccination sites.

The Johnson & Johnson vaccine has a 72 percent overall efficacy rate with 86 percent efficacy against severe forms of COVID-19 in the United States. In South Africa, the numbers were slightly lower, with 64 percent overall efficacy and 82 percent efficacy against severe disease due to the highly contagious coronavirus variant that has been rampant in Africa since the fall.

Merck & Co, another powerful pharmaceutical company, agreed to help produce the Johnson & Johnson vaccine as part of a deal brokered by the White House. The goal of this agreement is to produce doses faster to increase the supply of the vaccine and quicken the pace of vaccination across the United States. This will also help to combat the emergence of new coronavirus variants in the United States.

As a result of this new Johnson & Johnson vaccine approval and production agreement with Merck, President Biden announced that by the end of May there will be enough doses of the coronavirus vaccine for the entire adult population of the United States.