April 23 coronavirus news

No blood clots have been associated with coronavirus vaccines made by Moderna or Pfizer, a US Centers for Disease Control and Prevention expert said Friday.

The CDC’s Advisory Committee on Immunization Practices is meeting to discuss whether to change guidance for J&J’s Janssen vaccine. The CDC and the US Food and Drug Administration recommended pausing its use after six reported cases of women who developed a rare blood clotting syndrome called thrombosis with thrombocytopenia syndrome, or TTS, after receiving Johnson & Johnson’s Janssen vaccine in the United States. But no cases have been firmly linked with other vaccines used in the US. 

Shimabukuro told ACIP that 2.7 million doses of Pfizer/BioNTech coronavirus vaccine and 2.5 million doses of Moderna’s vaccine had been included in CDC’s Vaccine Safety Database as of April 17. He said 10 cases of a rare type of brain blood clot called CVST were reported afterward but five were ruled out because of the medical histories of the patients, and five more were ruled out because patients did not develop a low level of platelets. It’s the combination of blood clots and low platelet counts that is linked with the vaccines.

ACIP is expected to vote on any changes to its guidance for J&J’s vaccine later Friday. If ACIP recommends changes to the vaccine label — such as a warning, or changes to who it recommends should get the vaccine — CDC Director Dr. Rochelle Walensky will sign off and then the FDA will have to make any label changes.

Dr. Rochelle Walensky, director of the US Centers for Disease Control and Prevention, said Friday the risk-benefit analysis of the Johnson & Johnson Covid-19 vaccine considers who would prefer the single-dose vaccine or wouldn't otherwise have access to one of the two-dose vaccines currently authorized in the United States. 

The CDC has been working hard over the last week to determine if there have been any additional cases of blood clots among those people who have received the Johnson & Johnson Covid-19 vaccine, Walensky said. 

The J&J vaccine rollout has been on pause since April 13, after a small number of people experienced blood clots after taking the shot. 

Walensky said the agency’s analysis will be presented during the Advisory Committee on Immunization Practices meeting currently underway.

European Medicines Agency officials said at a news conference on Friday that the benefits of the AstraZeneca vaccine outweigh the risks, and that they will continue to review "very rare cases" of blood clots.

"Importantly, the data show that the benefits of vaccination increased with age and increasing levels of infection in the community,” said Dr. Peter Arlett, head of Pharmacovigilance and Epidemiology Department at the European Medicines Agency.

Arlett also said the European Medicines Agency is stepping back from reporting the numbers on blood clots, as the agency wants to contextualize the numbers and the risk.

Earlier this month, the EMA said a particular combination of unusual blood clots with low blood platelet counts should be listed as a side effect of the AstraZeneca vaccine, but stopped short of recommending its use be limited. The agency previously said the positive benefits of AstraZeneca's vaccine outweigh the risks. 

Dr. Rochelle Walensky, director of the US Centers for Disease Control Prevention, said Friday that the CDC recommends that pregnant people get the Covid-19 vaccine.

Her comment follows a new study that found no safety concerns among a large group of pregnant people who received the vaccine in their third trimester, and no safety concerns for their babies.

The CDC vaccine guidelines online have not been updated. They currently say that pregnant women may receive a Covid-19 vaccine when one is available, and getting vaccinated is a personal choice, but do not say the vaccine is recommended. CNN reached out to the CDC for further clarification. 

On Wednesday, the New England Journal of Medicine published preliminary findings from CDC scientists that determined that the mRNA Covid-19 vaccines made by Pfizer and Moderna do not appear to pose any serious risk during pregnancy. Last month, another study published in the American Journal of Obstetrics and Gynecology found mRNA Covid-19 vaccines are effective in pregnant and lactating women, and they can pass protective antibodies to newborns. 

Clinical trials of the vaccines did not include pregnant people so there was limited data on the safety of vaccination in pregnant people and babies. Scientists intend to follow up with the pregnant people in the study to assess the long-term safety of the vaccine during pregnancy.

Both the Johnson & Johnson and AstraZeneca Covid-19 vaccines appear to be setting off rare blood clotting events in a few people who get them, a top expert told vaccine advisers to the US Centers for Disease Control and Prevention Friday.

The CDC’s Advisory Committee on Immunization practices is meeting to discuss whether to change guidance for J&J’s Janssen vaccine. The CDC and the US Food and Drug Administration recommended pausing its use after six reported cases of women who developed a rare blood clotting syndrome after receiving J&J’s vaccine in the United States.

The AstraZeneca vaccine is not yet authorized for use in the United States, but use of the vaccine resumed in many countries in Europe after UK and European health authorities said the benefits outweighed the risks. Both vaccines use a common cold virus called an adenovirus to deliver genetic material to stimulate an immune response.

“It’s unclear what causes this to develop,” he added.

“The incidence — and this is based on the European experience, and the United Kingdom experience — is anywhere from one case per 100,000 to one in 250,000 of vaccine recipients,” Streiff said.

“Median onset of the symptoms after vaccination is about nine to 10 days,” he said, although in Europe some cases appeared 24 days after vaccination.

Most cases have been among women and people as old as 77 have been affected.

Streiff said he did not think it was possible to screen patients for risk factors for the blood clotting syndrome. “I don’t think we can just focus on oral contraceptive users and obese patients,” he said.

But he said awareness has helped patients get quick treatment. “Recognition that this syndrome exists is helping to improve outcomes,” Streiff said.

ACIP is expected to vote on any changes later Friday. If ACIP recommends changes to the vaccine label – such as a warning, or changes to who it recommends should get the vaccine — CDC Director Dr. Rochelle Walensky will sign off and then the FDA will have to make any label changes.

Pennsylvania has fully vaccinated more than 3 million of its residents, with first doses having been administered to over 45% of the population, its health department said.

That said, the state's current 14-day average of new cases continues to increase, but is still below what it was at the height of the spring peak in May 2020.

Pennsylvania began receiving Pfizer and Moderna Covid-19 vaccine shipments in December. The state also got a shipment of the Johnson & Johnson vaccine on March 1, but "shipments to Pennsylvania providers are currently paused out of an abundance of caution," according to a news release from the Pennsylvania Department of Health.

As India grapples with a devastating second wave of Covid-19 cases, the government's top scientific adviser says while they saw the signs of a next surge, "the scale and the intensity of it was not clear."

He added that India loosened restrictions "before we should have."

As soaring demand overwhelms the health care infrastructure, VijayRaghavan, who is also a co-chair of India's Covid-19 vaccine task force, admitted that PPE, ventilators, vaccines and hospital set ups need to be "scaled up enormously."

Families and hospitals are raising the alarm on acute shortage of oxygen supply for days and VijayRaghavan emphasized that the government is making all the effort to address it.

"Oxygen availability has been pushed over the last few days, both in terms of diverting manufacturing, importing, distribution and looking at local availability. This hopefully will start seeing results soon," he said Friday.

However, he admitted that the intensity of the second wave has rendered any amount of ramping up of health care capacity since the first wave "not yet sufficient."

In the face of this massive public health crisis, escalating vaccine production and rollout remains important not just for India but for the world, he told CNN. However, it's not just India's responsibility to manufacture but also other countries' responsibility to supply ingredients, such as the United States.

Once that happens, India can build up its capacity to fulfill its own needs as well as the world's, he said.

India reported 332,730 new Covid-19 cases on Friday, the highest number of daily cases globally for the second day in a row. This brings India's total to more than 16 million cases, according to a CNN tally of figures from the Indian Ministry of Health. The country has added more than 1 million cases in four days.

Watch:

White House Covid-19 coordinator Jeff Zients said during Friday’s coronavirus briefing that the federal government expects daily vaccination rates to "moderate and fluctuate" during the next stage of the US vaccination program.

Speaking about the areas of focus during the next phase of the vaccination program, Zients said the US “will continue to vaccinate millions of Americans each day.” But he added that vaccinating remaining populations of Americans will “take time and focus.”

CNN previously reported that the seven-day average of new Covid-19 doses reported administered has dropped below 3 million shots per day for the first time in more than two weeks, according to data published Thursday by the US Centers for Disease Control and Prevention.

The average pace of new doses reported administered has been greater than 3 million shots per day for most of April, reaching a peak of nearly 3.4 million shots per day on April 13.

A new study published by the US Centers for Disease Control and Prevention found people with mild or asymptomatic forms of Covid-19 can have long-term medical problems.

According to the study, nearly 70% of patients who hadn’t been hospitalized for Covid-19 needed to go back to the doctor 28 to 180 days after their initial diagnosis, according to medical records of adults enrolled in an integrated health system in Georgia.

Scientists analyzed the records of more than 3,000 patients and found that the people who were most likely to need to go back to the doctor were those who were ages 65 or older, women, Black adults and people who had three or more underlying health conditions — although, 60% of those who had some ongoing medical problem were people who had no underlying health conditions.

The most common new diagnoses were a cough, shortness of breath, chest or throat pain and fatigue which may suggest these patients had lingering Covid-19 symptoms, while more than one in three of these patients also sought out new specialists for problems with their skin, mental health issues, stomach and heart problems, the study said.

More about this study: A limitation of the study was that it could not pinpoint if this need for new care was related to a long Covid-19 issue, or if the patient had missed an appointment during the stay-at-home orders.

It was unclear if the number of patient visits was higher for recovering Covid-19 patients than it was for patients who did not have Covid-19. A large study published Thursday in the journal Nature did find that people who had Covid-19 seem to face a much greater risk of needing medical care in the six months after their diagnosis.

“Clinicians and health care systems should be aware of the possibility of medical encounters related to a previous diagnosis of COVID-19 beyond the acute illness,” the study said.