April 14 coronavirus news

Major League Baseball's Minnesota Twins shortstop Andrelton Simmons has tested positive for Covid-19 after refusing to be vaccinated against the virus.

In late March, Simmons said in a tweet, he would not be getting or advocating for the vaccine due to "personal reasons and past experience." 

Simmons is currently experiencing "very mild symptoms" and is resting comfortably at home, according to the Twins' president of baseball operations Derek Falvey.

"We want to continue to educate people in the environment. This is real. This is something that can enter. We know that," Falvey said on Wednesday. “Sometimes no one really knows exactly how it can come at different times. We know that from looking not just across our sport, but across all sports and across the country and the world. Our view of that is constantly reminding people of why we think it's a good idea to get vaccinated. Our docs have recommended that, and so we continue to provide them as resources to players, to learn as much as they can about this."

Simmons was notified of the positive test after Tuesday's game against the Boston Red Sox and was placed on the Covid-19 protocol list before Wednesday's doubleheader against the Red Sox.

Falvey added, "We're not out of the woods by any means on that front. Now is the time to be as vigilant as possible."

The pause on the Johnson & Johnson Covid-19 vaccine will allow researchers to investigate a potential link to severe blood clotting events, particularly whether certain populations are more susceptible, National Institutes of Health Director Dr. Francis Collins said Wednesday.

The US Centers for Disease Control and Prevention and FDA recommended a pause on use of Johnson & Johnson's coronavirus vaccine, following six reported US cases of a rare and severe type of blood clot.

“Many people have heard about blood clots as something that you get in your legs, maybe if nothing is done, they have the risk of spreading to your lungs,” Collins said at a virtual event hosted by the American Association for Cancer Research. “This is a different kind of blood clotting scenario, where there is an activation of the platelets in the body, so that they begin to clot in various places. Most dangerously, this happens in the cerebral venous sinuses inside the skull.”

Collins said that individuals who experience this kind of event have extremely low platelet counts, “because they've essentially been consumed.”

Collins noted that the concerns are similar to those raised with the AstraZeneca Covid-19 vaccine, which also uses an adenovirus vector platform.

“Some possibility here that it's something about the vector that in a very rare individual sets off this cascade,” he said. “We need to figure this out.”

More context: The cases of severe blood clots after vaccination with the J&J vaccine in the US were all among women. Collins noted that the pause will allow researchers to investigate whether particular populations are more susceptible and should perhaps not take the vaccine.

He assured people that the pause will not set back the vaccination effort in the US.

“In fact, the J&J vaccine supply was the smallest of the three and was not going to be particularly critical to get us to the point where everybody would have vaccine access by the end of May, or certainly by June,” Collins said.

Nearly 195 million doses of Covid-19 vaccine have been administered in the United States, according to data published Wednesday by the US Centers for Disease Control and Prevention. 

The CDC reported that 194,791,836 total doses have been administered, about 78% of the 250,998,265 doses delivered. 

That’s about 2.5 million more doses reported since yesterday, for a 7-day average of about 3.3 million doses per day. 

By the numbers: About 37% of the US population – nearly 124 million people – have received at least one dose of vaccine, and about 23% of the US population – about 76.7 million people – are fully vaccinated, CDC data showed.

Data published by the CDC may be delayed, and doses may not have been given on the day reported.

Vaccine advisers to the US Centers for Disease Control and Prevention ended an emergency meeting Wednesday without voting on changing any recommendations for Johnson & Johnson’s coronavirus vaccine.

Members of the committee said they did not have enough information to recommend changes in their recommendations, or even to suggest extending a pause in administering the vaccine.

The CDC and the US Food and Drug Administration recommended Tuesday that the United States pause the use of the Johnson & Johnson vaccine.

The vaccine has been linked, but not definitively, to cases of rare blood clots.

On Wednesday, the Advisory Committee on Immunization Practices heard details of six known cases of a rare type of blood clot called CVST found in combination with a low level of key blood-clotting cells. The condition is tricky to treat and doctors are warned not to use typical blood thinners to treat it.

They also heard about a possible seventh case, and heard details of one case in a volunteer during trials of the vaccine – a case that J&J initially said was not linked to the vaccine.

ACIP staff said they would look for a time that the committee could meet again quickly so the vaccine is not unnecessarily delayed if they decide it’s safe to continue giving it.

“We will find a time to reconvene,” ACIP executive secretary Dr. Amanda Cohn told the meeting. “We will try to identify what that date is by Friday of this week so that people have a little bit more time to get it on the calendars.”

Vaccine advisers to the US Centers for Disease Control and Prevention signaled Wednesday they may not be ready to vote on whether to revise their recommendations on who should get Johnson & Johnson’s coronavirus vaccine.

The CDC’s Advisory Committee on Immunization Practices held an emergency meeting to decide on whether to recommend extending a pause on giving the vaccine while investigators check into a possible link with rare blood clots. They may also be asked to vote on whether to recommend limits on who gets vaccinated based on age or sex.

But members said they may not know enough yet to make such recommendations.

"I do not want to vote on this issue today. I do not want to vote not to recommend the vaccine — I think that is not really something I necessarily believe,” Dr. Beth Bell, a clinical professor at the University of Washington in Seattle, said during the meeting.“I just don't feel there's enough information to make an evidence-based decision. We won't have all the information, but I think there are some things that we can gather relatively quickly, which all have to do with the benefit/risk balance."

"We do need to better understand the risk, which we know is going to be very rare, very low, but we really don't know exactly how low and how to correctly characterize it,” Bell added. “I think we need to not vote and gather the necessary information so we can make an evidence-based decision.”

More context: The group has a scheduled meeting in three weeks – on May 5, or could schedule another emergency meeting in a week or two.

But Dr. Nirav Shah, director of Maine’s Center for Disease Control and Prevention and representative for the Association of State and Territorial Health Officials (ASTHO), said waiting was equally bad.

“We in a situation where not making a decision is tantamount to making a decision,” said Shah.

Shah said people who could benefit from getting a one-dose vaccine would go unvaccinated as a result of further delay.

Vaccine advisers to the US Centers for Disease Control and Prevention could be asked to decide whether to recommend extending the pause on giving out Johnson & Johnson coronavirus vaccines.

The CDC’s Advisory Committee on Immunization Practices is holding an emergency meeting Wednesday to discuss cases of rare blood clots that may or may not be linked with J&J’s coronavirus vaccine.

They will be asked whether to modify their recommendations for the vaccine, the CDC’s Dr. Sara Oliver said. They may also be asked to consider a recommendation to extend the pause in administering vaccines.

“This could potentially allow for a more informed, specific recommendations for the Janssen vaccine,” Oliver told the meeting. The committee may recommend giving the vaccine only to certain age groups, since most cases appear to be among people under the age of 50, or perhaps only to men, as most cases of the rare blood clots have been among women.

“We could evaluate the risk by age, an informed possible age based recommendation. It would also allow for further assessment to see if the thrombocytopenic thrombotic risk extends beyond CVST cases,” she added. 

The concerning cases involve a rare type of blood clot, known as cerebral venous sinus thrombosis (CVST), that is found in combination with a condition known as thrombocytopenia – a low level of important blood clotting cells called platelets.

“However extension of the pause could have broad consequences. Individuals may want to receive the Janssen vaccine. In addition, a pause could have global implications, such as pausing clinical trials or limiting the ability of the Janssen vaccine in other countries with more limited vaccine supply,” Oliver said.

The ACIP will vote later Wednesday on its recommendations.

CDC vaccine advisers met today to review "rare and severe" blood clot cases among a small number of people who received the Johnson & Johnson vaccine.

Officials say there were six cases among more than 6.8 million Americans who received the vaccine. The FDA and CDC have recommended pausing use of the vaccine while it is being reviewed.

CNN was live earlier today, answering your questions about the vaccine pause. Watch more:

Headache appears to be the main symptom among the six women who developed blood clots after receiving a Johnson & Johnson coronavirus vaccine, Dr. Tom Shimabukuro, vaccine safety lead with the US Centers for Disease Control and Prevention's Covid-19 Response Team, said during a meeting of the CDC's Advisory Committee on Immunization Practices on Wednesday.

"The important thing to note here is the initial features are largely kind of nonspecific symptoms, which at initial presentation – or when a patient starts to become symptomatic – may seem kind of mild and not that clinically significant. Things like headaches, lethargy, chills, myalgia," Shimabukuro said. "Later features include severe headache, some focal signs, in one case severe abdominal pain, bruising, swelling in the lower extremities."

Shimabukuro referred to the six cases and said that "if you look at five of these six cases, really headache is the initial presenting feature and so I do think it's important in the setting where we are right now that health care providers maintain a high index of suspicion for possible CVST and confirm vaccination history among other things."

CVST refers to cerebral venous sinus thrombosis, which involves clotting in veins that drain blood from the brain. Shimabukuro noted that four of the six patients were treated with the anticoagulant drug heparin, but heparin is not the recommended treatment for this particular type of rare blood clot, which is accompanied by a low level of a blood clotting cell known as platelets. Heparin is a blood thinner and giving it to people with low platelet counts could cause hemorrhaging.

Among the six patients, Shimabukuro said that one has died, three remain hospitalized -- among which two are in intensive care, and two have been discharged home.

Remember: The CDC and FDA recommend the US pause the vaccine after six reported blood clot cases among more than 6.8 million doses of the vaccine administered in the US. The majority of people who took the vaccine are fine. Mild headaches and flu like symptoms are common after taking the vaccine – and mean it's working. However, if you are concerned or have severe side effects you should contact your health provider.

Some patients who developed blood clots after receiving a Johnson & Johnson coronavirus vaccine received the wrong treatment at first, a company representative told an emergency meeting of federal vaccine advisers Wednesday.

The Advisory Committee on Immunization Practices, which advises the US Centers for Disease Control and Prevention on vaccine issues, heard details of the six known cases of rare blood clots among about seven million people who got the vaccine in the US, plus a seventh suspected case. 

At least four of the six cases were treated with heparin when they first developed symptoms, Dr. Aran Maree, chief medical officer for pharmaceuticals at J&J’s Janssen vaccine arm, told the meeting. 

He gave details of what’s known about the cases, which include: a 45-year-old woman who died; a 38-year-old woman who has not recovered; an 18-year-old woman who has not recovered; a 48-year-old woman who has not recovered, a 26-year-old woman who has recovered and a 28-year-old woman whose status is unknown. They also include a possible seventh case – a 59-year old woman who has not yet recovered and whose blood clots might not fit the same profile as the others.

Heparin is not the recommended treatment for this particular type of rare blood clot, which is accompanied by a low level of a blood clotting cell known as platelets. Heparin is a blood thinner and giving it to people with low platelet counts could cause hemorrhaging.