Pause of J&J vaccine threatens to slow U.S. pandemic progress amid rising caseload

The photos of Clearwater Beach, Fla., went viral last spring: people crowded on the sand, seemingly unconcerned about the deadly new contagion coursing across the world. Local officials, accused of fueling a public health crisis, quickly shut 35 miles of county beaches and left them closed for weeks.

What a difference a year makes. The beaches were even busier this year, but officials say there were no talks of closure. There was also far less outcry.

And with good reason, according to many scientists and public health experts, who say that the outdoor spaces now warming under spring sun should be viewed as havens in the battle against a stubborn virus and restriction-induced fatigue. For more than a year, the vast majority of documented coronavirus clusters have been linked to indoor or indoor-outdoor settings — households, meatpacking plants, nursing homes and restaurants. Near-absent are examples of transmission at beaches and other open spaces where breezes disperse airborne particles, distancing is easier, and humidity and sunlight render the coronavirus less viable.

Americans could soon be ready to travel the world again, and many countries are eager to welcome U.S. tourism dollars back. But with most of the world lagging behind the United States in vaccinations, there could be uncomfortable disparities between travelers and their hosts.

A possible preview of the dynamic unfolded in Spain over Easter, when German and French tourists filled flights to favorite island destinations, while frustrated Spaniards were subject to coronavirus restrictions that prevented them from moving beyond their home regions.

European travel is not yet an option for Americans. The European Union still bans nonessential travel from the United States, as it deems U.S. viral levels too high. Meanwhile, a third wave of the coronavirus has shut down many of Europe’s cities. Parisians can’t stray more than six miles from their apartments. Rome’s restaurants are closed to sit-down dining. Shops in Munich have been shuttered.

When top Biden administration health officials gathered on a Zoom call Monday night, they knew they faced a difficult decision. Six women in the United States had developed extremely rare but potentially life-threatening blood clots after getting the Johnson & Johnson coronavirus vaccine — a problem with disturbing parallels to the one in Europe linked to AstraZeneca’s vaccine.

Initially, some suggested the government could just issue a warning to consumers and doctors. They didn’t want to undermine confidence in vaccines given the danger of covid-19. But as they talked, two big worries emerged. They feared there might be additional cases of brain blood clots they didn’t know about. And what if the government didn’t act quickly, and as a result more people got the wrong diagnosis and treatment and were hurt or died?

Their unanimous agreement to recommend a pause in using the J&J single-shot vaccine early Tuesday morning set off a fierce debate. Critics suggested they were overreacting, predicting the result would be fewer people getting vaccinated and more dying of covid-19, the disease caused by the coronavirus. Others praised the federal officials for acting quickly on their concerns — especially since the conventional treatment with anticoagulant drugs can have serious harm. The argument suggested there are no easy answers in a pandemic that has posed one excruciating challenge after another.

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A Virginia woman who died after suffering from a rare blood clot is one of six cases federal authorities are examining to determine whether the illnesses are related to the Johnson and Johnson vaccine — an investigation that led them to recommend a nationwide pause on the one-dose regimen Tuesday.

Virginia Department of Health officials said they received word from the Centers for Disease Control and Prevention that the woman’s death was being examined by the agency as it investigates possible side effects of the Johnson & Johnson vaccine.

The Virginia woman, 45, died on March 18, according to the Vaccine Adverse Event Reporting System, the system the CDC uses to monitor symptoms after vaccinations. She received the vaccine on March 6 and began feeling ill six days later, according to the report. The woman, who was not identified, died after suffering from cerebral venous sinus thrombosis in conjunction with thrombocytopenia, or low blood platelets — the combination of conditions that federal officials are investigating.

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More than a dozen states and U.S. territories reacted quickly to the FDA and CDC’s announcement on Tuesday, which called for a pause in the use of the Johnson & Johnson coronavirus vaccine while they review six U.S. cases of rare blood clots in people who had received the vaccine.

Alabama, Alaska, Arkansas, California, Florida, Illinois, Kansas, Georgia, Louisiana, Maryland, Massachusetts, Michigan, Missouri, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin and Puerto Rico ceased distribution while the CDC and the FDA investigates the cases.

The District of Columbia canceled all Johnson & Johnson appointments for the next five days. New York said it would give Pfizer-BioNTech vaccine doses to those who were scheduled to received the Johnson & Johnson shots.

Arizona, Indiana, Maine, Minnesota, Ohio and Texas did not call for a hard stop, but advised all vaccine distribution centers to temporarily halt Johnson & Johnson dosing until there is more information. Delaware said it would pause the Johnson & Johnson inoculations at state-run sites and advise providers and pharmacies to also pause. North Dakota is “strongly urging” providers in the state to pause.

All six cases of blood clots occurred among women between the ages of 18 and 48, and symptoms occurred six to 13 days after vaccination, according to the CDC and FDA. The CDC will hold a meeting Wednesday to review the cases and assess their potential significance, the statement said. The FDA will continue to investigate the cases.

Biden and former president Barack Obama will appear in an hour-long television special on Sunday to encourage Americans to get vaccinated.

The “Roll Up Your Sleeves” special is set to air on NBC at 7 p.m. Eastern time and was created by ATTN:, a media company, alongside the nonprofit Civic Nation’s Made to Save initiative, a campaign launched this month to push for equitable access to vaccines and to bolster confidence in the shots, especially in communities hit hardest by the pandemic.

Biden will speak directly to the public during his appearance, urging Americans to get a shot when they can, according to a news release from Civic Nation. The appearance comes as the administration continues a vaccination campaign that includes television ads and a grass-roots network of leaders meant to encourage people to get their shots.

The television special will feature former first lady Michelle Obama, who will appear alongside Faith Hill, Jennifer Lopez and Lin-Manuel Miranda. Top infectious-disease expert Anthony S. Fauci will be interviewed by actor Matthew McConaughey. Barack Obama will appear with NBA stars Charles Barkley and Shaquille O’Neal. The special will also feature television doctors Eric Dane, Ryan Eggold, Ken Jeong, Ellen Pompeo and Jane Seymour, according to the release.

The slate of big-name appearances also includes Billy Crystal, Wanda Sykes, Sterling K. Brown, Lana Condor, Jennifer Hudson, Dale Jarrett, Joe Jonas, Eva Longoria, Demi Lovato, Joel McHale, Kumail Nanjiani and Amanda Seyfried, as well as Vin Gupta, a critical care pulmonologist at the University of Washington.

Mayor Muriel E. Bowser (D) on Monday announced a $350 million assistance program for D.C. residents trying to pay past and future rent and utility bills.

The program — called Stronger Together by Assisting You (STAY DC) — will be funded by appropriations from Congress as well as money injected into the city by the American Rescue Plan, which was passed into law in March.

In a news release, Bowser said the purpose of the program is to help residents “pay their bills now so that they can stay in their homes once the public health emergency ends.”

The program’s launch comes as both tenants and small landlords in the District have stepped up their criticism of the District’s relief effort for tenants who are behind on rent but still shielded from eviction by the city’s pandemic-linked moratorium.

While the start of quarantine last Ramadan shut down everything normal about the holy month, for Karim Amin, it also brought an unexpected heightened spirituality and creative intensity.

“It hurt not to be around everybody [last spring], but we did a lot of dope things,” said the Baltimore entrepreneur and activist.

As Ramadan begins Tuesday, Amin is navigating a maze of decisions, including whether and where to listen to the nightly taraweeh prayer, how close to stand to others if he goes in person and how many people to break fast with. Embedded in each of these choices is the same dilemma: how to make the holy month meaningful and communal when Muslims are going in all different directions about how to mark it.

Amin is just one of millions of American Muslims for whom the second pandemic Ramadan is a spiritual, medical and political morass.