Panic porn: Did the CDC, FDA pour more doubt into vaccines after Johnson & Johnson pause?

“Something that is this rare and recognizable and treatable is not something that should derail use of the Johnson & Johnson vaccine, especially in this atmosphere of vaccine hesitancy. People are not going to remember that this was not a major risk. They’re going to remember the bad headline.”

That’s Dr. Amesh Adalja, an infectious disease expert and senior scholar at the Johns Hopkins Center for Health Security, regarding Johnson & Johnson’s decision to pause administering its vaccine, which had already been put in the arms of millions of Americans. The decision to pause was the result of six women developing a rare blood clot after receiving the shot; one of the women died.

On the headline part particularly, Adalja is correct: More and more Americans consume news on their phones and laptops in a fast-food manner by reading the headline and drawing their own conclusions from it instead of reading the story itself. In this case, some of the headlines were exceptionally (albeit not intentionally) misleading, potentially stoking unwarranted fear in the process. 

“FDA, CDC call for pause in use of Johnson & Johnson vaccine after ‘extremely rare’ cases of blood clots” — The Washington Post 

“Johnson & Johnson vaccine paused over rare blood clots” — The BBC 

“U.S. recommends ‘pause’ for Johnson & Johnson COVID vaccine to review blood clot cases” — CBS News 

Can you spot the one major omission in these headlines? 

It’s two hard numbers: six (the number of blood clot cases) and seven million (the number of vaccine shots administered). This is a huge, important part of the story that must appear somewhere in the headline to prevent readers from concluding that the blood clots are more widespread than they actually are. 

On this front, let’s look at the raw numbers for context.

Since the pandemic began, more than 560,000 Americans have died of COVID. That’s 1 out of 586 people. 

The J&J vaccine has caused rare blood clots in six women (aged 18-48) out of more than seven million people who have received a shot. But that means people getting the vaccine have more than a one-in-a-million chance of getting a rare blood clot.

For context, there’s a 1-in-500,000 chance each year that a person will be struck by lightning. So basically, you might be struck by lightning twice in one year before developing a rare blood clot from the J&J vaccine.

How about sleeping? Did you know that an average of 450 people die each year from falling out of bed?  

And that begs the question: Is this pause worth the doubt it may sow in vaccines? 

And another question: Why put a blanket pause across all age groups instead of those below, say, age 50? 

According to a Pew Research poll taken before the J&J vaccine pause, 30 percent of the American public does not currently plan to get a vaccine, regardless of whether it’s Pfizer, Moderna or J&J.

“Those who do not currently plan to get a vaccine (30% of the public) list a range of reasons why. Majorities cite concerns about side effects (72%), a sense that vaccines were developed and tested too quickly (67%) and a desire to know more about how well they work (61%) as major reasons why they do not intend to get vaccinated,” the March Pew poll found. 

Given that side effects are the biggest concern among those not planning to take the vaccine at this time, how does the J&J extremely rare side effect compare to, say, the side effects of birth control?  

Well, one out of 1,000 women taking birth control can experience a clot, according to the FDA. When expanded to women taking the pill for 10 years, that ratio is 1-in-100 women. Again, this is compared to one-in-one million with the J&J vaccine. 

For perspective, here are some numbers:

1 in 1,000,000: J&J vaccine
1 in 3,000: oral contraceptives
1 in 5: hospitalized COVID-19 patients

As someone who got the J&J vaccine 8 days ago, and who took oral contraceptives for 20 years, I’ll take these odds.

— Dr. Angela Rasmussen (@angie_rasmussen) April 13, 2021

On cue, you knew this pause would become another Super Bowl of political footballs. Here’s former President Trump slamming the Biden administration:

“The Biden Administration did a terrible disservice to people throughout the world by allowing the FDA and CDC to call a ‘pause’ in the use of the Johnson & Johnson COVID-19 vaccine,” Trump said in a Wednesday statement. “The results of this vaccine have been extraordinary but now its reputation will be permanently challenged. The people who have already taken the vaccine will be up in arms, and perhaps all of this was done for politics or perhaps it’s the FDA’s love for Pfizer.” 

So, what happens from here? As we know, fear sells. The question is: When the J&J pause is lifted days or weeks from now, will that get the kind of media coverage the original pause got? More than likely not, but the impression will be made. 

Stats guru Nate Silver of FiveThirtyEight sums up the situation compellingly here by making a point about cost-benefit. Did the administration and CDC consider the pros and cons of going ahead with a pause over a rare blot clot which people have a one-in-a-million chance of getting? 

6 cases out of 7 million people. What a disaster. This is going to get people killed. And it’s going to create more vaccine hesitancy. These people don’t understand cost-benefit analysis. They keep making mistakes by orders of magnitude. https://t.co/DQdvqoujHR

— Nate Silver (@NateSilver538) April 13, 2021

And with a great analogy here:

If out of the blue one morning Gov. Newsom was like “Shark attacks are extremely rare, but out of an abundance of caution, we’re closing every beach in California until we investigate more”, that’s not likely to get more people to go out to the beach, even once beaches reopen.

— Nate Silver (@NateSilver538) April 13, 2021

To Silver’s point, even if given the all-clear, would someone with even a slight fear of sharks ever get back in the ocean again? Same goes for vaccines. 

That’s the challenge and huge headache ahead for the CDC and Team Biden: Getting to herd immunity – which involves about 70 percent of the country getting vaccinated – while continually sowing doubt in a vaccine nearly a third of the country was already against putting into their bodies. 

Joe Concha is a media and politics columnist for The Hill.