The CDC and the FDA called for an immediate pause in use of the Johnson & Johnson vaccine after regulators said six women recently developed unusual clots. Nearly 7.5 million people in the United States have received the vaccine, which uses technology that Johnson & Johnson licensed from BIDMC.
Federal health officials on Tuesday called for a pause in the use of the Johnson & Johnson coronavirus vaccine, saying they are reviewing reports of six U.S. cases of a rare and severe type of blood clot in people after receiving the vaccine. The rare blood clots were first detected in people in Europe who had received the AstraZeneca vaccine. Dan Barouch, MD, PhD (Center for Virology and Vaccine Research, BIDMC), who has been developing the technology used in the Johnson & Johnson vaccine for years, noted in an email last week that there were a number of biological differences between the viral vectors, called adenoviruses, that are being used in the two vaccines.
BIDMC launched a new program, the Critical Illness and COVID-19 Survivorship Program, to provide clinical care for COVID long haulers and investigate why they continue to feel symptoms long after the days or weeks that represent a typical course of the disease. Harvard Gazette spoke with Jason Maley, MD (Pulmonary, BIDMC), who leads the program, about the program, what’s known about the condition, and what awaits discovery.
Dan Barouch, MD, PhD (Center for Virology and Vaccine Research, BIDMC) said the pause shows a “commitment to safety” as federal agencies investigate the cases of potentially rare blood clotting in six Johnson & Johnson vaccine recipients.
Regeneron Pharmaceuticals said that a single administration of its monoclonal antibody cocktail reduced the risk that volunteers exposed to COVID-19 would develop the disease by 81 percent. Dan Barouch, MD, PhD (Center for Virology and Vaccine Research, BIDMC),who partnered with Johnson & Johnson for the development of a COVID-19 vaccine, is an investigator in Regeneron’s study and noted the antibodies approaches are complementary.
As growing evidence suggests that brain and nervous-system problems are prevalent among “long-haulers,” the estimated 10 to 30 percent of COVID-19 survivors who remain ill months after their infection, BIDMC’s Critical Illness and COVID-19 Survivorship Program is the most comprehensive post-COVID clinic in New England. Jason Maley, MD (Pulmonary, BIDMC) directs the program and said the group is seeing 10 to 15 new patients a week and is fully booked for months. Tamara Fong, MD (Neurology, BIDMC) said long-haulers’ symptoms often resemble a post-concussion syndrome. But unlike with a concussion, it’s not clear whether the brain suffered a direct injury.
In a study conducted during the early days of the pandemic, scientists reported in The Annals of Neurology that nearly 10 percent of COVID-19 patients who experienced cognitive symptoms and were hospitalized during the early days of the pandemic experienced nonconvulsive seizure. The study was co-authored by Mouhsin Shafi, MD (Neurology, BIDMC) who noted only the sickest patients were monitored with EEG at the beginning of the pandemic and it’s not clear how common EEG abnormalities may have been in other patients.
Providing vaccines in the in-patient setting is a concern many hospitals face due to limited supplies and logistics. Sharon Wright, MD, MPH (Infection Protection, BILH) spoke to the approach BILH is taking to address this challenge for patients who received their first vaccine dose in the outpatient setting, and become eligible for their second dose during an inpatient stay at one of our hospitals.
Special clinics in Boston help “COVID long-haulers” – patients who struggle with lasting COVID-19 symptoms for weeks and months. Jason Maley, MD (Pulmonary, BIDMC), who leads theCritical Illness and COVID-19 Survivorship Program at BIDMC,noted patients improve over time and at their own pace, and there is potential for symptom improvement after vaccination – but most data is still anecdotal at this time.
Dan Barouch, MD, PhD (Center for Virology and Vaccine Research, BIDMC), who helped develop the Johnson & Johnson vaccine, spoke to the vaccine planning process and how, in some ways, the discovery of the virus with pandemic potential was a moment Barouch and team had been preparing for decades.
After a shortened 2020 season filled with grief and isolation amid the COVID-19 pandemic, the first pitches of Opening Day 2021 at Fenway Park on Friday afternoon were thrown out by new Boston Mayor Kim Janey, Cpl. Shamar Martin of the Army National Guard, and Edward Ullman, MD (Emergency Medicine, BIDMC). Ullman has overseen the first aid room at Fenway Park for 18 years, but he treated more than 1,000 COVID-19 patients as an attending physician in the BIDMC Emergency Department. He also oversaw the mass COVID-19 vaccination site at the Boston ballpark, which administered more than 56,000 doses of the vaccine.
A new study shows some hospitalized COVID-19 patients have non-convulsive seizures that may increase their risk of death. Mouhsin Shafi, MD (Neurology, BIDMC) co-authored the study and noted the findings suggest that COVID patients should be monitored closely for non-convulsive seizures.
In this opinion article, Jerome Groopman, MD (Experimental Medicine, BIDMC) discussed the COVID-19 pandemic and how global instability has caused a worrying rise in epidemics.
In a letter to the editor responding to “Prepare Yourself for Grief” (At Home, March 14), Dorothy Holinger, PhD (Psychology, BIDMC) proposed a national day of mourning to acknowledge the nation’s collective grief for more than half a million deaths of grandparents, mothers, fathers, children, siblings and life partners and to celebrate those who were with them as they died.
Sharon Wright, MD, MPH (Infection Protection, BILH) spoke to the CDC director’s latest warning about a potential fourth wave of the virus and noted that although we are close to being able to get more vaccine to get people vaccinated, we are also seeing the number of people acquiring COVID-19 increasing. Wrights cautions it’s still important to physically distance, wear a mask and stay mostly with members of our own households.
During the early days of pandemic lockdown, clinics and hospitals were forced into a massive telemedicine shift. Now, as doctors resume in-person visits, virtual care is poised to play a permanent role. Daniel Sands, MD, MPH (Primary Care, BIDMC) noted healthcare professionals have learned much about the many different things doctors can do to connect with patients in ways never seen before.
A recent study of transplant recipients, who take drugs to suppress their immune system, found that most failed to produce antibodies against the coronavirus after a first dose of vaccine. Dan Barouch, MD, PhD (Center for Virology and Vaccine Research, BIDMC) who worked on developing the Johnson & Johnson COVID-19 vaccine, noted it is expected that vaccines will have reduced immune response in immune-suppressed populations.
Public health advocates and academics are asking for the government to exert NIH patent rights over the Moderna vaccine to make it more widely available in the developing world. Kenneth Mayer, MD (Infectious Disease, BIDMC) noted that requiring technology sharing and using the WHO to work with technology organizations in other countries are amongst the things the government can do in a regulated way.
Kevin Tabb, MD (CEO, BILH) shared lessons learned from the COVID-19 pandemic, including approaches to patient care, telehealth, vaccine development and vaccination rollout.
In this article about long-haul COVID-19 sufferers, Jason Maley, MD (Pulmonary, BIDMC) described the common symptoms long-haul COVID-19 patients experience.
