REGIONAL— Concerns over six cases nationally of a rare blood clotting disorder halted administration of the Johnson & Johnson COVID-19 vaccine in Minnesota on Tuesday, but the expected brief suspension may have little effect on a vaccination effort that is beginning to show signs of lessening demand in certain areas.
The Centers for Disease Control and Food and Drug Administration recommended the pause as they review data about an extremely rare and severe type of blood clot that has been discovered in six women between the ages of 18 and 48. The clotting manifested itself between six and 13 days after receiving the one-shot J&J vaccine.
Gov. Tim Walz addressed the pause in a Tuesday morning press conference.
“This is the way the system is supposed to work— I expect this to be a short pause,” Walz said. “Your chance of dying of the virus is one in 560. Your chance of dying from this vaccine is one in a million.”
State Health Commissioner Jan Malcolm said that she is not aware of any blood clot cases connected to the 184,000 J&J vaccinations administered in Minnesota. She recommended individuals who have received the J&J vaccine who experience severe headache, abdominal pain, leg pain, or shortness of breath within three weeks of getting the shot should contact their health care provider.
St. Louis County Public Health Director Amy Westbrook said on Tuesday that her department has administered only 270 doses of the J&J vaccine.
“The Johnson and Johnson vaccine hasn’t really gotten distributed very widely in Minnesota since we started receiving it,” Westbrook said.
The county has targeted J&J vaccinations, in part, for college students, and had intended to use it for an upcoming vaccination clinic at Vermilion Community College in Ely. The clinic will still be held ,using a different vaccine, Westbrook said.
Bois Forte tribal clinics also had been administering J&J shots, and health officials there quickly announced on Tuesday that they were suspending the use of that vaccine and switching to the Moderna two-shot regimen.
Declining demand?
Now months removed from the day the state’s online vaccination registration system opened and crashed due to overwhelming demand, and only two weeks after Walz opened eligibility to anyone 16 and older, evidence is mounting that some areas of the state are seeing decreasing demand for vaccinations.
The clearest sign is in southern Minnesota, where both Faribault and Martin counties have declined their scheduled allocations of vaccines because they are having trouble filling appointments.
In the North Country, Cook Hospital announced a 60-slot vaccination clinic for this Friday on April 8. On Monday, four days later, the hospital posted a notice to its Facebook page that there were still appointments available, a different scenario from its three-day, 300-dose clinic in late February when slots were snapped up and there was a waiting list for appointments.
St. Louis County Public Health offered online registration this week for six vaccination events in the Duluth area, Hibbing and Eveleth, and a review of site registrations on Wednesday morning by the Timberjay found a large number of openings. The first clinic on Wednesday at Pike Lake was booked solid, but as of Wednesday morning 300 slots remained open for Thursday and Friday sessions at that location. A Thursday clinic at the Shriners Event Center had more than 250 open appointments. For a half-day clinic on Thursday in Hibbing, only the 9:30 a.m. slot was full, with room for 156 more patients. Friday’s six-hour clinic in Eveleth had openings across the board, with 460 appointments still available. While many of those slots will likely be filled, the pace of enrollment lags significantly from similar online registrations for other vaccine providers just a few weeks ago.
Westbrook acknowledged that the demand for vaccinations, at least through large community clinics, appears to be slipping.
“I think that’s definitely happening, at least what we’re seeing with our clinics in the northern part of the county, and we’re also seeing that start to happen in the southern part of our county,” Westbrook said. “We’ll probably end up shifting in the next few weeks, we’ll likely move away from the larger sites and do more targeted vaccinations.”
More than 2.1 million Minnesotans, 48 percent of the population age 16 and over, have received at least one dose of COVID-19 vaccine, and last week state officials initiated a concerted effort to reach targeted groups of essential workers, beginning with food service employees.
As of last Saturday, 91,000 residents of St. Louis County had received at least one dose of vaccine, and Westbrook said that a targeted approach to educate different groups about the benefits of vaccinations will be helpful.
“There’s a lot of benefits to employers promoting vaccines, because people who are fully vaccinated now don’t have to quarantine if they’re fully vaccinated and are exposed, so there’s a financial benefit there when people don’t have to take time off of work,” she said. “For students, we want to see them enjoy their graduations and their sports teams and their proms, so that also is an incentive to get vaccinated. We’re doing some targeted outreach to those groups specifically.”
Old to young
Key indicators of the prevalence of COVID-19 continued their upward trends in the county and statewide this past week, with numbers similar to concerning levels recorded in October. But with initial vaccination efforts in the state focused on the elderly, it’s now the younger part of the population driving the increase.
“We’ve seen our numbers sort of flipped on the edges,” Westbrook said. “We haven’t seen a huge shift in the percent of cases of 20 to 64-year-olds, but we’ve seen a dramatic drop in 65-plus cases, and that is being replaced by the under 20 group. We’re seeing our hospitalizations increase, and the age distribution is younger. We’re not seeing as many people go into the ICU, which is great.”
Schools and sports-related activities are among the factors fueling the increase in the school-age population, Westbrook said.
“We haven’t had a ton of change in health behaviors among the 20 to 64-year-olds, but we have seen a shift in the behaviors of adolescents,” she said. “More kids are in school, sports are going on again. In sports for younger kids we haven’t seen that as much as we have with school-associated sports.”
County trends now appear to be driven by case increases in the central and southern regions, as the spike that hit the Ely area has mostly subsided, with only eight new cases reported last week, ten fewer than the week before.
“2021 didn’t start off very well for the Ely community, but it’s getting better,” Westbrook said. “Forty percent of Ely’s total cases have been reported in 2021. But the trend for the past couple of weeks, since late March, has been that cases are decreasing, so that’s good.”