Welcome to Episode 25 of “COVID: What comes next,” an exclusive weekly Providence Journal/USA TODAY NETWORK podcast featuring Dr. Ashish Jha, dean of the Brown University School of Public Health and an internationally respected expert on pandemic response

COVID: What comes next - With Dr. Ashish Jha

PROVIDENCE – The decision by the Centers for Disease Control and Prevention and the Food and Drug Administration to recommend an immediate pause in administration of the Johnson & Johnson vaccine demonstrates that “the system is working,” pandemic expert Dr. Ashish Jha said on Tuesday while recording the “COVID: What Comes Next” podcast.

The federal recommendation follows reports of six women, ages 18 to 48, who developed an unusual blood-clotting disorder after receiving the single-dose vaccine. One died and a second woman is hospitalized in critical condition.

“Obviously, none of us wish this had happened,” said Jha, a physician, scientist and dean of Brown University’s School of Public Health. But he added: “We have a system that always errors on the side of safety and I like that.”

Despite this setback to plans to get more people vaccinated in hopes of reaching herd immunity as soon as possible so that life can begin to return to a semblance of normalcy, Jha said “I remain very confident that the J&J vaccine is very safe.”

And he brought context to the situation, noting the importance of millions of people having received the protection of a Johnson & Johnson shot.

“We are aware of six cases out of seven million people vaccinated,” he said, “so these are exceedingly rare events… If you compare that to what would have happened for those seven million people -- if even a chunk of them had gotten COVID -- the complication numbers would have been dramatically higher.”

Scientists are now analyzing data “to make sure: Are there other cases out there that we're not aware of, that we haven’t caught,” Jha said, and also to determine why all six cases of the disorder were experienced by women and what implications that will have in deciding what recommendations come next.

“So then the question is: Should we make decisions like, say, let's unpause but let's not give women 18 to 48 this vaccine and let's have them get Moderna or Pfizer.”

As the news broke Tuesday morning, an audience member whose 18-year-old daughter received the Johnson & Johnson vaccine on Sunday was quick to ask: “What should we be watching for,” in terms of possible complications.

The rare disorder, Jha said, is known as “cerebral venous sinus thrombosis,” which he defined as “basically the veins in your in your brain, in your head, get clots. And so, as you might imagine, it's pretty serious -- but treatable if you catch it early. So what are the main symptoms? Pretty severe headaches, double vision, other neurologic symptoms.

“Typically, this has happened in this small number of cases [about] six to 14 days after and what I would say to folks is: Just keep an eye out for any untoward symptoms. Certainly, if you start developing severe headaches, if you start developing problems with your vision, things that would trigger alarm bells anyway,” don’t ignore what is happening.

“These are not subtle things like ‘oh, I woke up this morning and I feel a little bit off.’ If you feel any of these symptoms, take it seriously, go get it checked out and let's figure out if you're one of the very, very unlucky people who's had it.”

He concluded: “It's a very rare thing. If the numbers end up being six in seven million -- or about a one-in-a-million overall risk -- that's a lower risk than like your risk of getting hit by lightning in a given year. We have to keep things in perspective.”

Also during recording of this 25th episode of the weekly podcast, available exclusively from The Providence Journal and the USA TODAY NETWORK, Jha analyzed the crises in Michigan and India, where he was born and still has relatives and friends. Both the state and nation are suffering significantly now from COVID-19.

Jha also answered more audience questions sent to the podcast (they can be submitted by emailing [e-mail]):

◘ A man from southern New England asked about reactions to the second doses of the Pfizer and Moderna vaccines, which vary from none to mild to severe: “Is there any correlation between your immune system reacting and the expected effectiveness of the vaccine?”

Jha’s abbreviated answer: No, the vaccines are effective regardless of reaction. For those who have no reaction and wonder if they have been immunized, Jha gave assurance that they have. “What I say to people who don't have a reaction is ‘Mazel tov, you got lucky. Good for you!’ ”

◘ Another person wanted to know if it is safe to sing in a community chorus again.

Jha answered: Not yet.

◘ A listener in New York City asked about her children, who may want to visit Europe in the next few months after being vaccinated. Given the B117 variant and other factors, would that be safe?

“Most Western European countries will have a good chunk of people vaccinated and case numbers very low by late summer, but probably not early summer,” Jha said. “So I would be I would be hesitant about making plans right now because there's so much uncertainty across all these countries.”

This weekly podcast is hosted by G. Wayne Miller, health reporter for The Providence Journal.