We're up to 15 cases of J&J clots, still all in women (not counting the one man in the trial). The rate for women 18-49 is not one-in-a-million anymore, but 7 per million.

ACIP meeting agenda: https://www.cdc.gov/vaccines/acip/meetings/downloads/agenda-archive/agenda-2021-04-23-508.pdf

slides: https://www.cdc.gov/vaccines/acip/meetings/slides-2021-04-23.html

webcast link: https://www.ustream.tv/channel/VWBXKBR8af4

Scheduled to run until 5pm today with a vote at EOD that could end or extend the pause.

Of the 15, only 2 are reported as using oral contraceptives and none pregnant or postpartum. Here's more details on risk factors:

Symptoms among those whose clots were in the brain:

6 people who were hospitalized before the CDC alert were treated with heparin; none of those hospitalized afterwards were. That means the announcement worked to get the message out, and may have saved lives.

Panel members noting that it's pretty impressive that we were able to detect something this rare. Shows that safety monitoring systems are working and that people care.

To those who say "why not just give it to men" or "just use it in older people," these are the reasons why that's not a simple solution:

Here are the pros and cons of 4 options they are considering:

- recommend NOBODY get the vaccine
- recommend for everybody 18+
- recommend only for age 50+
- recommend for everyone but make sure women <50 know about the risk & consider other vaccines if desired

My hunch is they'll choose something like that last option, but it's still a complex question. This risk/benefit calculation (attached) is for J&J versus no vaccine.

In practice, of course, some of the people who don't get J&J would get a different vaccines. Others might not.

J&J was a top option for outreach to homeless, homebound, migrant populations. If it were only available to men in those pops, would be hard to vax whole families.

Imagine if you're one of those and the vaccine van rolls up and says "men only." Kinda sucks if you're a woman who just wants a vaccine and can live with a 7-per-million risk.

That's why I expect them to unpause with no restrictions, just a warning.

But I'm guessing (and editorializing a bit) here. Lots of pros and cons to consider. We should have a decision by 5pm according to the schedule.

It's been an hour and I still can't tell the difference between option 2 and option 4, but it sounds like those are the ones the panelists are interested in.

They went for option 2, btw: recommending the vaccine to everyone 18+, with the FDA to provide the warning label.