Top 5 Takeaways

1. Preferential Recommendation: The Advisory Committee on Immunization Practices (ACIP) now recommends mRNA COVID-19 vaccines over the Janssen vaccine for all persons aged ≥18 years.
2. Safety Concerns: Cases of thrombosis with thrombocytopenia syndrome (TTS) and Guillain-Barré syndrome (GBS) have been reported after Janssen vaccine administration.
3. Emergency Meetings: ACIP held multiple emergency meetings to review updated safety data and benefit-risk assessments for the Janssen vaccine.
4. Benefit-Risk Analysis: The benefits of mRNA vaccines outweigh those of the Janssen vaccine, especially considering the higher vaccine effectiveness and fewer severe adverse events.
5. Continued Monitoring: CDC and FDA will continue to monitor adverse events and update recommendations as new data emerge.

Original Article Author and Citation

Corresponding Author

Sara E. Oliver, yxo4@cdc.gov

Suggested Citation

Oliver SE, Wallace M, See I, et al. Use of the Janssen (Johnson & Johnson) COVID-19 Vaccine: Updated Interim Recommendations from the Advisory Committee on Immunization Practices — United States, December 2021. MMWR Morb Mortal Wkly Rep 2022;71:90–95. DOI: http://dx.doi.org/10.15585/mmwr.mm7103a4

Summary

On December 16, 2021, the ACIP recommended the preferential use of mRNA COVID-19 vaccines over the Janssen adenoviral-vectored COVID-19 vaccine for all persons aged ≥18 years. This decision followed a review of updated vaccine effectiveness and safety data, particularly concerning cases of TTS and GBS reported after Janssen vaccine administration. The recommendation aims to prioritize the higher effectiveness and safety profile of mRNA vaccines.

Methods

The ACIP reviewed data from multiple sources, including the Vaccine Adverse Event Reporting System (VAERS), benefit-risk assessments, and epidemiologic studies. The data included incidence rates of TTS and GBS, vaccine effectiveness estimates, and COVID-19 hospitalization rates. The ACIP also considered the availability of mRNA vaccines and their use in various settings.

Discussion

The ACIP’s decision was influenced by the higher vaccine effectiveness of mRNA vaccines and the more severe adverse events associated with the Janssen vaccine. The committee emphasized the importance of informed decision-making for vaccine recipients, especially those with contraindications to mRNA vaccines. They also discussed the need for equitable distribution of mRNA vaccines, particularly in hard-to-reach populations.

Conclusion

The ACIP’s updated recommendation reflects a comprehensive review of the benefits and risks associated with COVID-19 vaccines. The preferential use of mRNA vaccines aims to maximize public health benefits while minimizing adverse events. Continuous monitoring and timely updates to vaccine recommendations will be essential as the COVID-19 pandemic evolves.

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