J&J vaccine pause won't cause shortage, but more went to vulnerable places in Tucson area

After federal officials called for a nationwide pause in the use of the Johnson & Johnson coronavirus vaccine on April 13, a few vaccination efforts were disrupted in Pima County, but it hasn’t caused a widespread vaccine shortage.

“(The pause) does more to perhaps threaten equitable distribution, more so than the bigger picture of getting the absolute numbers we need to be successful,” said Dr. Joe Gerald, an associate professor with the University of Arizona’s College of Public Health.

Health experts are using the pause to investigate a severe type of blood clot in six patients, out of the approximately 7 million people who have received this vaccine.

The Johnson & Johnson vaccine has accounted for a small fraction of all the vaccines administered in Pima County. Only about 4% of vaccinated people have been given it, according to an Arizona Daily Star analysis of Pima County vaccine data through April 12.

However, of the approximately 17,800 Johnson & Johnson doses administered countywide, a higher percentage went to people in neighborhoods with more social vulnerability, as measured by an index of U.S. Census data.

The vast majority of vaccinated people have either received the Moderna or Pfizer vaccines. About 50% of vaccinated people have had at least one shot of the Moderna vaccine and 46% have had at least one dose of the Pfizer vaccine.

For some people, however, the Johnson & Johnson vaccine had advantages over the other two because it only requires one dose.

Public health experts point out this is especially true for those experiencing homelessness, residents in remote areas or workers who can’t take time off for a second appointment.

El Rio Health, the county’s largest medical and dental provider, had to cancel vaccinations for about 200 people in places like homeless shelters this past week when officials halted use of the Johnson & Johnson vaccine.

This is in addition to canceling hundreds of vaccination appointments for patients at El Rio clinics across the county, while they ordered more Moderna vaccines for next week, said Heidi Kurgat, El Rio pharmacy manager and quality director.

While the total number of administered Johnson & Johnson vaccines pales in comparison to the number of other vaccine regimens administered in Pima County, a higher percentage of Johnson & Johnson vaccines went to census tracts with high social vulnerability, according to the Star’s analysis of countywide vaccine data. Census tracts are roughly equivalent to neighborhoods.

A neighborhood’s social vulnerability score is measured by an index of U.S. Census data on income, age, race, language, housing type, occupation, education attainment, access to transportation and more.

This index is meant to help officials find areas that may need additional support preparing, weathering and recovering from disasters or hazardous events.

People in neighborhoods with the most social vulnerability have been vaccinated so far at a much lower rate than those in neighborhoods with less vulnerability.

Each neighborhood’s social vulnerability is scored on a scale from 0 to 1, with higher numbers indicating greater vulnerability. Pima County has more neighborhoods with higher social vulnerability scores than neighborhoods with lower social vulnerability scores.

People in the most vulnerable neighborhoods, those with a score of .75 or greater, have been vaccinated at a rate of about 297 per 1,000 people.

Meanwhile, people in the least vulnerable neighborhoods, those with a score of .25 or less, have been vaccinated at a rate of 562 per 1,000 people.

“We know in areas that have higher social vulnerability there were more cases and are more cases of COVID and death,” said Jess Seline, the county’s health equity program manager.

“So it’s kind of the same tune as what’s been playing out in the whole pandemic, unfortunately.”

Pima County health officials are addressing this by using neighborhood social vulnerability scores, along with COVID-related metrics, such as the rate of cases and deaths, to decide where to send mobile vaccine clinics. They want to send these clinics to where people need them most and might otherwise have a hard time accessing a vaccine.

The single-dose Johnson & Johnson vaccine was one way to fully vaccinated more people in these areas faster.

The mobile vaccines have stopped using the Johnson & Johnson vaccine for now, along with the rest of the nation, but Seline said they have plenty of Moderna vaccines on hand.

Just because someone comes to a mobile clinic doesn’t mean they can’t come back for a second shot, although the one-dose option did make it easier, Seline added.

In Pima County, people who live in neighborhoods with the highest social vulnerability scores have received more Johnson & Johnson vaccines than people in the least vulnerable areas, according to the Star’s analysis of data.

The most vulnerable neighborhoods in Pima County have received 36% of all Johnson & Johnson vaccines.

The least vulnerable neighborhoods, received about 19% of Johnson & Johnson vaccines.

And the opposite is true for the Moderna and Pfizer vaccines. People in the most vulnerable neighborhoods have received a lower percentage of these vaccines than people in the least vulnerable neighborhoods.

Neighborhoods with a score of .25 or less received about 29% of the Moderna and Pfizer vaccine regimens, while neighborhoods with a score of .75 or more received about 20% of these regimens.

The county’s mobile vaccine clinics are meant to lower as many barriers as possible to help more people get vaccinated in vulnerable neighborhoods.

“So the idea is you don’t have to make an appointment. It’s free. Walk up or drive through. And another barrier could potentially, for some people, be having to go back again,” Seline said.

“Johnson & Johnson was a great option for the mobile sites.”