The companies manufacturing COVID vaccines and other drugs

Tuesday’s recommendation from U.S. health authorities to pause distribution of the Johnson & Johnson COVID-19 vaccine has received a wave of reactions. The fallout for national vaccination campaigns varies widely, but – fairly or not – things are looking grim for the reputation of J&J’s once-hailed vaccine.

J&J itself delayed deliveries of the vaccine to the E.U. following the U.S. recommendation. The E.U. vaccination campaign is lagging, partly thanks to similar worries about the AstraZeneca vaccine, and European Commission officials responded with “urgent” concern to the prospect of a further supply shrinkage.

Meanwhile, South Africa also temporarily suspended J&J shots Tuesday. By Wednesday, sources told Italy’s La Stampa that the European Commission would not renew E.U. contracts with either J&J or AstraZeneca, and the E.U. simultaneously ordered 50 million more Pfizer/BioNTech doses. Fortune’s David Meyer sees this as Europe going “all-in” on mRNA-based vaccines, and abandoning the adenovirus-based J&J and AZ shots.

As if that weren’t enough, the CDC’s vaccine review board on Wednesday decided it needed more time to review and collect data, extending what might have been a two-day pause for at least another week.

All of this, it bears reiterating, comes in response to a risk that is still unproven and, at worst, appears slim. The six cases of dangerous blood clotting that triggered the U.S. pause arose out of 6.8 million doses delivered. Those cases may not have been caused by the vaccine at all, though similar cases among patients who received the AstraZeneca vaccine may suggest a common cause. But even if the vaccine is linked to clotting, it has been widely observed that the current incident rate suggests less risk than comes with taking oral contraceptives, which can trigger a different kind of clotting that is also potentially fatal.

This is not entirely doom and gloom for J&J. In a perfect world, the CDC and others would identify clear risk factors linked to negative outcomes with the J&J vaccine, and then direct doses into lower-risk arms. The six clotting cases at the center of the U.S. pause were all in adult women under 50, so discouraging or barring that group from taking the J&J vaccine may do the trick. And while it’s a grim calculus, any J&J doses the U.S. or E.U. decide they don’t want to distribute would probably be welcomed by some nations that still face serious vaccine shortages – the risk of COVID-19, after all, still appears much greater than any risk from the J&J vaccine.

The stock market has also had a measured reaction so far to J&J’s bad news. J&J stock climbed roughly 15% between October of 2020 and January of 2021, when the release of positive phase 3 trial results sent the stock to a peak of $170 before drifting closer to $160. The ‘pause’ announcement on Wednesday only knocked about 2.5% off that number, and today the price more than recovered.

Myself and others have wondered whether the pause would give ammunition to anti-vaxx conspiracists, but a small survey by Echelon Insights found that the J&J pause made 58% of Americans more confident in vaccines rather than less. A more robust YouGov poll found a major decline in trust of the J&J vaccine specifically, but little or no decline in faith in the Moderna and Pfizer vaccines.

It seems Americans may be interpreting the pause carefully and, I would argue, correctly: If health authorities are willing to hit pause on J&J over a handful of cases and a single death, it highlights just how safe the other options likely are.

David Z. Morris
david.morris@fortune.com
@davidzmorris

DIGITAL HEALTH

Heathrow hopes vaccination records can save it. The U.K. is well ahead of its former E.U. colleagues on vaccination, and Heathrow Airport officials are hoping a standardized vaccination record will help it better serve vaccinated travelers. Currently, Fortune's Sophie Mellor writes, required PCR COVID-19 testing is slowing the airport down and contributing to a daily loss of £5 million ($7 million). The U.S. CDC has also said vaccinated travellers won't need to be tested for COVID-19. (Fortune)

INDICATIONS

A scourge of fraudulent bleach ‘cures’. A Miami-based company called Oclo is the latest in a string of advocates for a fraudulent ‘miracle cure’ that essentially amounts to drinking industrial bleach. The concoction, often referred to as a “miracle mineral solution,” or MMS, is being widely promoted and marketed through social media. Another Florida-based vendor masquerading as a church has been linked to seven deaths, and two deaths in Argentina have been linked to Andreas Kalcker, the German self-styled researcher who originated the deadly scam. Particularly worrisome is that fraudsters appear to be targeting the vulnerable: Oclo is marketing primarily to U.S. Latinos, who are at substantially higher than average risk for COVID-19. The faux Florida church appeared to target Colombian nationals, where vaccinations are much harder to come by than in the U.S. (The Guardian)

Denmark abandons AstraZeneca. Danish health authorities on April 14 decided to permanently suspend the use of the AstraZeneca vaccine, following accelerating worries about a rare risk of blood clots. Two deaths have been tentatively linked to the AZ vaccine in Denmark. The country’s health authorities say they believe they can rely only on Pfizer and Moderna doses, which use a different technology and have not been linked to clotting risk, to complete its vaccination program. (Washington Post)

THE BIG PICTURE

Brazil in free-fall. Officials from global health NGO Médecins Sans Frontières today described the COVID-19 pandemic’s impact on Brazil as a “humanitarian catastrophe,” and the response of the government of Jair Bolsonaro as “a threat to its own people.” MSF head Meinie Nicolai said that Brazil’s response could be considered the worst of any nation on Earth, because of its failure to advocate for known control measures such as masks and physical distancing. As of right now, Johns Hopkins data shows Brazil’s overall COVID death rate is only the sixth-worst in the world, and slightly better than the United States’. But Brazil’s cases are trending dramatically upwards, already nearly matching the case numbers of the (substantially larger) U.S. (The Guardian)