VA Puget Sound Health Care System
The Food and Drug Administration (FDA) has authorized three COVID-19 vaccines. VA is following Centers for Disease Control and Prevention (CDC) and U.S. Food and Drug Administration (FDA) guidance to pause in providing the Janssen vaccine at this time. This pause is due to a concern about possible rare side effects. Your safety is our top priority. For more information, go to the CDC website. Read the CDC and FDA statement on the Janssen COVID-19 vaccine. If you have a vaccine appointment scheduled, your VA health facility will work with you to determine what to do next.
Congress has passed a new law that allows us to offer COVID-19 vaccines to more people. VA is now able to offer vaccine to the following groups who are eligible for a COVID-19 vaccine at VA when their local VA facilities have enough vaccine:
- Spouse of a Veteran
- Caregivers of a Veteran
- Recipients of Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) benefits
The best way to stay informed is to sign up to tell us you'd like to get a COVID-19 vaccine at VA. Your local VA facility will then contact you when they have a vaccine for you.
For your continued health and safety during this pandemic, please don't come to a VA health facility to request a COVID-19 vaccine without an appointment unless you are coming to a specific scheduled event such as a walk-in clinic or drive-through clinic that does not require an appointment.
Note: Your employer, pharmacy, or local public health officials may offer you a COVID-19 vaccine. We encourage you to take the first opportunity you have to get a vaccine at the most convenient location for you.
COVID-19 Update - April 13, 2021 (updates in blue)
Veterans who have symptoms of COVID-19 such as a fever, cough, shortness of breath, difficulty breathing that’s new or getting worse, fatigue, muscle or body aches, headache, new loss of smell or taste, nausea, vomiting or diarrhea, current runny nose or nasal congestion or have had contact with someone diagnosed with COVID-19, should contact VA Puget Sound before coming to one of our care sites for a scheduled visit. This can be done by sending a secure message through My HealtheVet or by calling 1-800-329-8387. This helps VA Puget Sound protect our Veterans, medical staff, and other patients.
VA has temporarily paused administration of the Johnson & Johnson COVID-19 vaccine based on CDC and FDA recommendations. VA Puget Sound is still offering Moderna and Pfizer vaccines, in which similar events have not been noted. Those scheduled for Johnson & Johnson will be rescheduled to either receive Moderna or Pfizer. You can learn more about guidance on the Johnson & Johnson pause by visiting the FDA website.
All health care eligible Veterans can call 206-716-5716 to schedule your vaccine.
Newly eligible individuals under the SAVE LIVES Act can sign up for the vaccine by visiting the vaccine information page on va.gov
For information about vaccinations at VA Puget Sound, please visit our website at www.pugetsound.va.gov and visit www.va.gov to sign up for regular updates.
Here are some answers to frequently asked questions:
Why has the VA paused the used of the Janssen (Johnson and Johnson) COVID-19 vaccine?
On April 13, 2021, CDC and FDA recommended pausing use of the Janssen COVID-19 vaccine while they investigate reports of rare and serious blood clots called cerebral venous sinus thrombosis (CVST) in vaccine recipients: https://www.cdc.gov/media/releases/2021/s0413-JJ-vaccine.html.
Out of an abundance of caution, VA has paused the used of this vaccine.
Why did the CDC and FDA make this recommendation?
The CDC and FDA closely watch all new vaccines for side effects. When serious side effects are reported by patients and health care providers, the CDC and FDA look closer to see if the side effected is related to taking the vaccine. Currently, CDC and FDA are reviewing data involving six reported U.S. cases of a rare and severe type of blood clot in individuals after receiving the J&J vaccine. In these cases, a type of blood clot called cerebral venous sinus thrombosis (CVST) was seen in combination with low levels of blood platelets (thrombocytopenia).
All six cases occurred among women between the ages of 18 and 48, and symptoms occurred 6 to 13 days after vaccination. Treatment of this specific type of blood clot is different from the treatment that might typically be administered. Usually, an anticoagulant drug called heparin is used to treat blood clots. In this setting, administration of heparin may be dangerous, and alternative treatments need to be given.
How many people have been given the Janssen (Johnson and Johnson) COVID-19 vaccine in the US and at the VA?
According to Centers for Disease Control and Prevention (CDC), in the United States, as of April 12, more than 6.8 million doses of the Johnson & Johnson (Janssen ) vaccine have been administered in the U.S.
As of April 13, 2021, just over 100,000 persons had been given the Janssen vaccine from VA. https://www.accesstocare.va.gov/Healthcare/COVID19NationalSummary. There have not been events of CVST reported in patients vaccinated with Janssen vaccine by VA at this time, and further review is ongoing.
Has the VA seen any cases of CVST?
CVST has not been reported in patients vaccinated with the Janssen (Johnson and Johnson) COVID-19 vaccine by VA at this time.What is CVST?
CVST, or Cerebral venous sinus thrombosis, happens when blood clot forms in the brain’s venous sinuses (type of blood vessel). This can cause symptoms including headache, vision changes, or symptoms of a stroke.
What are symptoms of CVST?
CVST may be suspected in patients who present with:
- New onset headache
- Headache that is different from the usual symptoms (for example, change in character or severity, and may occur 7 or more days after vaccine)
- Encephalopathy (acting confused or not like one usually acts)
- Signs or symptoms of intracranial hypertension (severe headache, visual changes)
- Focal neurologic symptoms and signs, or neurologic symptoms involving multiple vascular territories (like weakness, trouble speaking, or seizures)Diagnosis of CVST is via urgent neuroimaging with brain MRI and magnetic resonance (MR) venography, or with cranial CT with CT venography if MRI is not an option.
What should I do if I have symptoms of CVST?
Contact your health care provider if you have symptoms.
If your symptoms are severe, call 911.
How many people have been given the Janssen vaccine from VA?
As of April 13, 2021, just over 100,000 persons had been given the Janssen vaccine from VA.
This information is publicly reported here: https://www.accesstocare.va.gov/Healthcare/COVID19NationalSummary.
There have not been events of CVST reported in patients vaccinated with Janssen vaccine by VA at this time, and further review is ongoing.
Can non-Veterans and Veterans covered under the Save Lives Act receive health care from VA for a side effect experienced after a COVID-19 vaccine?
I received the Janssen (Johnson and Johnson) COVID-19 vaccine and am now worried. What do I need to know?
CVST events have been very rare. The CDC and FDA have been actively monitoring for possible reactions related to COVID-19 vaccines, and reported 6 cases in 6,800,000 doses. The events that did occur were in the first two weeks after receiving the Janssen (Johnson and Johnson) COVID-19 vaccine so persons who received the vaccine more than two weeks ago would be considered even less likely to have this happen. If you received the vaccine in the last 2 weeks and think you may have symptoms of CVST [listed above] please contact your health care team or call 9-1-1 if symptoms are severe.
Will I still be able to get a COVID-19 vaccine from VA?
There two other COVID-19 vaccines that are still available at VA. VA will offer these vaccines as a temporary replacement for the Janssen (Johnson and Johnson) COVID-19 vaccine until more is known about the safety of the Janssen vaccine.
I really wanted to get the Janssen (Johnson and Johnson) COVID-19 vaccine from VA
We understand that changing from a single dose to a two-dose vaccine may affect your plans significantly. However, we are highly committed to the stringent safety measures in place for COVID-19 vaccines under emergency use authorization.
VA will continue to carefully follow the FDA and CDC for guidance on the safety of all COVID-19 vaccines. The FDA and CDC review may find that the cases of CVST are linked to the vaccine or that they are not. VA will restart using the Janssen (Johnson and Johnson) COVID-19 vaccine if the FDA and CDC recommends the vaccine for use after their review.
Are there other symptoms that I should contact my health care team about?
Any potential significant side effect to any COVID-19 vaccine should be reported to your health care team. This is important for your health and is also critical for ongoing safety monitoring of the COVID-19 vaccines under emergency use authorization.
- Cases of unusual blood clots with low platelets have occurred in people who received the Janssen COVID-19 vaccine. Similar cases were seen in another type of COVID-19 vaccine not in use in the United States.
- The chance of having this occur is very low, but being aware of symptoms can help you get prompt medical treatment and avoid complications.
- You should seek urgent medical attention immediately if you have any of the following symptoms in the weeks following your Janssen COVID-19 vaccine:
- shortness of breath
- chest pain
- leg swelling
- persistent abdominal (belly) pain
- neurological symptoms, such as severe and/or persistent headaches or blurred vision
- tiny blood spots under the skin beyond the site of the injection.
- Speak to your healthcare professional if you have any questions about new symptoms or about the Janssen COVID-19 vaccine.
Have similar events been seen with the other COVID-19 vaccines VA is using?
CVST has not been observed in the other vaccines in use in the United States, namely the Pfizer-BioNTech and Moderna COVID-19 vaccines. Both of those vaccines are mRNA vaccines, which is a different type of vaccine than the Janssen COVID-19 vaccine.
Have similar events been seen with any other COVID-19 vaccine?
Yes, the combination of CVST and low platelets has been observed with the AstraZeneca COVID-19 vaccine, which is not currently authorized for use in the United States. The following link is a press release regarding events that occurred in recipients of the AstraZeneca vaccine. While this is a different vaccine from the Janssen COVID-19 vaccine, both are vaccines of the same type (adenovirus viral vector vaccines) https://www.ema.europa.eu/en/news/astrazenecas-covid-19-vaccine-ema-finds-possible-link-very-rare-cases-unusual-blood-clots-low-blood
For the AstraZeneca vaccine, out of 25 million people who received vaccine, there were 62 cases of cerebral venous sinus thrombosis (CVST) and 24 cases of splanchnic vein thrombosis (clot in a vein that helps drain the digestive system). These cases were reported to the safety reporting systems in the EEA and UK.
Should I avoid taking any COVID-19 vaccine for now?
No. Currently, reported events from the Janssen COVID-19 vaccine are rare. Similar events have not been reported with the other FDA-authorized COVID-19 vaccines, which have been safely administered to millions of people in the United States. The pause in use of the Janssen vaccine is a good example of the intensive safety monitoring and proactive intervention from CDC and FDA.
Veterans with questions about COVID-19 or vaccination should call 1-800-myVA411 or (1-800-698-2411). press 8 for COVID information or visit www.va.gov/health-care/covid-19-vaccine/
Veterans seeking additional information should visit the VA Coronavirus Vaccine FAQs webpage.
VHA Keep Me Informed which allows Veterans to sign up to receive email updates: https://www.va.gov/health-care/covid-19-vaccine/stay-informed
You can also get updates on social media: https://www.facebook.com/vapugetsound and https://twitter.com/VAPugetSound. If you would like to receive automated updates via email, please sign up with your email address on our website - https://www.pugetsound.va.gov/index.asp - look under the social media icons on right for "Subscribe to Receive Email Updates."
We also continue to maximize personalized virtual care options. We know these services have been a valuable link to our Veterans during this challenging time, providing increased access to care regardless of where you live. Here are some examples of ways you can access care from home:
Telephone or Video Appointments: Receive care at home—either over the phone or via video using VA Video Connect on your computers, smartphones or tablets. To set up virtual appointments, send your health care team a secure message on My HealtheVet by visiting myhealth.va.gov. While Veterans may also call us at 1-800-329-8387, VA is requesting that Veterans only call with urgent needs at this time.
Prescription Refills: Veterans can request prescription refills, order and ship medications home using My HealtheVet or Rx Refill mobile app. Download the app at mobile.va.gov/app/rx-refill.
Secure Messaging: With a free My HealtheVet Premium account, Veterans can send secure messages to their health care team online to ask non-urgent health questions, request referrals and send updates about medical conditions. Other tools and services available to Veterans with the Premium account include, ability to access health records, view military service information and ability to join video visits using the VA Appointments tools. There are two ways to register, online or in-person at a VA facility. With the threat of COVID-19, the in-person option has been suspended.
To upgrade online using a VA HealtheVet sign-in partner (DS Logon and ID.me), follow these steps: From the My HealtheVet sign in page, sign in to your Advanced My HealtheVet account using a sign-in partner. Select the Upgrade Now button. Check the certification box to verify account owner. Select Continue. Check the Accept My HealtheVet Terms & Conditions box. Select Continue to complete the upgrade.
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