Thrombosis with Thrombocytopenia Syndrome

Women 18 through 49 years of age can receive any FDA-authorized COVID-19 vaccine. However, they should be informed of the rare risk of TTS after receipt of the Janssen COVID-19 Vaccine in their age group and the availability of other FDA-authorized COVID-19 vaccines.

Although the cause of thrombosis with thrombocytopenia syndrome (TTS) associated with the Janssen COVID-19 Vaccine is unclear, it appears to be like heparin-induced thrombocytopenia (HIT). Until more information becomes available, experts advise that persons with a history of an immune-mediated syndrome characterized by thrombosis and thrombocytopenia, such as HIT, should be offered another COVID-19 vaccine (i.e., mRNA vaccine) ) if it has been 90 days or less since their resolved illness. After 90 days, patients may be vaccinated with any FDA-authorized COVID-19 vaccine.

A second dose of Janssen COVID-19 Vaccine is not recommended for people who had TTS after their first dose. These people may receive a dose of mRNA COVID-19 vaccine as a booster dose at least 2 months (8 weeks) after their dose of Janssen vaccine and after clinical condition has stabilized. A consultation with the patient’s clinical team, including hematologists or other specialists should be considered.

FDA has added a warning to the EUA and fact sheet for recipients. Additional recipient education materials can be found at CDC Recommends Use of Johnson & Johnson’s Janssen COVID-19 Vaccine Resume | CDC