PENDLETON — Eastern Oregon officials are raising concerns over vaccine hesitancy and adapting their efforts amid a national “pause” over the use of the Johnson & Johnson vaccine while federal health regulators investigate six rare reports of blood clots in women ages 18 to 48.

The six cases are among the nearly 7 million people who have received the Johnson & Johnson vaccine in the United States as of Monday, April 12, with no other serious adverse reactions having been reported, according to the New York Times.

“I’m worried that it’s going to drive anti-vaccine messaging and hesitancy further,” Umatilla County Public Health Director Joe Fiumara said of the pause. “There’s a very small number of folks. We’re talking less than one-in-a-million chance. I definitely think this is a move out of an abundance of caution, but I’m worried that the messaging that will be carried with it is that the vaccine is not safe.”

One of the women has died and another is hospitalized and in critical condition, and all six women developed the illness within one to three weeks of receiving the Johnson & Johnson vaccine, according to federal officials. None of the six women were from Oregon, according to the state.

In a statement, Johnson & Johnson advised people who’ve received its vaccine to contact a health care provider if they experience symptoms of blood clots within three weeks of their vaccinations, which can include headaches, abdominal pain, leg pain or shortness of breath.

County response

The announcement prompted Oregon health officials on Tuesday, April 13, to suspend the use of the Johnson & Johnson vaccine statewide. At least 85,148 Oregonians have received the vaccine so far, according to state health data as of April 12.

In response, Morrow County officials on April 13, canceled the last clinic scheduled during an eight-day commitment with the Federal Emergency Management Agency and the Oregon Health Authority intending to vaccinate people en masse with 2,000 doses of the Johnson & Johnson vaccine.

“It was going to be our last strong day in Morrow County,” Morrow County Commissioner Melissa Lindsay said. “This is really depressing and disappointing and frustrating. We really want to get people vaccinated so we can keep moving forward, and as we see (coronavirus cases) going up around the state, it’s just concerning.”

Officials had only used “about 800 doses” of the Johnson & Johnson vaccine at the clinics, said Lindsay, who believes the low turnout was partly due to vaccine hesitancy among newly eligible groups.

“I’m definitely worried about how this will play into that hesitancy,” she said of the pause.

In Umatilla County, officials will now be using Moderna vaccines at clinics originally scheduled with Johnson & Johnson vaccines, including those geared toward agricultural workers and local schools, according to county health officials. Other facilities using Johnson & Johnson will also be halting efforts, county health officials said.

Alisha Lundgren, deputy director for Umatilla County Public Health, said the pause will not force the county health department to cancel events or slow its efforts.

Umatilla County Commissioner George Murdock called the latest pause a “disaster.” He’s concerned the pause could drive the county’s already-low vaccine rates further down as cases rise elsewhere in Oregon.

“We’re already having difficulty trying to get a larger percentage of our residents to get a shot in the first place regardless of the manufacturer,” he said. “Anything like this sets back our efforts.”

In all, more than 2,200 doses of the Johnson & Johnson vaccine have been administered in Umatilla County, according to state health data. More than 800 doses of the vaccine are on hold for the time being, according to county officials.

Murdock estimates that more than half of the county’s residents are reluctant to get the vaccine. And in recent weeks, the health department has consistently seen leftover doses and open appointments at vaccine clinics, which officials attribute to vaccine skepticism.

The pause comes as Umatilla County reports some of its lowest COVID-19 data points since the pandemic began and was recently lowered by the state to the moderate coronavirus risk category.

The county reported 33 cases last week and 25 the week before — the lowest two-week total since last spring, according to county health data. The county also reported a testing positivity rate of 3% last week and has no active COVID-19 hospitalizations, according to county officials.

“The statistics for cases and hospitalizations show that we’re making real (progress) with the health of our citizens,” Murdock said. “We don’t want to lose that momentum.”

Morrow County cancels FEMA clinic

The Morrow County clinic was one of three clinics nationally where FEMA assisted local officials with a vaccine rollout, providing staffing and resources that small counties typically lack. For Lindsay, the canceled clinic felt like a lost opportunity.

“It was a lot of people on the ground that gave our health department a break,” she said. “We most likely won’t see that kind of dedication from the federal government to a small county (again).”

And with cases rising statewide and nationally, it is concerning that “now our ability to vaccinate is slowed down,” Lindsay said.

The county was planning to give its leftover doses to Malheur County to help raise its vaccination rates, “but at this point that will be on hold,” Lindsay said.

The remaining doses will be kept in refrigerated storage for the time being, but they will expire in June, as all Johnson & Johnson vaccines do after three months, a possibility Lindsay called “concerning.”

Dr. Janet Woodcock, the commissioner of the Food and Drug Administration, said at a news conference on April 13 that the pause is expected to last “a matter of days.” That time frame, however, is contingent upon what federal officials learn in their investigation, Woodcock added.

Umatilla County shifts efforts

Lundgren said the pause illustrates that officials are making a painstaking effort to ensure the vaccine’s safety and efficacy.

“It shows that our systems that we have in place to help make sure that we catch safety (concerns) are working,” she said, adding that those systems, which report adverse vaccine events, “should give people even more comfort about the vaccine.”

The Johnson & Johnson vaccine has recently become a popular option focused particularly toward agricultural workers in Eastern Oregon — a workforce hit disproportionately hard by the pandemic and who have often opted for the single-dose option because they often can’t take time off work, officials say.

County health officials this week had scheduled clinics at both Riverpoint Farms and Lamb Weston in Hermiston, where employers had specifically requested the single-dose vaccine for their workers. Though the clinics are still being conducted with the Moderna vaccine, Fiumara said he’s worried that the turnout could be lower.

“Our concern is if anybody who turns (the vaccine) down today because they wanted the one dose, in a week, if we’re allowed to do it, are they going to come back?” he said. “That’s the fear.”

Last week, officials held a clinic in Milton-Freewater where people were given the option to choose the vaccine they wanted. Out of 365 doses administered, 166 people chose the Johnson & Johnson vaccine.

“Demand was going down already,” Fiumara said of the county’s latest vaccine rates, which have often ranked among the lowest in Oregon. And most of the demand that was left was specifically for the Johnson & Johnson vaccine, Fiumara said.

Murdock said he hopes “people distinguish between the issue with Johnson & Johnson and not expand that to concerns about Pfizer or Moderna.” He said putting numbers into perspective is important, as the concerns over getting COVID-19 should outweigh the concerns over the safety of getting the vaccine.

“The country has given (hundreds of millions) of vaccines, and over half a million people have died of COVID-19,” he said. “And yet, incidents involving 10 or 12 people seem to be blown out of proportion and cause undue problems.”