(NEW YORK) -- With the Johnson & Johnson COVID-19 vaccine still on pause in the U.S. after reports of a rare but severe blood clotting disorder in a small number of the roughly 7 million people who've received the shot, health experts now are focusing on what could be behind those uncommon adverse events.
Doctors, scientists and public health experts are turning to Europe for clues, where a similar vaccine made by AstraZeneca -- not yet authorized in the U.S. -- also has been linked to a number of rare blood clots.
"The AstraZeneca and Johnson & Johnson vaccines are made in a similar way," said Dr. William Schaffner, an infectious disease physician at Vanderbilt University with expertise in preventive medicine and health policy. "But the carriers are different kinds of adenoviruses ... that's part of the background information, why indeed there is a pause now."
"It's hard to say if it's the same problem," said Dr. Richard Kuhn, Ph.D., a virology expert at Purdue University, "but it does seem the vaccine triggers an antibody response that activates platelets, leading to clots."
While many experts have hesitated to say for sure if there is a link, Schaffner said there's a growing consensus in the scientific community after none of these rare clots have been linked to the Pfizer or Moderna vaccines, which use mRNA, a different technology.
"I think we shouldn't be coy about that any longer," Schaffner said, adding that it may be time to "accept the fact that these are vaccine-induced but very rare events."
But experts cautioned that even if there is a link, current evidence suggests the risk of developing a blood clot after getting the Johnson & Johnson vaccine is exceedingly low -- lower, in fact, than being struck by lightning.
Responding to a report on one of the six clot cases published in the New England Journal of Medicine, Johnson & Johnson penned a response Friday, insisting a clear link has not yet been established.
"At this time, evidence is insufficient to establish a causal relationship between these events and the [Johnson & Johnson] vaccine," Janssen scientists said, adding that the vectors used in their vaccine and AstraZeneca's are "substantially different" and that those differences could lead to "quite different biological effects." The researchers added that "more evidence is needed" to further clarify the cause of this clotting, combined with low platelet count in those receiving the COVID-19 vaccine.
Next week, the Centers for Disease Control and Prevention's independent advisory committee will review all evidence and make a recommendation about whether to resume using J&J vaccines.
Still with more questions than answers, scientists are exploring different theories about why this type of shot -- called a viral vector vaccine -- might cause rare clotting problems.
Vaccines work by prompting our immune systems to develop antibodies against a virus, and a prevailing theory is that viral vector vaccines somehow trigger an abnormal immune response, leading to the blood clots.
Scientists in Germany identified a specific antibody in many people who developed clots after receiving the AstraZeneca vaccine -- and U.S. researchers subsequently identified the same antibody in individuals who developed similar clots after getting a J&J vaccine. In these subjects, the body's immune system has formed antibodies that attach to platelets, the specialized blood cells that join together to form clots.
"It's not the vaccine that's causing it -- it's the body's immune response to the vaccine," said Dr. Alex Spyropoulos, a blood clot specialist and professor at the Feinstein Institutes for Medical Research. Experts say the condition, cerebral venous sinus thrombosis, or CVST, is exceedingly rare.
The Food and Drug Administration and CDC said that in the six women who experienced a clot, the problem manifested six to 13 days after receiving the shot, a time frame that tracks with an immune response, Spyropoulos said.
It's still not clear why a vaccine would trigger this cascade of events, but researchers said it mimics another well-documented reaction to heparin, a common blood thinner. For this reason, the CDC and FDA have warned against using heparin to treat anyone recently vaccinated with the Johnson & Johnson vaccine.
Existing evidence from the United States and Europe hints that women may be at greater risk – perhaps in part because women are already more likely than men to develop CVST, based on previous data.
"We have to be careful about the assumptions we make," Spryopoulos cautioned, "especially given how infrequent these events have been."
It's possible similar cases will develop in men, but if the CDC advisory panel concludes that the risk is higher in women, the FDA could move toward a black box warning -- a label for drugs and medical devices with potentially serious side effects – on the Johnson & Johnson vaccine for certain women.
Though the abrupt halt to an already authorized vaccine may instill concerns and foment hesitancy around the vaccine, experts said it's a good sign drugs are being properly vetted for safety.
"I really want to stress to the public that they need to remain confident in our concepts and the times regarding vaccines in general," said Dr. Jason Goldman, an internal medicine doctor representing the American College of Physicians on the expert panel said, adding that members of the general public should "not to let this sour your decision on getting vaccinated in general."
"We do have confidence in the process," Goldman added. "And we will make the right decision regarding public safety."
Amanda Benarroch, M.D., a psychiatry resident at Mayo Clinic in Rochester, Minnesota, is a contributor to the ABC News Medical Unit. ABC News' Sasha Pezenik and Sony Salzman contributed to this report.
(NEW YORK) -- COVID-19 has taken the lives of more than 565,000 Americans and counting.
Those we've lost come from all backgrounds and include the very people -- first responders and medical staff -- who have been working on the front lines. But the virus has also highlighted the disparities in the U.S. -- taking a disproportionate toll on communities of color, the elderly and the poor.
Each week ABC News is spotlighting several Americans who have lost their lives to COVID-19. This week, we're highlighting a Georgia county commissioner, a devoted Alabama dad and a dedicated Philadelphia police officer.
Henry County, Georgia, Commissioner Gary Barham, who held the position in his home county since 2013, died on March 2, The Atlanta Journal Constitution reported.
Henry County spokeswoman Melissa Robinson said, "Gary was a servant leader who cared deeply for Henry County and worked across the aisle and all lines for the betterment of Henry County and its citizens. Gary was a true gentleman and the voice of reason for so many. We are all better for having known him, and he will be deeply missed."
Fellow district commissioner Dee Clemmons told ABC News, "Gary Barham fought to the end, through his battle with COVID, with unwavering love and service to this community he called his hometown and his desire for unity will remain as my guide. That’s how I will remember my colleague and friend."
Barham is survived by his wife of 34 years, two sons and five grandchildren, The Atlanta Journal Constitution said.
Alfonzia Jackson, a father of two girls ages 4 and 6, died on Feb. 2, 2021, The Miami Herald reported.
The 35-year-old Birmingham man also leaves behind his wife of seven years, the Herald said.
Jackson loved to dance with his daughters and paint their nails, the Herald reported.
His wife, Ashley Jackson, wrote on Facebook, "Our girls are going to truly miss you, you were an amazing dad and I will keep your memory alive through them and they will always remember you."
Erin Tokley, 47, was a 24-year veteran of the Philadelphia Police Department.
Tokley, who was also a minister at a Philadelphia church, died on March 3, 2021, ABC Philadelphia station WPVI reported.
"Our department has a heavy heart," tweeted Inspector Verdell Johnson, the commanding officer of training and education.
"His final message to me was, 'I'm gonna keep fighting until I come home,'" said his wife, Octavia, according to WPVI.
(NEW YORK) -- When Kristi Escobar was offered an appointment to get the Johnson & Johnson vaccine last Monday, she wondered if she should wait for another option.
J&J was the newest of the three vaccines available. And there had been a recent report of contamination issues at a supply plant in Baltimore that prevented the company from shipping doses using that facility.
But Escobar, a 38-year-old teacher at a community college who had tested positive for COVID-19 in January, knew that aggressive new variants of the virus still posed a threat, and that health experts recommended that people with prior infections still get the vaccine.
"I trusted in what they said as far as, 'Take the vaccine you can get,'" she said.
On Tuesday, the day following her shot, Escobar was stunned to learn that federal regulators had recommended a nationwide suspension of all J&J injections following reports of rare, but serious blood clots.
The cases were extraordinarily rare -- 6 out of nearly 7 million people who had gotten the vaccine suffered blood clots in the brain and low platelets. A person is twice as likely to get hit by lightning than to have such a serious a reaction to the J&J vaccine. What's more is that blood clotting can be a serious complication of COVID-19 too, which has already killed more than 566,000 Americans.
In fact, the complications were so limited that several governors and health experts heatedly criticized the decision to continue a "pause" in injections, arguing it could put even more lives at risk due to COVID.
Still, the reports of complications felt personal to Escobar, and many other women who recently received J&J shots. Each of the six cases in the U.S. were women of childbearing age, between 18 and 48. One of the women, a 45-year-old, also from Virginia, died.
Escobar said she immediately began to cry when she heard the news.
"My fear is probably not rationale," she said. "But I can't help it. It's just how I feel."
Escobar is now among the estimated 3 million Americans who got the J&J vaccine recently enough that the Centers for Disease Control and Prevention are urging them to be on the lookout for severe headaches, chest or leg pain or difficulty breathing.
Timing of a person's symptoms matter. Among the six cases under investigation, the symptoms emerged six to 18 days following the injection.
People who got the J&J shot more than three weeks ago are not considered at risk, and experts say it's normal to experience mild flu-like symptoms in the 24-48 hours following a vaccine. The rare blood clotting has not been associated with the Moderna or Pfizer vaccines.
Angie Willson, a 45-year-old mom and nurse anesthetist in Detroit, said she relates to the anxiety. Willson had purposefully sought out the J&J vaccine, believing it was a "more traditional choice" among the COVID vaccines and driving an hour-and-a-half out of state to get it almost two weeks before the nationwide suspension.
As a health care worker, Willson could have gotten vaccinated sooner, but didn't pull the trigger until the recent surge in COVID-19 cases flooded her Michigan hospital with younger patients whose lungs were ravaged by the virus.
Now, she said, her feelings are mixed.
"I'm glad I'm building antibodies, but I'm sweating it. ... It's very emotional," Willson said.
With the nationwide suspension in place, regulators are now watching to see if more cases might emerge in the coming days that will help solve what has become a frustrating medical mystery: Is the J&J vaccine to blame for these very rare, but very serious blood clots? Are young, healthy women most at risk? Is this type of vaccine still safe for other people?
One primary concern is how health care providers can treat any complications, even if they are rare. So far, officials say doctors should avoid heparin in these cases because the blood thinner appeared to make the complications worse.
In a statement, J&J said it believes "in the positive benefit-risk profile of our vaccine." But the company also agreed to delay its rollout of the vaccine in Europe and pause its clinical trials until more data comes in.
"The safety and well-being of the people who use our products is our number one priority, and we strongly support awareness of the signs and symptoms of this extremely rare event to ensure the correct diagnosis, appropriate treatment and expedited reporting by health care professionals," Paul Stoffels, a vice chairman and chief scientific officer at J&J, said in a statement.
Top government officials insisted this week that they expected the matter to resolved in a matter of "days." But answers don't seem to be coming any time soon.
An independent government advisory panel decided on Wednesday that it needs more data before it can recommend a next step. The panel's next meeting is scheduled for April 23, and will be livestreamed to the public.
"We want this to be a pause long enough to get the answer to come to a conclusion that is reasonably, scientifically based. But not long enough so that we can erode confidence in this vaccine," said Dr. Jose Romero, who chairs the panel, which advises the CDC.
In the meantime, Escobar said she is searching the internet several times a day in the hopes that there is an update. She also is marking the days on her calendar until she gets past the estimated 18 days after her shot when experts say her risk level of complications will drop.
"I've calmed down since Tuesday, for sure," she said. "But I am wishing these days go faster."
Willson estimates she only has a couple more days until she is in the clear.
(ANN ARBOR, Mich.) -- As COVID-19 vaccines have rolled out and the world begins to slowly reopen, a Michigan mother is encouraging others to continue living with caution as her child fights the virus.
"This is serious and it's killing people," Andrea Bell told Good Morning America. "Maybe you're not at risk, but I sure bet someone you love is."
"I never thought in a million years that I'd be sitting here," she added. "I never thought we'd have to experience COVID this closely, but I was wrong. I think people are tired and they're craving normalcy, but there's nothing normal about your child on ECMO."
ECMO stands for extracorporeal membrane oxygenation -- a treatment in which blood is pumped out of the body to a machine that removes carbon dioxide and sends oxygen-filled blood back to tissues in the body. It’s used to help the heart and lungs heal, according to Mayo Clinic.
Bell, of Ann Arbor, is currently in isolation with her daughter Fiona. The 1-year-old is being treated at University of Michigan's CS Mott Children's Hospital. Fiona is breathing on a ventilator, sedated and is on ECMO.
Fiona was diagnosed with spina bifida in utero and hydrocephalus -- a condition which causes a buildup of fluid in the brain. Fiona had a surgical procedure where a shunt was placed in her brain to release the fluid and pressure.
Fiona also had a tracheostomy last summer. Bell said that because of Fiona's medically-fragile airway, she and her husband Kirk had their "home in lockdown" since the start of the pandemic.
"The severity of what's happened to Fiona is not because of her spina bifida, it's because COVID basically ate through her right lung and that's what put her on ECMO," Bell said. "It's more so related to the tracheostomy. Any kid that has a trach is at a higher risk for respiratory things."
On April 2, doctors suggested she bring Fiona to the emergency room for evaluations after she struggled with respiratory care. Hours later, Fiona spiked a fever and was having trouble breathing. She then tested positive for COVID-19.
Bell said she's not certain how Fiona contracted the virus, though said she had been to her rehab clinic and hospital for therapies.
Kristen Padilla is Fiona's pediatrician at Mott Children's. Padilla said Fiona has been a "fighter her entire life" and has undergone multiple surgeries before she turned 1.
"She’s a remarkable little girl who always greets you with a smile and her family has played it incredibly safe throughout the pandemic," Padilla told GMA. "We discussed that a COVID-19 illness could be serious, however, we never expected this."
She added, "In Fiona’s case, the only thing that could have been done differently was to make sure every person she ever came into contact with was vaccinated. It is my hope that people will see this beautiful toddler and realize that their actions can affect others. Receiving a COVID-19 vaccine and following pandemic precautions are the only ways to protect our most vulnerable, like Fiona."
In March, Pfizer and BioNTech announced that their COVID-19 vaccine is 100% effective against the virus in children ages 12 to 15.
They also launched a global COVID-19 vaccine trial that will ultimately enroll 4,500 children between the ages of 6 months and 11 years old.
Their vaccine is currently authorized -- under the federal drug administration’s emergency use authorization -- to be distributed in the U.S. for use in people ages 16 and up.
Earlier this month, CDC director Dr. Rochelle Walensky told ABC News chief medical correspondent Dr. Jennifer Ashton that kids 12 and up might be able to get the vaccine starting "mid-May," pending Food and Drug Administration authorization for that age group.
Younger children will come later.
Bell said Fiona will receive the vaccine once it becomes available and her doctors give the go-ahead.
Fiona is in stable condition. Her chest X-rays have improved, and as of Thursday, she was able to sustain her breath on the ventilator, Bell said, adding that she's confident she will be bringing Fiona home soon.
"What's really incredible about Fiona is she will wake up from brain surgery and be smiling," Bell said. "She's so feisty and sweet ... it sounds like a cliche, but she lights up the room."
As Fiona continues to fight, the Bell family has been receiving cards, picture books and artwork from kids around the world, which Bell hangs in Fiona's hospital room. Bell said Fiona's favorite color is yellow.
Mail can be sent to: C.S. Mott Children’s Hospital, Attn: Fiona Bell Pediatric Intensive Care Unit 10 East 1540 East Hospital Drive Ann Arbor, Michigan 48109.
Bell said she encourages people to continue wearing masks. She hopes Fiona's story inspires others to get the vaccine, she added.
(NEW YORK) -- The Johnson & Johnson vaccine pause, likely to last another seven to 10 days while a federal advisory committee evaluates a possible link to a rare but severe blood clotting disorder, may deal a blow to vulnerable populations -- the homebound, homeless and incarcerated among them -- because it had been easier to get those individuals one shot than two, health experts said.
In addition to being a single dose, the J&J vaccine "is easier to store than the two mRNA vaccines that require freezing," said Dr. Wafaa El-Sadr, a professor of epidemiology and medicine at Columbia University. "That adds to the complexity of trying to set up vaccinations in settings that are not clinical."
"The reality is, not every site is equipped to to handle the mRNA vaccines," added Dr. John Brownstein, an epidemiologist at Boston Children's Hospital and ABC News contributor. "J&J is a really important vaccine for those who are most vulnerable to the consequences of this virus."
"That's the concern I have," he added. "There's going to be barriers to access that come from this pause."
At George W. Hill Correctional Facility in Pennsylvania, a for-profit facility run by the GEO Group, Thursday was supposed to be vaccine day. A mass vaccination event had been scheduled for the roughly 1,300 people incarcerated there -- all were to be offered a Johnson & Johnson shot. Tuesday's pause to examine the vaccine more closely put those plans on hold indefinitely.
"We certainly hope that that the pause is a temporary one," Kevin Madden, chair of the jail oversight board and a Delaware County council member, told ABC News. "If that pause lasts too long, then perhaps we can revisit the conversation with GEO about moving to an alternative vaccination."
Compared to a state prison, George W. Hill's population is more transient. A sizable portion of those incarcerated likely will leave the facility in the next 25 days, making Johnson & Johnson shots a better option, Madden explained.
The two-dose vaccines "create a logistical challenge," he said. "Not not an insurmountable one, but one you've got to work through to schedule a second shot."
The delay comes after a year in which prisons have been the site of repeated COVID-19 outbreaks -- since March 2020, at least 392,595 people in prison have been infected and 2,515 have died, according to The Marshall Project, which is tracking prison data from all 50 states and from the Federal Bureau of Prisons.
Ninety of the 100 largest COVID-19 clusters occurred in prisons and jails as of August 2020, according to the COVID Prison Project.
Many prisons are chronically overcrowded, dormitory settings with shared toilets and showers.
"Social distancing is impossible," said Claire Shubik-Richards, executive director of the Pennsylvania prison society, a nonprofit prison advocacy group. "All the mask-wearing and hand-washing in the world will not keep the virus from spreading in a congregate care setting like a prison."
But despite those factors, many states have been slow to vaccinate incarcerated populations, in part because it's not a politically sympathetic group, Shubik-Richards explained.
While there's no official tracking system for vaccinations in correctional settings, 137,064 people in state or federal prisons had received at least one dose of the COVID-19 vaccine as of April 1, out of roughly 2.2 million incarcerated people nationwide, according to an article published in the journal Health Affairs, which used COVID Prison Project data.
Before the Johnson & Johnson pause, in Pennsylvania "very few county facilities had even begun to start vaccinating incarcerated people," Shubik-Richards said. The pause may push that timeline back even further, she added, and that delay could have serious consequences.
"Prison outbreaks are going to be one of the handful of events that will prolong or deepen this fourth wave," Shubik-Richards said.
'Prisoners are keenly aware'
While Dr. Anthony Fauci has said that the Johnson & Johnson pause should be viewed as a "testimony to how seriously we take safety," some experts are worried that the pause could lead to increased vaccine hesitancy, particularly in vulnerable populations that might be less likely to trust medical institutions in the first place.
"Vaccine confidence tends to be lower amongst people who have been disenfranchised," El-Sadr, said.
Among incarcerated people, that hesitancy may be tied to a historical legacy of doctors experimenting on people in prison.
Shubik-Richards pointed to the infamous Holmesburg Prison experiments, during which a Philadelphia dermatologist tested skin and beauty products, as well as more dangerous drugs, like the herbicide dioxin, on people in prison.
"It's not ancient history," Shubik-Richards said of the prison experiments, some of which lasted well into the 1970s.
At George W. Hill Correctional Facility, Madden said that because they haven't been able to offer shots yet, hesitancy hadn't been a problem. At neighboring county jails, Madden said, the issue had come up.
"We're preparing for that," he said.
Despite legitimate reasons for incarcerated people to be skeptical about new medical treatments, "I think prisoners are keenly aware of how devastating COVID-19 has been on prison populations," El-Sadr said. "It's a very fine balance."
She also said she hoped that the pause wouldn't dissuade policymakers from expending every effort to vaccinate prison populations.
"The other vaccines that we have at our fingertips may be more complicated," she said, "but it's worth the effort."
(NEW YORK) -- Shaina Oliver's asthma flares up on cold days. Her kids can't play outside, often due to the heavy air pollution surrounding their community.
"It becomes a burden because you have to buy more air filters for each room," she said. "And it's not really possible for everybody to do air filters in every room."
Oliver, a field organizer for Moms Clean Air Force, lives in north Denver, which at one point was one of the most polluted zip codes in the U.S. The Suncor refinery, located just north of where she lives, is located in a predominantly Black and brown community. But if you head to the south side of Denver, she said, there are no homes near refineries.
"I think dealing with asthma is a form of environmental violence and racism on our people because we're the ones being impacted with the air pollution," she said. "We're the ones being segregated into these sacrifice zones."
Dr. Myrriah Gómez, an assistant professor at the University of New Mexico, said to understand environmental racism, it's important to understand precedent.
"European colonization, European colonialism, settler colonialism," she told ABC News' Good Morning America. "European settler colonialism was the first environmental trauma to the Indigenous peoples of the current United States."
Gómez researches environmental justice and environmental racism, inspired by her family history when the Manhattan Project -- government research studying nuclear weapons -- took place in Los Alamos, New Mexico, a community where the Tewa Pueblo people and Hispanic homesteaders resided.
According to Gómez, among many injustices that occurred when the project entered the state, her own great-grandparents were dispossessed of their ranch in the 1940s.
Because the lab needed workers, her grandfather worked cleaning tools that were used in experiments. Her family associated his exposure to harmful materials with his cancer diagnosis and death.
Similarly, Oliver, who is a member of the Navajo Nation in Shiprock, New Mexico, said her family has been impacted for generations by environmental racism from the Indian Removal Act of 1830 to the Indian Relocation Act of 1956.
Her grandfather, who relocated to Denver and then returned to the reservation in order to maintain ownership of their land, was one of many Navajo workers who worked in a coal plant on the reservation as well as in uranium mines before protective gear was administered. He later died of leukemia.
"When you are trying to get people to understand environmental racism, you have to have a conversation of how race exists in the United States and other places in the world," Gómez added.
History of environmental racism
In 1982, environmental justice sparked national attention when state government officials decided to dump loads of soil contaminated with toxic PCBs at a landfill in Afton, North Carolina, a predominantly African American community.
"It was utter disregard for the health and safety of the community where the landfill was sited," Dr. Benjamin Chavis Jr. told GMA.
Chavis was one of many activists who protested the state's decision to unload the waste. Once demonstrations began, Chavis said he received calls from people all over the country who detailed similar experiences happening to Native American, Latino, Black and Asian and Pacific Islander communities.
After weeks of demonstrating, the state still moved forward with dumping the waste in Afton. It was during this period of time that Chavis coined the term "environmental racism."
"When I first coined the term, environmental racism, it was racial discrimination and environmental policy, and environmental actions because these communities are being triaged," he said.
A national study, "Toxic Waste and Race," co-authored by Chavis in 1987 concluded race was a factor in deciding where to build waste facilities.
Chavis said incidents of leukemia and cancer increased after the Afton community was exposed to the pollutants from the toxic waste.
"So this delivery wasn't by accident, that these types of waste facilities were being put in these minority communities, racial and ethnic communities. It was deliberate," he said.
The disproportionate impact of COVID-19 on Black and brown communities exposed more background information about preexisting health conditions within minority groups.
A 2020 National Urban League study, "State of Black America," said the Black American community is three times more likely to get COVID-19 than white Americans, indicating that Black Americans were more susceptible to the virus due to their preexisting conditions.
"So the question is, what causes and what has caused and what tends to cause these preexisting conditions like asthma, and multiple forms of cancer, and it's directly related to the air we breathe, to the water we drInk and to the food we eat and to where we live," he said.
"A lot of places where the residences are in communities are over-exposed to pollutants and to toxins," he added.
Environmental racism today
Gómez added the importance of reminding students in her class that these acts are still happening.
"And by still happening, I mean, like, even the things that happened 100 years ago are still not rectified in terms of environmental hazards in their own communities," Gómez said.
According to a 2018 report by the Environmental Protection Agency, people of color are more likely to be impacted by particulate matter than white Americans, which can contribute to more health conditions.
While some examples of environmental racism have reached national attention, such as the water crisis in Flint, Michigan, and toxic locations like "Cancer Alley" along the Mississippi River, Gómez said there are many cases at the local level that also require attention.
"Environmental racism includes excluding people of color from decision-making processes," she said. "So if you don't have people of color being represented at the table, so to speak, in these decision-making places, [then] nobody is looking out in the best interests of those people."
Seeing Rep. Deb Haaland, U.S. secretary of the interior, make history as the first Native American appointed as a cabinet secretary was a significant moment for Gómez, adding that her appointment meant Indigenous lands and communities were finally going to be at the table.
For Oliver, pushing for change means listening to Gómez's advice and taking a look back.
"I think addressing those racist agendas that we consider laws, policies, treaties, regulations; those are [the places] where I would like to see political leaders really address," Oliver said.
(NEW YORK) -- When the pandemic hit more than a year ago, rates of depression soared, with 28% of respondents in one survey reporting depressive symptoms compared with 9% before COVID-19.
As levels of depression rise, public health experts typically expect suicide rates to follow. But two new studies show deaths by suicide possibly declined during the pandemic's early months.
After one study, published in JAMA, found that suicide rates declined in the United States from 2019 to 2020, a second study, published in Lancet Psychiatry and which included data from 21 different countries, suggested that suicide numbers were unchanged or lower in the pandemic's early months.
However, experts said, these two studies don't paint a complete picture.
"It's too early to know what the impact of COVID on suicide will be," said Dr. Panagiota Korenis, M.D., a forensic psychiatrist at the BronxCare Health System.
Korenis suspects that there will be a delay before we can fully appreciate the mental health impact of COVID-19.
The first study, for example, relies on provisional data. However, Robert Anderson, Ph.D., chief of the Mortality Statistics Branch at the Centers for Disease Control and Prevention, said he does expect suicide rates for those dates "will remain a decline" after a fuller analysis is completed.
"Because they typically require a death investigation, [reported] suicides are more likely to be delayed relative to other leading causes of death," said Anderson, adding that because death investigations may be delayed, especially during a pandemic, some causes of death are harder to count, such as overdoses. "We don't know what's behind an overdose -- if it's accidental or suicide."
The Lancet paper's authors suggest that some decrease in suicides in the early months of the pandemic could be attributable to the success of government and public mental health interventions as well as acts of solidarity in the community.
"The government helping people financially, people doing good things, heroic things, helping elderly neighbors" all may have been positive things that helped provide stability, Korenis said.
But, experts said, suicide rates could worsen the longer COVID-19 lingers.
"In some instances, COVID did inspire the best in us," Korenis added, "but for many people, these moments have fizzled into burnout and emotional fatigue."
Psychiatric research shows that there are several factors that may increase someone's risk of dying by suicide, such as having a mental illness like depression, financial hardship, having easy access to lethal means -- especially guns -- and a lack of protective factors like stable employment or solid relationships.
The pandemic saw many people lose jobs and struggle to maintain relationships, which could prove worrisome, experts said.
"It is hard to know why suicides have declined as mental health and economic problems have been on the rise," Anderson said.
Even with potentially promising data for the pandemic's early months, as rates of depression, anxiety disorders and other mental illnesses rise, many still are experiencing an increased risk overall of suicide.
"We are seeing an uptick in depression, an uptick in anxiety, an uptick in psychotic disorders," Korenis explained, "and how we do managing those patients will determine how COVID impacts our suicide rates once the pandemic is over."
If you or a loved one is experiencing suicidal thoughts, The National Suicide Prevention Lifeline provides 24/7, free and confidential support. Call 1-800-273-8255 for help.
(NEW YORK) -- Dr. Sharon Ingram, a board-certified OBGYN in Florida, was in medical school when her four-month-old son, Alton Jr., died of sudden infant death syndrome (SIDS) while at a day care center.
"I dropped out of medical school because I thought that I should have been not studying," Ingram told ABC News' Good Morning America about losing her first-born child nearly 20 years ago. "I thought I should have been with him because maybe I could have made a difference, although I know now that you cannot."
The death of Alton Jr., who was called A.J., was considered a case of infant mortality because he died before his first birthday. On average, around 20,000 infants die in the United States each year, according to the U.S. Centers for Disease Control and Prevention (CDC).
It was only after her son's death that Ingram realized she had a major risk factor for infant mortality simply by being a Black woman.
"A.J. wasn’t sleeping on his belly, I had prenatal care, he wasn’t low birth rate, but there were still some risk factors that we overlooked," she said. "One, I was Black, two, I had a son, and, three, he passed away in December, in a cold climate."
Ingram, who ultimately returned to medical school and chose to become an OBGYN, said she remembers being surprised when she saw her race listed as a risk factor for infant death.
"I was totally shocked," she said. "I remember thinking, ‘Why is that?’"
Nearly 20 years after A.J.'s death, Black babies still have a higher chance of dying than white infants, data shows.
Babies born to Black women in the U.S. have two times the infant mortality rate of babies born to non-Hispanic white women, according to the Department of Health and Human Services' Office of Minority Health.
Black babies are also nearly four times as likely to die from complications related to low birthweight and have over twice the SIDS mortality rate as non-Hispanic whites, according to the Office on Minority Health.
"If we look at the last five years, we are doing a good job at decreasing the infant mortality rate in general but the gap [between Black and white babies] is still there, so though the overall rate is going down, the gap is still double," Ingram said. "It makes you step back and say, ‘Why is this happening?’"
Implicit bias and Black infant deaths
Ingram and other experts point to implicit bias and institutional racism in medicine as two of the reasons for the disproportionate number of Black infants dying in the U.S.
And they say the higher rate of Black infant deaths can be traced back to the medical care Black women receive during pregnancy.
"Looking at racial disparities in general, when we look at babies, it really starts with the mom," Ingram said. "There is a discrepancy in care for Black women and that is why we have premature birth rates and see so many pregnancy complications that can result in infant death."
Black women in the U.S. -- which continues to have the highest rate of maternal mortality among developed nations -- are more than twice as likely to die during childbirth or in the months after than white, Asian or Latina women, according to the CDC.
Black women are also more likely than white, Asian or Latina women to die from pregnancy-related complications regardless of their education level or their income, data shows.
"A Black woman doesn’t have to be poor for her life to be at stake and for her baby’s life to be at stake," Ingram said. "When we step back and look at that, it’s a direct correlation to why we have disparity in Black babies’ mortality as well."
The top five causes of infant mortality in the U.S. are birth defects, preterm birth and low birth weight, maternal pregnancy complications, sudden infant death syndrome and injuries, according to the CDC.
At least two of those causes -- preterm birth and low birth weight and maternal pregnancy complications -- often start with the type of care the mother receives during pregnancy, according to Rachel R. Hardeman, Ph.D., an associate professor at the University of Minnesota School of Public Health and founding director of the Center for Antiracism Research for Health Equity.
"What we know is that the stress and the cumulative disadvantage of racism throughout the life course brings Black women into pregnancy at less than optimal health," she told GMA. "It’s literally sort of the wear and tear on the body, a chronic stress that’s taking a toll on the body and prompting these biological changes in many women that then affect their health and the health of their babies."
Hardeman continued, "And not only that, but then they come into a health care system that historically has not provided equitable care to Black people."
The issue of disparities in health care for Black women and Black babies was front and center at the highest level of government this week when the White House issued its first-ever presidential proclamation marking Black Maternal Health Week.
"Over the years, I've heard many stories," Vice President Kamala Harris, who hosted a round table on the issue Wednesday, said. "Stories of women who are experiencing postpartum depression, only to be dismissed. Stories of women telling their doctors they were experiencing pain, only to be ignored. Stories of women who could not hold their newborn baby because that child had to be on life support or receive a blood transfusion after blood transfusion after blood transfusion."
"Black women deserve to be heard. Their voices deserve to be respected, and like all people, they must be treated with dignity," said Harris, who described what Black women face as a "maternal health crisis."
In her remarks at the round table, Harris cited the primary reasons for the maternal health crisis as "systemic racial inequities and implicit bias."
President Joe Biden has proposed $200 million for racial bias training for health care providers and reproductive health services. The American Rescue Plan, which Biden signed into law in March, included $30 million in funding for implicit bias training.
Implicit bias -- when people associate stereotypes or have attitudes toward other people without consciously doing so -- and institutional racism are primary drivers of unequal care buried deep in the health care system, according to Hardeman.
In a study co-authored by Hardeman that was published last year, Black newborns’ in-hospital death rate was found to be a third lower when Black newborns were cared for by Black physicians rather than white physicians.
"We’re not talking about individual racist physicians who are doing bad things to Black infants. That’s not at all what we’re seeing here," Hardeman told GMA. "What I think we’re seeing are health care delivery systems where racism is baked into all aspects of the system."
"It’s hard to identify, but it shows up in the ways that patients are cared for or not cared for in those systems," she said.
Hardeman this week began offering online education courses for perinatal providers focused on implicit bias, part of new training requirements in California under a law that went into effect last year.
She describes the education curriculum as one of the ways that health care systems can start to make the big changes needed to shift the outcomes for Black moms and Black babies.
In addition to making sure medical students and medical professionals are mandated to learn the health effects of structural racism and implicit bias, Hardeman wants to see health care systems meet standards of addressing structural racism and achieving equity in health outcomes in the same way they must meet safety and performance standards.
Making sure the health care staff is diverse is also critical, according to Hardeman, as well as giving Black providers the power to create new systems that suit the needs of the patients and families they serve.
"We have to be willing to reimagine what care should look like for Black birthing people and for everyone," Hardeman said. "I think there’s a real opportunity to rethink how we’re doing things versus sort of plugging the holes or stopping the bleeding."
For Ingram, she said that going through the death of her son made her a better physician, one who is more compassionate and more empathetic and who sees her patients as whole people.
She said health care providers have to "do better" when it comes to recognizing and understanding their implicit bias so that patients' needs are met and heard, and so that Black women and Black babies are kept alive.
"I explain it to my [OBGYN] partners like this, ‘Do you and your [sibling] view the world the same? Do you think the same?’ and they say, ‘No, I don’t view the world the same as my brother,'" said Ingram. "This is what it is. Everyone views the world differently. It’s not a right or wrong, you just view it differently."
"As practitioners, it means we have to step back, take a minute, kind of readjust ourselves and make sure that we’re looking at every patient that comes in the door for what are their risk factors? What are they bringing to the table? What do I need to educate them on? What are they high risk for? What do I need to take a little bit more time to talk with them about? What's the data here?" added Ingram. "It’s important to just be aware."
(NEW YORK) -- Of the roughly 7 million people who have been safely vaccinated and protected from COVID-19 with the single-dose vaccine from Johnson & Johnson, there have been six confirmed cases of developing a rare but severe blood clot disorder after taking the shot.
Though it's not yet known whether the vaccine has a direct causative effect on the clots, an independent Centers for Disease Control and Prevention panel adjourned Wednesday without a vote, leaving a pause on the Johnson & Johnson vaccine in place until the panel fills out a more robust understanding of these adverse events.
All of the reported and confirmed cases so far were observed in women between 18 and 48 years old.
A seventh possible case, in a 28-year-old woman, was included Wednesday as the Advisory Committee on Immunization Practices debated whether to recommend lifting the pause or giving the shot to only certain groups. The committee said it needed more information on all of the cases and will continue to monitor for more before making a recommendation.
"Everybody is at risk," Dr. Sarah Long, a pediatrics professor at Drexel University, said at the meeting. "And although it's a very small risk -- it is so serious."
Here's some of what we know about the cases so far.
Of the six known cases so far, all are white females, with a median age of 33. Within a week or two of taking their shot, they began getting headaches, some of them also had muscle aches, chills, fever, back pain and labored breathing.
Some of these are typical side effects of the vaccine, but the increasing severity of symptoms was not. The clotting in the brain found in these women -- clots that form in the brain's sinus veins and clog its drainage system -- was also different.
Three women remain hospitalized, with two in intensive care.
A 45-year-old woman living in Virginia has died. She got the J&J vaccine in early March, and 11 days after taking the shot, she was hospitalized with serious adverse symptoms. She died a week later, on March 18.
In Nebraska, a 48-year-old woman with an "unremarkable" past medical history was taken to the ER after three days of malaise and abdominal pain. She remains critically ill.
Another woman, 38, also presented with cerebral venous sinus thrombosis, or CVST. She has not recovered.
A 59-year-old woman with no known coronary artery disease who had taken the J&J vaccine presented with extensive deep venous thrombosis on her left side seven days after taking the shot. She has not recovered.
An 18-year-old in Nevada with unknown risk factors got the shot, and two weeks later presented with CVST with hemorrhage. She has not yet recovered.
A 26-year-old woman with obesity in the New Jersey-Pennsylvania area got the shot and seven days later presented with symptom onset. She has since been discharged from the hospital.
As Johnson & Johnson shots remain on hold, pending a deeper understanding of who may be at risk, panel members acknowledged the delicate balance between racing forward to beat the virus and its variants, but doing so safely.
"This is so challenging because the impact of ACIP decisions on the global stage is clear," said Dr. Grace Lee, co-chair of a panel on the committee. "I continue to feel we're in a race against time and the variants but we need to do so in the safest possible way."
The CDC says anyone who recently got the J&J vaccine should be aware of oncoming severe headaches, severe abdominal pain, or shortness of breath within a week to three weeks after Injection, and to seek medical attention and mention your vaccine if that happens. They should have diagnostic tests to see if they should avoid the blood thinner heparin during your treatment.
(NEW YORK) -- Blood donations and supply levels have reached alarming lows, as blood centers say they see increased demand from hospitals.
Getting donations has been a challenge throughout the pandemic, with blood drives at schools and workplaces -- the bread and butter of blood centers -- largely canceled. The American Red Cross saw its lowest blood donor turnout last week since the pandemic began, with an 11% drop compared to its average during this time.
Dr. Pampee Young, chief medical officer for the American Red Cross, told ABC News the drop was "quite unusual," even for pandemic standards.
"This is extremely concerning," Young said. "This is occurring at a time when we're seeing a very, very strong demand for blood products. In fact, greater demands than before the pandemic."
Young posits the increased demand may be due to hospitals catching up on elective surgeries and critical care that have been postponed due to the pandemic, or possibly increasing organ transplants. The decrease in turnout is less clear to her.
"This is a time where a lot of people go on spring break and that could be a part of it. But we don't suspect it is because it appears to be more pronounced than in prior years," she said. "It could be just a harbinger of challenges coming down the pike. We are emerging from the pandemic and that could be influencing donor behavior."
The Red Cross believes some donors may be "self-deferring" donating blood after getting a COVID-19 vaccine dose. The organization has seen confusion on social media in particular around donating after getting the now-suspended Johnson & Johnson vaccine. It has been working to clarify that people do not need to defer donating to the Red Cross after getting one of the three COVID-19 vaccines currently authorized in the U.S., including the J&J vaccine.
Whatever the reason, "as we try to meet patient needs, this decrease in donor turnout is a big concern for us," Young said.
Versiti, which operates blood centers in four Midwestern states, has also seen increasing demand from hospitals as blood supply levels in some regions reach a "crisis situation."
"We are seeing an uptick in regular surgical procedures," Dr. Dan Waxman, vice president of transfusion medicine and senior medical director at Versiti, told ABC News. "But at the same time, now that we're getting into better weather, unfortunately, we're seeing more vehicular trauma and in certain parts of our service area we're unfortunately seeing more trauma from guns."
Waxman said blood supply levels have been tight, particularly in Indiana and Michigan, where they've dropped to critically low levels. In general, Versiti aims to have a three-day supply of blood available to its partner hospitals, which include over 90 in Indiana and over 80 in Michigan. In both states, that has dropped to less than a day's supply, the company said Tuesday.
The supply rarely gets that low, Waxman said.
"We're filling our orders so the hospitals have blood in their refrigerators and there's plasma in the freezers, but it's very difficult," he said. "We have to kind of get ahead of ourselves on this, and the only way to do that is to have people come to us and donate."
Waxman believes spring break, and people getting out more as COVID-19 restrictions loosen, may be impacting donor availability.
"The people who have been our donors and continue their donors, at the moment there, they may be traveling for the first time in a year," he said.
For over a year, blood centers, which tend to reach people out in the community, have been working to bring people to their sites.
The majority of blood donations to Versiti -- around 70% -- would typically come through mobile drives at places like high schools, universities, places of worship and businesses, Waxman said. In the first quarter of 2021, the number of donations to Versiti blood centers from schools and businesses has dropped by 40%, or nearly 20,000 units of blood, the company said.
The Red Cross has seen its number of school and university drives drop by 50% during the pandemic, Young said. That drop has also had "significant implications" on meeting the needs of patients with sickle cell disease, as much of its African-American donor base would be reached through those types of drives, Young said.
Amid the increased need, blood centers are urging eligible individuals who are feeling well to donate.
"We're hoping that our donors will do what they've always done, which is to come out and help us," Waxman said. "It's going to be an ongoing challenge I think for some time."
(NEW YORK) -- When he was 36, Brian Kozera heard a word he never expected to hear from a doctor: cancer.
Six years later, Kozera, a police officer and dad, is now preparing to fulfill his lifelong dream of competing in the Ironman World Championship in Kona, Hawaii. Calling the opportunity “a dream,” Kozera reflected on the tough years since he first learned he had cancer.
Kozera, a lifelong athlete, was in training for a Half Ironman triathlon when he sustained a hernia. During surgery for his hernia, doctors found an irregular lymph node that turned out to be cancer.
“It was devastating. How could this happen?” Kozera said in an interview with ABC News' Good Morning America.
After going through several doctors, Kozera landed at Fox Chase Cancer Center in Philadelphia, where he found out he had a rare form of lymphatic cancer called lymphocyte deficient Hodgkin lymphoma.
The cancer had spread to his abdomen, hip, chest and spine. He underwent 16 rounds of outpatient chemotherapy but was later admitted into the hospital to undergo more chemotherapy and a bone marrow transplant.
As an athlete, Kozera said walks around the hospital floor weren’t enough to keep him active, so he decided to bring in his own exercise bike.
“Staying in shape is what I could control,” he added.
It was there in his hospital room that Kozera started training for his next Ironman race.
Following months of intensive treatment, Kozera was in remission.
He now gets blood tests every six months but said, “It’s always in the background that it [the cancer] can come back.”
Since leaving the hospital Kozera, now 42, has competed in six Ironman races, including Ironman Austria in 2016. Now he's ready to fulfill his dream of competing in the Ironman World Championship.
He was chosen by Team in Training of the Leukemia and Lymphoma Society (LLS) as one of six athletes to participate in the race in October.
“It’s the dream I never dreamed of happening,” Kozera said.
To prepare for the big race, Kozera is going through intense training and aiming to raise $100,000 for LLS.
“I get to raise money for people who were in my situation,” he said.
An independent Centers for Disease Control and Prevention panel that convened Wednesday to review Johnson & Johnson vaccine data adjourned without voting on a new recommendation, leaving a pause in place until they get more information.
Several doctors on the committee indicated they were not comfortable recommending the pause be lifted or recommending it be given only to specific age groups without more data. CDC Dr. Amanda Cohn said they will try to meet again in a week to 10 days.
The panel convened the day after the CDC and Food and Drug Administration recommended a pause on all distribution of the J&J vaccine after discovering a total of six patients who suffered rare blood clots after getting the one-dose shot. The six cases were out of a total of nearly 7 million doses given since March, meaning the CDC and FDA assumed the chances of the blood clot were around 1 in 1 million.
All six cases were in women between the ages of 18 and 48. Their symptoms happened between six and 13 days after they received their shot, and were separate from any side effects during the first 48 hours after getting the shot, which is common.
CDC Director Rochelle Walensky and the White House coronavirus response team, including Dr. Anthony Fauci, the nation's chief infectious disease expert, said the pause was intended as a precaution and to ensure confidence in the vaccine.
"Right now, we believe these events to be extremely rare, but we are also not yet certain we have heard about all possible cases as this syndrome may not be easily recognized as one associated with the vaccine," Walensky said at a White House briefing on Wednesday.
"CDC and FDA are working rapidly to investigate each case and understand whether there is a causal relationship between these blood clots and vaccine administration," she continued.
Walensky said she was confident that finding these cases proved the system was working.
"Jointly, CDC and FDA were able to identify these rare events and act quickly to alert health care providers and the public," Walensky said.
She explained that the initial decision on Tuesday to recommend all states hold off on giving the J&J shot was for three main reasons: to alert health care providers on how to treat any clots, as they shouldn’t be treated by the common blood-clot medicine Heparin; to find any additional cases of blood clots after receiving the vaccine; and to give the independent panel of CDC experts time to review the data.
J&J was approved by emergency authorization in late February. The U.S. contracted 100 million doses of the vaccine. It has only accounted for 5% of all vaccine shots administered in the U.S. so far, according to the White House. Pfizer and Moderna, the two-shot mRNA vaccines that were approved in December, have supplied more doses over time and make up the bulk of the U.S. vaccine supply.
The White House maintained on Wednesday that the pause in J&J would not affect Biden's goal to have all American adults vaccinated by the end of May, despite the role J&J played in achieving that timeline.
(NEW YORK) -- The miracle of life was just quadrupled for this family in northern California.
Haley Andrews, Katie DeAngelis, Amy Gossett and Caroline Toth are four sisters close in age -- Andrews and DeAngelis, twins, are 33; Gossett is 32; and Toth is 30. They're also pregnant at the same time. To make the experience even more special, their due dates are essentially a month apart.
"Being able to find out that my three sisters were also pregnant was just beyond any dream I could have imagined," Toth said Good Morning America.
The announcement and journey was made all the more memorable because they're going through it together.
"It's nice to have somebody who's going through it at the exact same time," Andrews said. "We kind of swap experiences just like, 'Oh, are you feeling like this today? Has that started yet?' And it's been really great."
"It's just been really neat to walk this journey together," Toth said. "We all talk pretty much every single day, talking about different symptoms and what everyone is experiencing."
Constant contact with each other is not a new concept for the sisters, who are all extremely close. Growing up, the sisters would often see their relatives and formed bonds not only with each other, but with their cousins as well.
"Your cousins and your siblings are your best friends. You unite on a whole different level," Gossett said.
The four newborns will grow up in the same environment their parents did, with a big, tight-knit family around them.
"They'll all have each other, which is a big blessing," Gossett added.
The sisters' parents, Beth and Ted Gaines, a former California state senator, are thrilled and looking forward to having all of their grandchildren together soon.
They're also no strangers to having a big family to manage. They have a total of six children and already have three grandchildren. Once the four newborns have all arrived, they'll have a total of seven grandchildren.
"Them being pregnant together has really just been wonderful," Beth Gaines said. "Two of them -- the twins -- have never been pregnant before. So it's really fun watching their relationships blossom."
She and her husband have already started shopping for their incoming family members and have purchased a large swing set, toys and cribs.
With so many family members in the mix, get-togethers occur on a frequent basis.
"It's a pretty traditional family," Gossett said. "We all spend Christmas together. We all spend Thanksgiving together. Every birthday is celebrated together."
The first of the four sisters to give birth, DeAngelis, did so earlier this month, and now the rest of the family is eagerly awaiting the other newborns which are due in June and July.
(NEW YORK) -- For colleges and universities, the one-shot Johnson & Johnson COVID-19 shot has been the simplest solution for quickly and fully vaccinating students who will soon disperse around the country in early May, otherwise risking both infection and transmission as they go.
But when it was paused on Tuesday in order for the Centers for Disease Control and Prevention and Food and Drug Administration to further investigate rare blood clots in a very small percentage of patients, those schools had to temporarily return to the drawing board.
Schools that had other vaccine options on hand said they would reschedule students to get Pfizer or Moderna shots -- but students would then have to figure out how to get their second shot in three to four weeks if they planned to be home for the summer by then. While this could be a potential inconvenience for students, finding a second dose elsewhere is also likely possible as vaccine supply continues to increase nationwide.
Still, many schools hoped the pause would be lifted soon so they could continue administering the J&J vaccine.
"Our concern, and what we're going to work through now, is ... we like the Johnson and Johnson vaccine ... because it was one and done," SUNY Chancellor James Malatras said on Tuesday. "It is very easy for a residential student to get one shot and then go home for the semester."
Though the White House coronavirus response team has said it hopes the pause won't last longer than days or weeks, more concrete guidance is expected to come on Wednesday, when an independent panel of CDC experts will meet to review the data and recommend next steps.
At the same time, most schools are fighting a time crunch, attempting to vaccinate as many students as possible in the short time frame between when students become eligible -- which, in most states, has been over the last few weeks -- and when they leave for the summer in early May.
Recent data shows that cases are rising among young, unvaccinated people, even as cases drop among the most high-risk, elderly groups who are mostly vaccinated. And public health experts worry that college students could carry the virus home with them.
"One of the last risks is the idea of hundreds of thousands of kids flying back and forth," Connecticut Gov. Ned Lamont said on Tuesday, when asked about the path forward for colleges who intended to vaccinate students with J&J.
In order to get ahead of that risk, Lamont pushed for students to get an mRNA vaccine, either Pfizer or Moderna, at college, even if they had to schedule their second shot elsewhere. Lamont said they would work with other states to make sure students could get their second dose and urged schools to get students at least some degree of protection before traveling home for the summer.
"Remember, Pfizer and Moderna are 85% effective after the first shot," Lamont said, referring to early data from clinical studies.
"We're going to try and get all of our college kids at least that first shot of vaccine and we want all the other governors to do the same with their colleges," he said.
Chief operating officer for Connecticut Josh Geballe said he thought it would be increasingly easy for students to find second shot appointments in May because, by that time, states will likely have more supply than demand.
"We'll certainly be hosting many second dose clinics here in Connecticut, making it very easy for students who are returning to Connecticut, if they got their first dose somewhere else, to get their second dose here," Geballe said.
Students were also urged to take advantage of alternative vaccines at the Ohio State University, home to around 45,000 students. The university's Wexner Medical Center began offering the Pfizer shot in place of cancelled J&J shot appointments on Tuesday.
For students who would need a second dose in a different location, a spokesperson for the medical center said they would be advised to either track down an appointment for a second dose in the place they'd be in three weeks, or wait to get their first dose until they return home.
Similarly, at the University of Michigan, students were offered Pfizer or Moderna instead of J&J, but were told that they should keep their summer plans in mind when making their appointments.
"If you've chosen an appointment at any vaccination clinic because of the one-dose J&J vaccine, please note that clinics will now be administering only the Pfizer and Moderna vaccines, which require a second shot three or four weeks later. Getting a first dose this week would put your second dose -- depending on which vaccine -- in early-to-mid May, so please plan accordingly based on your availability," the University of Michigan president and other leaders wrote to students in a community-wide email.
But at smaller schools that were only offering J&J, the only option was to temporarily cancel shots.
Findlay College, a small school in northwest Ohio that had recently been given 1,200 J&J vaccines by the state, still had 800 shots on hand when they temporarily halted vaccinations on Tuesday.
"At this point we're just waiting on guidance from the state and the CDC," said Natasha Lancaster, a communications specialist for the college. "Once we're given permission or any direction on if we can resume, we will be scheduling some more time and dates for vaccination clinics."
Findlay College planned to vaccinate about one-third of its 3,800 students with the J&J vaccine.
In New York, the nation's largest state school system, SUNY, had just been allocated 21,000 doses of J&J on Monday, before the CDC and FDA called for a pause on the vaccine.
The chancellor, Malatras, called the decision a "COVID curveball," but said they would work to get students an alternative option.
"We might have to just change how we approach this a little bit, give different alternatives for our students, but I still think we'll be able to get most of our vaccinations in before they go home, and if not, while they're at home for summer break," Malatras said.
Malatras said he remains hopeful that they will be able to start administering J&J vaccines in the coming days.
All appointments for the 21,000 J&J doses announced Monday were filled, he said, so the "demand is there."
(NEW YORK) -- A mother of two has come up with a unique solution for when her kids are squabbling over the same toy.
Mariko Fairly is a California-based parent coach and board certified behavior analyst who helps families tackle challenges like sleep, aggression, sibling interactions and play skills. Recently, she's shown parents an innovative way of getting kids to stop arguing over shared toys. She's named it "the toy draft."
"In my clinical practice, I've used preference assessments to identify toys and objects that would motivate kids to learn," Fairly told ABC News' Good Morning America. "I took that idea and adapted it to the toy draft with my own kids."
When Fairly's children, Logan, 6, and Boden, 4, would disagree on toy-sharing, she'd lay out several items for a toy draft -- aka a preference assessment -- to identify what kids like and rank them in order of desire.
Fairly places the bin of toys in the middle and each child picks one toy. Flip a coin on who goes first and everyone gets three turns each.
"They may not love their choice, but they do have a choice," Fairly said. "There is power and control in having a choice."
On March 19, Fairly posted an Instagram video of her kids engaging in a toy draft. She offered them different types of superhero capes, masks, dolls and toy vehicles.
Instead of arguing, they enjoyed doing it.
Farily offered more unique tips for parents when kids are arguing over toys:
Narrate instead of intervening
Be the sportscaster instead of the referee. Instead of taking sides, describe what's happening.
Fairly suggests saying, "You took the toy, and now your sister is crying." This way, you're not taking sides. They then have the opportunity to work it out themselves. If they can't, then decide how you'll get a little more involved.
Don't put the toys away
Teach some alternative methods, like the toy draft. If the toys get put away and the kids hear, "Now, no one gets to play," then they aren't learning.
Set up a 'crash zone'
If one child is building or creating, parents will often see a sibling or another playmate wreck the scene.
Set up a "crash zone" or other area with the same building toys. That area is for crashing, separate from the area that's reserved for building.
Pay attention to and praise the behaviors that you want to see more of
Call attention to when they take turns, when they swap or share toys. Say things like, "I love the way you're playing."
"What you pay attention to is what you're going to keep seeing," Fairly explained.
Use the term 'take turns' instead of 'share'
Fairly said it varies for kids, though sharing is a practice that's not likely learned until age 3 or older. An alternative to sharing is taking turns for kids between ages 2 and 3.
"The more practice, the more they'll learn," Fairly said. "Sharing to them means, 'You want me to give up this thing I love, to this other person.'"
Try using a timer to introduce the idea of taking turns with one toy.
What works for some may not work for all
What works for siblings might not work with their cousin or peer. Once kids learn strategies like toy drafts, they'll start attempting them on their own and introduce them to each other.