Although use of Johnson & Johnson's (J&J's) single-dose vaccine remains on hold in the United States, a new poll suggests the pause might not increase vaccine hesitancy. At the same time, other messages—including the possible need for Covid-19 booster shots—appear to be fueling people's apprehension.

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J&J resumes vaccine rollout in Europe with updated label

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Last week, CDC and FDA in a statement recommended a pause in the use of J&J's single-dose Covid-19 vaccine after six people—out of about 6.8 million Americans who had received the vaccine at the time— developed a rare and severe type of blood clot called cerebral venous sinus thrombosis (CVST). According to the statement, the agencies recommended the pause "out of an abundance of caution" as CDC and FDA scientists examine the potential link between the vaccine and CVST. Following the recommendation, J&J decided to delay its vaccine rollout in Europe, the New York Times reports.

On Tuesday, the European Union's drug regulator, called the European Medicines Agency (EMA), in a statement said "a warning about unusual blood clots with low blood platelets should be added to the production information" of J&J's vaccine after finding a "possible link" between J&J's vaccine and extremely rare blood clots. EMA said the cases of CVST are very similar to the rare blood clots seen among people who have received AstraZeneca's Covid-19 vaccine, for which EMA previously recommended a similar label change.

Even so, EMA emphasized that the J&J vaccine's "overall benefits" in preventing Covid-19 "outweigh the risks."

Immediately after EMA released its statement, J&J announced it would resume its vaccine rollout in Europe and update its label "to include important information on the diagnosis and management of this very rare adverse event."

Panel to vote on J&J's vaccine

On Friday, the Advisory Committee on Immunization Practices (ACIP), a panel of outside experts that advises CDC on vaccines, will meet to vote on whether use of J&J should resume in the United States after declining to make a recommendation last week.

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William Schaffner, a non-voting ACIP member and infectious diseases professor at the Vanderbilt University School of Medicine, said he believes ACIP either could recommend the United States stop using J&J's vaccine or that it should resume the vaccine's use, likely with a warning about the vaccine's potential adverse effects and statement advising certain high-risk patients to not use the vaccine.

Jose Romero, ACIP's chair, said he doesn't think ACIP will recommend the United States completely stop using J&J's vaccine. However, Romero said the committee could decide to recommend the pause in the vaccine's use continue until more data is available.

Separately, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and chief medical advisor for the White House's Covid-19 response, during an interview on CBS's "Face the Nation," said, "I would be very surprised … if we don't have a resumption in some form by Friday."

Although the committee's recommendations are non-binding, federal health officials have said they intend to use its advice and a separate investigation by FDA to guide their decision on J&J's vaccine.

Will an extended pause fuel vaccine hesitancy?

At the time the distribution of the J&J vaccine was paused, some experts expressed concern that the pause could fuel vaccine hesitancy—but an Axios-Ipsos poll released Tuesday suggests those concerns may be misguided.

The poll, conducted from April 16 to 19 with a nationally representative sample of 1,033 adults ages 18 and older, found 88% of Americans believe the CDC and FDA acted responsibly when they recommended the pause. The poll also found Republicans and Democrats were roughly equally likely to support the pause in the vaccine's use.

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"People are unfazed," said Cliff Young, president of Ipsos U.S. Public Affairs. "The way forward is about the vaccine, so if there's any stumble, people are going to pay attention to it — but it hasn't had an impact thus far" on willingness to get vaccinated.

Separately, a national poll conducted by pollster Frank Luntz for the de Beaumont Foundation from April 15 to 16 found 63% of respondents believe people should continue to get vaccinated as soon as they can with Covid-19 vaccines developed by Pfizer/BioNTech and Moderna, despite the pause in J&J's vaccine use.

However, the poll showed that other emerging messages are leading to anti-vaccine sentiments, including news that people may need booster shots to maintain their protection against Covid-19 and coronavirus variants, the Washington Post reports.

Where America's coronavirus epidemic stands

According to data compiled by the Times, the United States' average daily number of newly reported coronavirus cases over the past week was 64,530—roughly equal to the average from two weeks ago.

The Times' data showed that, as of Tuesday morning, the rates of newly reported coronavirus cases were increasing in Puerto Rico, Guam, Washington, D.C and 25 states. Those states are Alabama, Arkansas, Colorado, Delaware, Florida, Georgia, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maine, Michigan, Minnesota, Mississippi, Missouri, Nevada, New Mexico, North Carolina, Oregon, Pennsylvania, South Dakota, Washington, Wisconsin, and Wyoming.

In the remaining states and U.S. territories, rates are decreasing, according to the Times' analysis.

Meanwhile, data also shows hospitalizations are rising again. According to the Times' data, 45,755 Americans with Covid-19 were hospitalized on Tuesday—up by 9% compared with the average from two weeks ago.

Even as cases and hospitalizations are increasing, data shows deaths are continuing to decline. According to the Times' data, 729 new deaths were linked to the coronavirus on Tuesday, down 8% compared with the average two weeks ago (Cheng, Associated Press, 4/20; Stevis-Gridneff, New York Times, 4/20; Mascarenhas/Cohen, CNN, 4/20; Mauldin, Wall Street Journal, 4/18; EMA release, 4/20; Talev, Axios, 4/20; Lonas, The Hill, 4/20; Diamond, Washington Post, 4/20; New York Times, 4/20).