Public Health – Seattle & King County has learned of the death of a King County resident from a rare blood clotting syndrome after receiving the Johnson & Johnson (J&J) COVID-19 vaccine. The individual, a woman in her late 30s, is the first confirmed death in King County from this very rare vaccine complication. The U.S. Centers for Disease Control and Prevention (CDC) has reported only three other confirmed deaths nationally.  

We at Public Health are saddened by this loss and offer condolences to the woman’s family and loved ones.  

The resident received her vaccination on August 26, 2021 and died on September 7, 2021. Her cause of death was determined to be thrombosis with thrombocytopenia syndrome (TTS), a condition that has been identified as a rare but potentially serious adverse event in people who received the J&J vaccine. The diagnosis was confirmed by the CDC’s Clinical Immunization Safety Assessment Project.  

Blood clots and the J&J vaccine 

In April of this year, the CDC paused its authorization of the J&J vaccine in order to study the risks from these rare complications. The CDC then lifted its pause after determining that the benefits of the vaccine far outweigh the risks.  

During the pause, and again in recent days, public health agencies contacted medical providers and clinicians to help inform providers of the potential adverse event and treatment protocols.  

The risk of any complication is extremely low. If you receive the vaccine and develop severe headache, abdominal pain, leg swelling, or shortness of breath, contact your health care provider or an urgent care center. 

Risks versus benefits of vaccination 

The CDC concluded that the benefits outweigh the risks for continued use of the J&J vaccine.   

Out of 12.5 million doses of the J&J vaccine administered as of July 8, 2021, 38 people have had confirmed cases of TTS, according to the CDC, and the majority of these people have recovered.  

Women aged 18-49 are at higher risk for these adverse events compared to women 50 years and older. However, even for this younger age group, the risks from COVID-19 outweigh the risks from the J&J vaccine. The CDC conducted an individual-level analysis that assessed the risks and benefits of receiving versus not receiving a J&J COVID-19 vaccine during the 1-month period after the J&J vaccine pause. For every 1 million doses of the J&J vaccine administered to women aged 18–49 years, 297 hospitalizations, 56 ICU admissions, and six deaths related to COVID-19 could be prevented, compared with seven expected TTS cases.  

As with many medications, the risk of serious adverse events is small, but not zero. It is vital for people to have this information in order to make their own informed decisions. For this reason, it is important to provide education about the risk for TTS and availability of other COVID-19 vaccine options, particularly for women aged 18-49 years. 

It is important to note that the most widely available vaccines in King County and across the country, those produced by Moderna and Pfizer, have not been associated with this rare condition.  

Vaccines are safe and effective 

Vaccinations continue to prevent many deaths and hospitalizations. Over the last 30 days in King County, an unvaccinated person’s risk of dying from COVID-19 was 57 times higher than a vaccinated person of the same age. The risk of being hospitalized with COVID-19 was 41 times higher for an unvaccinated person, compared to a vaccinated person of the same age. In King County to date, 1,899 people have died from COVID-related illness. 

Public Health – Seattle & King County and state and federal health agencies take vaccine safety very seriously. Public Health medical staff conduct a daily review of medical records to identify patients who may have had adverse health outcomes related to vaccination. In addition, CDC, FDA, and other federal agencies review COVID-19 vaccine safety monitoring data regularly and in great depth.   

Public Health will continue to monitor the evolving science and the guidance from the federal government. Vaccines remain our best defense against the pandemic, and we urge all eligible county residents to complete their vaccination series as soon as possible. Vaccines are free, and widely available. Find a convenient vaccine site on King County’s COVID-19 vaccine web page.  

Originally published October 5, 2021.