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WASHINGTON – The pause in distribution of the Johnson & Johnson vaccine this week threatens to create a significant hurdle to President Joe Biden’s campaign to combat “vaccine hesitancy,” just as the administration approaches a critical point in its efforts to persuade Americans wary of getting vaccinated.

Many of those eager for a coronavirus vaccine have now received one, and officials are increasingly focused on rural and minority communities suspicious of the vaccines’ safety. Officials’ decision to halt distribution of a vaccine, however cautionary, following potentially serious side effects, however rare, could set back those efforts, public health experts said.

Compounding the challenge, the Johnson & Johnson vaccine has been central to Biden officials’ strategy for inoculating skeptical and hard-to-reach populations. Unlike other authorized vaccines, Johnson & Johnson’s version does not need to be stored at ultracold temperatures and, crucially, it requires only one dose.

“This is devastating,” said Frank Luntz, a longtime GOP pollster who has been working to win over vaccine-hesitant Republicans. “At the very moment that conservatives were starting to reconsider their hesitancy, they are told that their fears are real and justified. Right now, there are thousands of people saying, ‘See, I told you so.’ “

Biden officials were quick to minimize the impact of the pause, which was enacted as authorities reviewed reports of six U.S. cases of a rare but severe type of blood clot among the approximately 7 million people who received the shot.

They noted that only a small fraction of Americans have received the Johnson & Johnson vaccine and stressed that the administration remains on track to meet its inoculation goals even without it, given the ample supplies of the Pfizer-BioNTech and Moderna vaccines.


“This announcement will not have a significant impact on our vaccination program,” Jeffrey Zients, Biden’s coronavirus response coordinator, said in a hastily arranged appearance in the White House briefing room on Tuesday, adding that the country has “more than enough” of the other vaccines to continue the current rate of 3 million shots a day.

Later in the day, Biden added that the need for a pause reaffirmed his strategy to acquire extra doses for the federal program and to hold on to them even as pressure has built to send supply abroad.

“I made sure we have 600 million doses,” Biden told reporters in the Oval Office, referring to the Pfizer and Moderna vaccines. “So there’s enough vaccine that is basically 100% unquestionable for every single, solitary American.”

But in a tacit recognition of the need to address constituencies already skeptical of the coronavirus vaccines, Biden officials fanned out talk to target audiences.

Surgeon General Vivek H. Murthy was booked to appear Tuesday night on TV programs run by the right-leaning Sinclair Broadcast Group and Gray Television to discuss the Johnson & Johnson safety review. The two news organization have programming in many local media markets.

José Montero, a top official at the Centers for Disease Control and Prevention, went on Univision and Telemundo to reach Latino audiences.

Members of Biden’s coronavirus response team also held a call with more than 2,300 members of their “community corps,” a group the White House has collected of “trusted messengers.” Senior administration officials briefed prominent Black physicians. Top CDC and Food and Drug Administration officials reached out to key members of Congress. And the CDC held a call with top doctors and plans to brief clinicians on their decision, the White House said.

“People are very eager to see how we react to this. Do we put the data out? Do we try to sweep it under the rug? Do we contextualize it?” said Andy Slavitt, the White House’s senior adviser for the coronavirus response. “The approach we’ve chosen to take is one that is very much fact-based, very much conversation-based and very much ‘give people the real information.’ I think that’s all you can do.”

Various groups of Americans are reluctant to take the coronavirus vaccine for different reasons.

Many African Americans remember the decades of mistreatment of Black patients at the hands of the medical profession. Some conservatives are wary of any government-sponsored push aimed at influencing Americans’ behavior. Others worry that the coronavirus vaccines were approved too quickly. Still others subscribe to unfounded conspiracy theories about the vaccines’ purpose.

Tuesday’s announcement could play into all of those anxieties, public health experts said.

“We’re very concerned that this announcement for very rare side effects could have a disproportionate impact in triggering and bringing fears to the surface,” said Douglas Kriner, a government professor at Cornell University who has studied vaccine hesitancy.

Kriner said survey respondents had raised questions about coronavirus vaccines that ranged from understandable to improbable. “Four percent of people volunteered in an open-ended question that death was a common side effect” of getting vaccinated, Kriner said.

The dilemma now facing U.S. officials parallels a problem that European leaders grappled with last month, after regulators paused AstraZeneca’s coronavirus vaccine for safety reviews, prompted by similar reports of rare blood clots.

The European Medicines Agency, the continent’s top regulator of pharmaceuticals, ultimately reaffirmed that the AstraZeneca vaccine was safe and effective. But polls found that public trust in the shot significantly declined in Europe after the episode.

British Prime Minister Boris Johnson, French Prime Minister Jean Castex and German President Frank-Walter Steinmeier all publicly received AstraZeneca shots in subsequent days as officials rushed to shore up confidence in the vaccine.

But because so many American leaders – including Biden, Vice President Harris and former president Donald Trump – have already been vaccinated, it is not clear whether American officials can use a similar strategy.

Slavitt cited significant differences between the European situation and the current pause. In many parts of Europe, he said, the AstraZeneca vaccine was the sole shot available, and the message from European authorities was sometimes contradictory.

“It just got confusing,” Slavitt said. “Confusion hurts you in this kind of situation, and I think if we avoid that we will minimize unnecessary damage.”

Leslie Francis, a medical ethicist at the University of Utah, agreed that being clear and transparent about a rare vaccine side effect is what public health officials should be doing. She said she believes a key reason officials are pausing the vaccine is for general public messaging.

“People want to make super sure no one has a reason to be suspicious of vaccination,” Francis said. “I think that reason is a really strong reason. It’s so important to seem trustworthy and to be trustworthy. It’s about bending over backwards about vaccines.”

Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases, played down the impact of the announcement on groups hesitant to get a vaccine.

He noted that about 120 million Americans have received shots, and that the majority were made by Pfizer or Moderna.

“There have been no red-flag signals from those,” Fauci said. “So you’re talking about tens and tens and tens of millions of people who receive vaccine with no adverse effect. This is a really rare event.”

When the pause was announced Tuesday morning, it prompted an immediate round of questions from governors who were participating in a regularly scheduled Tuesday call with the White House coronavirus response team.

Several of them raised concerns about whether it would damage their efforts to combat vaccine hesitancy. “Folks came in pretty hot,” said one person who was on the call, who spoke on the condition of anonymity to discuss a private conversation.

Nebraska Republican Gov. Pete Ricketts, who was on the call, said he pushed the White House officials to keep the pause as brief as possible. “Your chance of dying from covid is much greater than the one in a million chance of developing this thrombosis from the vaccine,” Ricketts said.

He added that many in his rural state prefer the Johnson & Johnson vaccine because it only requires one dose and because it is more easily stored.

Trump weighed in with a statement decrying the decision to suspend distribution of the Johnson & Johnson product, saying it had proved “extraordinary” and warned that its “reputation will be permanently damaged” by the action.

He also predicted that those who have already taken the Johnson & Johnson vaccine will now be “up in arms” and suggested, without any evidence, that the pause was a political decision designed to help Pfizer, a company that Trump has railed against for failing to produce a vaccine ahead of the November election.

The Johnson & Johnson vaccine was authorized for emergency use in late February.

A senior administration official, who spoke on the condition of anonymity to speak frankly about a delicate situation, said the episode shows the strength of the system, not its weakness.

The clinical trials for the Johnson & Johnson vaccine included tens of thousands of people, the official said, but it would not necessarily have detected a problem that could be as rare as one in a million.

“If you’re on an airplane, the gold standard doesn’t mean you don’t run into turbulence,” the official added. “The gold standard means that you have practices and tools for dealing with situations that occur and minimize the damage.”

Some public health experts backed up this contention.

“This should add to our confidence, not shake it – even for six cases, the Biden administration made the decision to prioritize safety,” said Brian Castrucci, an epidemiologist who leads the de Beaumont Foundation, a public health organization. “What concerns me most is how this moment, these data, will be weaponized by those interested in sowing seeds of doubt in the vaccine.”

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The Washington Post’s Frances Stead Sellers contributed to this report.

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