>> Good afternoon.

And thank you for joining us, I'm mandy cohen secretary of the Department of Health and Human Services and I'm joined by Amanda Fuller more the state's chief pharmacist and head of covid vaccine operations.

Monica mcghee and Nicole FOX are our American sign language interpreters and Jackie and jasmine metivier or Spanish interpreters.

So today out of an abundance of caution the Center for Disease Control and Prevention and the Food and Drug Administration recommended a pause in the use of the Johnson and Johnson COVID-19 vaccine.

The recommendation follows 6 reported cases of a rare type of blood clot individuals after receiving the J and J vaccine.

Now our primary concern is the health and safety of all North Carolinians therefore we are following those recommendations of the FDA and CDC and asked are vaccinating providers to pause the administration of the jandj a COVID-19 vaccine until we learn more.

The safety system in place is working as it should.

These adverse offense appear to be extremely rare.

There have been 6 reported cases of this rare blood clot which was also seen in combination with low levels of blood platelets.

This is a very different and rare type of blood clot and needs to be treated differently.

Usually in and take Aggieland drug or a blood thinner called heparin is used to treat blood clots but in this case.

Administration of heparin may be dangerous and alternative treatments are needed.

All 6 cases occurred among women between the ages of 1848.

And symptoms occurred in days 6 to 13 after vaccination.

None of the 6 reported cases were here in North Carolina.

And as of last night, North Carolina providers had administered 242,000 doses of the change a vaccine.

And is important to note that the vast vast majority of people who received the Johnson and Johnson vaccine, we'll only experience the expected temporary reactions like soreness of an arm or feeling achy or tired for a day or 2.

That's what I experienced when I got the Johnson and Johnson shot.

Mild headaches and flu like symptoms in the first few days after a vaccination can be expected and are not associated with this more severe concern.

And while as it is extremely rare that you could have a severe adverse reaction.

People who have received the Johnson and Johnson vaccine and who develop severe headache severe abdominal pain leg, pain or shortness of breath with in 3 weeks of their vaccination should contact their Healthcare provider and let them know that you've had the change a vaccine.

Again today's actions are result of a vaccine safety system that is working.

Our safety monitor cyst monitoring systems are highly sensitive which is how the CDC could identify such a rare number of events.

This pause will allow them to look further at the data and make sure that providers know how to treat this rare blood clot.

All vaccines are closely monitored.

And you can play a part in that promoting their safety.

Anyone experiencing possible side effects should report them to the vaccine adverse for event reporting system or vaers this national system collects data to look for adverse events that are unexpected.

We're appear to happen more often than expected or have had some sort of unusual pattern of occurrence.

The CDC is convening a meeting of their Advisory Committee on immunization practices to review these cases and the FDA will review that analysis as it is also investigating these cases and out of abundance of caution we will pause the use of the Johnson and Johnson vaccine until that process is complete and further recommendations are provided.

So if you have an appointment for Pfizer or Moderna please go to your vaccine appointment as planned.

If you have an appointment for Johnson Johnson, your appointment will need to be rescheduled.

We'll continue to provide everyone with timely and accurate information as we learn more.

COVID-19 vaccines remain the most effective way to end this pandemic by preventing the spread of COVID-19 preventing hospitalizations and death.

Our goal is that everyone gets a safe vaccine.

Everyone 16 and older is eligible right now to get vaccinated these vaccines are free and you don't need an ID or insurance you can learn more about vaccines at your spot.

Your shot dot and see .gov and with that we will open to your questions.

>> The first question today is from Brian Anderson with the Associated Press.

>> I think only Anderson here with the says he's impressed.

Thank you for the question.

I know you just said that if you have to change a point then you'll need to have a schedule but we know some clinics are saying that you could just come in and get a different shot just to be clear you're not the plight of others that scene in the state to say anyone should come if they have a change appointment just get a different vaccine.

Thank you.

>> Thanks Brian.

So I have Amanda Fuller more with me who heads our covid vaccine operations but let me start by saying that are providers are making adjustments right now to how they are handling that many will need to be rescheduling their appointments some will be able to shift over to the vaccine different vaccines, the Moderna or the Pfizer either way we want to make sure that our vaccine providers are communicating with everyone clearly so that they know what they're getting when they show up let me turn it over to Amanda Fillmore.

>> Good afternoon.

Thank you.

So we do anticipate that at this point based on our current state inventory.

We have about 85,001st doses of the Pfizer and Moderna vaccine available.

We're also receiving additional first as inventories today and tomorrow.

We have a starter Cohen said asked our providers to reach out proactively to vaccine recipients who are scheduled for Johnson and Johnson vaccine to let them know what their individual options or if that is to reschedule if they choose to do so or come in to receive another vaccine.

But we do anticipate that we still have vaccine available for anyone that wishes to receive it.

Next question.

>> We have a follow-up from Brian Anderson with a P. >> Thank you and we know that the acting head of the country has been a major concern on so far we've heard from some experts who say if anything that should give people more confidence that Moderna and Pfizer are are safe and effective even more than they thought.

And it's gone through more rigorous testing.

I guess what's your message to people who see this as a sign that vaccines are on safe and that they should just.

Hold out and not get one.

>> Well I think that today's announcement shows that we have a robust safety system in place and that that system is working to identify any concerns this is a pause.

So that folks can look at the data understand concerns and make further recommendations we also want to make sure the provider community knows how to treat these very rare events and these did very unique kinds of blood clots as I said I think the system is working as intended and we very much in courage.

Those who have their Pfizer or their Moderna appointment for this week to keep those appointments to get vaccinated as soon as possible, we know these vaccines are safe.

They are effective at preventing covid they are pretty effective at making sure you're not getting into the hospital.

That you are not dying from this.

This virus.

So we want to make sure everyone gets vaccinated as soon as possible.

>> The next question is from Maureen o'boyle with wbtv in Charlotte.

>> 5 doctor Cohen thanks for taking my question.

I can reiterate to those viewers who are concerned that got the Johnson and Johnson vaccine has to who need to be concerned the people who just recently had a correct.

>> But thanks for that question.

So if you have recently had the Johnson and Johnson vaccine and you are feeling well.

You don't need to do anything right now and you should not be concerned what we're talking about today is an incredibly rare event literally one in a million we've seen 6 cases and in 600 more than sorry 6 million doses of Johnson and Johnson given across the country.

So again this is a very rare event in a few gotten Johnson and Johnson, and you feel well I have gotten Johnson and Johnson and feel well nothing for you to be concerned about going forward if you or someone who's had Johnson and Johnson within the last 3 weeks and after day 3 of your vaccine you develop a severe headache.

Severe abdominal pain difficulty, breathing leg pain.

Then you should be calling your doctor or other health care provider and let them know you're having those symptoms and to let them know that you've had the Johnson and Johnson vaccine again.

We think most folks are really just going to have the normal kinds of side effects that we're seeing after Johnson and Johnson in the first 24 or 48 hours people feeling a little cry me tired soreness of their arm other than that if you are feeling well after you've got near Johnson and Johnson vaccine.

The only thing you could be doing is making sure that if something is it you are experiencing something you can report that to the vaccine adverse reactions system that there's system a new pro port that through.

Through that if you're having any other issues.

>> The follow-up Marina boil wbtv.

>> Doctor Cohen this announcement today almost seemed as a way to also educate Healthcare providers and making sure they are treating this particular rare blood clots.

Differently as you mentioned.

Would you agree.

>> Yes, thank you so much, we do agree that this is a way that we want to make sure our providers have a high degree of suspicion if they are seeing someone with a clot and with low platelets that they should be asking about vaccine history and making sure to put these pieces together to say hey this blood clot is not like a typical blood clot in probably needs to be treated differently.

They said in this case, this is a kind of blood clot that is associated with low platelets and you don't want to be using anti-coagulants called heparin in this case you need to be using other treatments and so that is something we're making sure to communicate to our providers.

>> Our next question from Jonah Kaplan ABC 11.

Good afternoon.

Colin, I wondered you know you've got the Johnson Johnson shot I got the job and the job that shot, I know my answer that question.

>> But if you were they have an appointment tomorrow for Johnson Johnson knowing what you know today would you still be getting the shot.

>> Well thanks for that Jonah I did get the Johnson and Johnson shot in within the first 24 hours I really just felt a little bit a key and has sought well since and that's what the vast vast majority of folks are experiencing which is just some temporary reaction.

What we're talking about today is an incredibly incredibly rare literally one in a million type of adverse reaction but we do want folks to know about it I think it's our vaccine safety system working.

And so if you are having those severe reactions of a severe headache after day 3 CE abdominal pain leg pain, shortness of breath please do get in touch with your provider as of right now vaccine administration's with Johnson and Johnson are paused so we are not going to be vaccinating any until we get further guidance from the federal government.

>> We'll follow-up Jonah Kaplan ABC 11.

>> Thanks very much, how concerned are you about this happening now, especially when we're finding out from some providers and some of the counties are starting to have more appointments opening up.

And maybe a supply goes up demand starting to plateau.

>> Well I again I think this is our vaccine safety system working as intended and I think folks should feel really good about the fact that Moderna and Pfizer have been being used here in North Carolina and around the country and around the world.

Since December we continue to monitor for and any adverse reactions to that but the good news is that we continue to see temporary reactions to vaccines just in the first 24 to 48 hours soreness at your arms feeling a little cromie so we encourage folks to get that safe and effective vaccine as soon as it's available to you there are appointments right now for Pfizer and Moderna we encourage folks to get them as soon as possible.

>> The next question is from the new year next seat with ABC 45.

>> Yeah, I think you're drinking my question.

So I guess my question now really tough looking forward of course that we are starting to back think North Carolinians now we're taking away the Johnson and Johnson vaccine is there any fear that this is going to push the state further behind when it comes to allocating effecting from getting the take down.

>> Well thanks for that first I would say that you know every state in our country is in the same boat here we are all pausing together in terms of using the Johnson and Johnson right now and I would say the vast majority of the vaccines we've been given out or the Pfizer and Moderna vaccines and in fact continue to see even increases in the manufacturing of that so you know we've had a pretty robust supply now for a number of weeks and will continue to see that going forward into the future.

Let me see if the man wanted to add more now she likes that answer okay.

Thank you smear.

>> Our next question is from Adam Wagner with the news and observer.

>> You can't going to keep taking my question.

I'm just wondering about when you had the first indications this might happen and then sort of what the decision-making process was like this morning was was continuing to administer J J ever on the table.

>> Well Adam thanks for that question and I'll turn over to Amanda because we found out through our communication channels with our federal partners very early this morning around 7.30 in the morning.

At that point when they are making a recommendation to us again they are able to see data across the country that were often not able to see just here in North Carolina we very much want to follow the guidance of the FDA and CDC we've done that throughout this pandemic and so it really wasn't a a conversation about should we pause we wanted to just communicate as quickly as we could with our providers about what we know when we know it and so again 7.30 this morning got that information quickly shared in.

Some information with our vaccine providers encouraging them to stop and pause their their vaccinations with Johnson and Johnson.

Thank U next question.

>> All we have a follow-up from ad online.

>> Yeah, I think it's a curious question as well.

You mentioned that there were 85,000 doses of Pfizer and Moderna the area now for those left over from last week and if so is it concerning that there are that many doses of the vaccine left over from the previous week.

>> Your first I would say I want to thank our vaccinating providers for getting shots into arms quickly and equitably and I know that because of some of the the changes in the allocations as well as the Easter holiday we we are still administering vaccines.

But let me turn it over to 2 and for more.

>> So when we look back in our inventory, those 85,000 doses are.

Much of them are from last week there tends to be a little bit carried over each week.

We are working with our providers to do as much as we can do to be able to make that vaccine available in more places to make it more accessible to work with our providers to increase their there are to decrease their no show rates have folks come in for those appointments as secretary Cohen said we have also just come out of a time period of the Easter holiday.

Many people being out of town for spring break so we will of course continue to follow that inventory to ensure that we are able to move it as quickly as possible including moving it.

Amongst our providers to help increase those vaccine.

Outlets.

>> The next question is from lunch agreeing with blue Ridge public radio.

>> Thank you for taking my question.

It seems the vaccine recipient to develop clots were we're on the younger younger age range same for AstraZeneca could you help us understand the review process for the Johnson and Johnson vaccine that will happen going forward and do you think this perhaps the change a vaccine could come out with age restrictions on the other end.

Thank you.

>> Thanks for the questions.

So right now the 6 cases that were identified or in women between the ages of 1848 here right on the younger and but I think we're just at the beginning of understanding a full investigation that is what is happening right now with these cases I know the CDC and FDA are working hand in hand they'll be meeting with their advisory committee tomorrow to further understand this and to make sure that they are making recommendations going forward, so I don't want to speculate yet about what could come out of this again and incredibly rare event literally one in a million.

But I think this is our vaccine safety system working to identify something that may be associated the vaccine now it's our time to do the investigation.

And we'll learn more over the next couple of days.

>> Our next question is from Sharon than we expect from you one.

>> Hi doctor Khan thank you for my question.

What would be an acceptable number before the CDC year at Yale halted.

That does dissemination of the vaccine.

I mean it sticks cases with 5 has been OK but hadn't grown out of the not right.

And how did these numbers compare to react severe reactions from other kinds of vaccines.

Like flu shots for mmr or malaria or other things that people get.

>> Sharon thanks for that question and I'd have to defer your your question to the FDA and CDC to understand their threshold for saying was at 5 cases are 6 cases in terms of making that decision I think it's a combination of what they that the case itself.

The severity of this kind of of reaction but it's also to make sure that as we mentioned earlier that are vaccine providers know that this is not but a typical clot if you will it is a very rare form of a clot they need a different kind of treatment so I think the pause at this moment was twofold one is as I said to Ike is to investigate these cases to understand them.

But it's also to make sure that our medical community is understanding that these rare clots do require a different kind of treatment it's not typical anticoagulation but rather other kinds of immune related.

Treatments that are needed to treat this.

>> We'll follow up from Sharon been written with spectrum.

>> I thank you one follow-up is that since the number of cases are the incidents of cases seems to be more Lex limited to women between the age of 1848.

Why do you think there's been a pause on how all of the vaccinations and not just that select group.

>> Thanks Aaron I think it's so that folks can identify additional cases I think the cases we have seen have been in women who tend to be younger I think folks want to understand are there other cases in men in different age groups before they make any other additional recommendations so this pause gives them the time to do that investigation and to communicate with the medical community about treatment.

>> The next question is from rose Hoban with North Carolina help you.

>> Picture Klein thanks much for taking my call.

You know you're talking about this.

This is a pretty subtle message about have the vaccine safety system that's working.

You don't have a plan for combating the.

You know that there's just a from medical misinformation machine that's out there.

And already you know they're already using this episode to Janet March fears about you know potential.

Problems with the vaccines, you know what's your plan for combating some of that misinformation.

>> Well the first thing is being here today to make sure folks understand what this is and what this isn't it is a pause folks are investigating further.

And what it tells you is that our vaccine safety system is working.

But it also says is that the Pfizer and Moderna vaccine which we've been using for much longer than the Johnson and Johnson vaccine.

We continue to use we continue not to have an issue with and so if you do have a your appointment for Moderna or Pfizer this week we encourage you to keep those there are spots available we want folks to get vaccinated as quickly as possible as you know we've been doing a lot of work to help folks understand the benefits of vaccine.

The facts that they are safe and effective.

The fact that they are now L available everywhere and folks are eligible for that if you're over the age of 16 will continue to do education work PSA is working with trusted partners I think this is where partnership is really important.

To make sure we're combating any misinformation we will continue to share what we know when we know it and so that folks can trust that myself the department is always giving you timely and accurate information.

>> We'll follow-up from rose Hoban.

>> Yeah I I did a quick look out on the the blood clot great for people take oral contraceptive pill.

And it's about you know one in a 1000 over the course of the year.

You know we're sitting this one in a million.

Here you know can you and in in pretty much the same population can you.

So it is you know why like taking such an extreme move with this particular therapeutic.

When we have other therapeutic in similar population where.

You know what class are more common.

>> But thanks rose I think 2 reasons why this pause is being taken one is to see if there are other cases associated.

>> With with >> the vaccination and making sure they were understanding and investigating the cases that are there and understanding them better.

And the other part of this is this is a very different and rare type of clot that needs to be treated differently so the clot you mentioned related to oral contraceptive is a different kind of at clot with a different kind of treatment.

This is more rare and actually requires as I said not anti-coagulants but rather a different immune mediated treatment, it's really important for medical community to understand that as well as have a high suspicion of of putting these pieces together if you have someone who has severe headache has clot has low platelets and in the context of having this vaccine making sure your reporting that case and we're understanding how all these pieces fit together.

>> We'll take our final question can vary from Michael Hyland CBS 17.

>> I this is Michael Hyland from CBS 17 I want to clarify something you said earlier that you all had reached out to the vaccine providers encouraging them to pause on this.

So to be clear do they have to stop administering the change a vaccine for the virus have any discretion whatsoever to continue administering the vaccine right now.

>> Similar to the guidance that came to the state from the federal government, it's not a mandate to stop vaccinating it is is strong recommendation to pause that is what we've recommended to our vaccine providers again this is a very rare event that we're talking about and in that our vaccine providers do have the wiggle room to decide that they want to keep vaccinating we're asking folks to pause as we understand this better.

In the moment and we will learn more over the cup over the next couple of days, but again there's no mandate to stop vaccinating it is our strong recommendation to follow the guidance of the FDA and the CDC at this moment as we learn more.

>> And finally a follow-up Michael Hyland.

>> My question was asked about was I'm going forward with this strategy in terms of how you allocate the vaccines that are one of the benefits potentially to the Johnson Johnson vaccine.

You get to some populations, especially people who have a difficult time scheduling the 2 doses and trying to follow up happens is this going to do anything to affect your strategy going forward, it's especially if some people may be a little more reluctant to get the Johnson Johnson vaccine.

>> Well thanks Michael and I'll turn it over to Amanda from our to talk about what we're doing just this week in this moment to make sure that folks can continue to get access to vaccine.

But I think you are right in saying the Johnson and Johnson was very appealing because it both had a different way of storage so did not need the deep freezer that some of the other vaccines needed.

It was able to we wrote a moving around more easily and certainly the one and done was very appealing.

At 4, 4, populations, particularly that we're we're warm are moving around and maybe leaving campus like our college students so we wanted very much relook at our strategy, but I think we'll also learn more over the next couple of days again, not sure yet how long the investigation will go on from the CDC and FDA we're hopeful it will be a short period of time so we'll understand how we're going to use the Johnson and Johnson going forward let me turn to Amanda Fuller more just to talk a bit about what we're asking our providers to do in this moment.

>> Thank you so we are right now asking providers to make the Pfizer and Moderna that they have available and as many time slots and options as is possible.

We will continue our allocations this week in a similar fashion to what we use.

Last week specifically for our Moderna and Pfizer and we will also use the Moderna that we have available to open up vaccination vaccine availability to as many providers as we currently have enrolled in activated in our system.

Again we see this as a as a very clear sign that our safety system is working and so we're asking our providers with that in mind to make every effort to continue vaccinating with the Pfizer and the Moderna vaccine that they have available and that's arriving today and tomorrow.

>> OK I think that's the end of our time I'll just close by reminding folks that we continue to see viral spread across North Carolina, so take care of each other make sure you're still wearing your mask when you're out in public and to get your vaccine as soon as it's available to you thank you.