The Texas Department of State Health Services is sending more than 140,000 doses of the Johnson & Johnson vaccine to providers across the state this week, but after six reported cases of a rare and severe blood clot in patients who received the vaccine, the Centers for Disease Control and Prevention and U.S. Food and Drug Administration are recommending a pause.

None of the six cases of the blood clot occurred in Texas, according to a news release by the DSHS, which joined the FDA and CDC in recommending the pause. The six cases occurred six to 13 days after vaccination in women between the ages of 18-48, according to a joint statement from the FDA and CDC.

Dr. Peter Marks, director of the FDA's Center for Biologics Evaluation and Research, said in a media conference that one case was fatal, and one patient is in critical condition.

The single-shot Johnson & Johnson vaccine is the least administered nationwide among the three versions of the vaccine available to Americans. According to CDC data, about 6.9 million doses of the Johnson & Johnson vaccine have been administered, accounting for about 3.6% of all doses. There have been no similar complications reported as a result of either the Moderna or Pfizer vaccines.

Dr. Anne Schuchat, principal deputy director of the CDC, said anyone who received the vaccine within about the last two weeks should be aware of symptoms including severe headaches, abdominal pain, leg pain or shortness of breath and contact their health care provider to seek medical treatment if the symptoms occur.

"These symptoms are different from the mild, flu-like symptoms that many people experience in the couple of days after receiving the vaccine," Schuchat said in the call with reporters.


Although the cases are extremely rare—fewer than one in 1 million recipients of the Johnson & Johnson vaccines experienced the blood clot—the CDC and FDA are reviewing the cases during this recommended pause. Dr. Janet Woodcock, acting commissioner of the FDA, told reporters she expects the pause to be "a matter of days."

Marks emphasized the FDA and CDC message to providers is a recommendation and not a mandate, leaving both medical providers and patients to make individual decisions.

"If an individual health care provider has a conversation with an individual patient and they determine that the benefit-risk for that individual patient is appropriate, we’re not going to stop that provider from administering the vaccine," he said.

Travis County hub providers Austin Public Health and UT Health Austin are both receiving shipments of the Moderna and Pfizer vaccines this week. However, while most of APH's allocations have been Moderna, the public health provider did receive 1,000 Johnson & Johnson doses the week of April 5 intended for mobile vaccination efforts, according to Texas Department of State Health Services weekly allocation reports.


Dr. Mark Escott, interim Austin-Travis County health authority, told Travis County commissioners and Austin City Council members April 13 that APH would pause the administration of those Johnson & Johnson doses.

In Harris County, Judge Lina Hidalgo said public health providers will continue their vaccination efforts while following FDA and CDC guidance to pause distribution of the Johnson & Johnson vaccine. The vaccine hub at NRG Stadium was the largest single recipient of Johnson & Johnson vaccine doses over the first two weeks of April with 42,000 doses delivered per week, according to DSHS reports, but Hidalgo said the county will be providing other types of vaccine during the pause.

"We're asking folks who have an appointment with Harris County Public Health to get a vaccine to not cancel the appointment," Hidalgo said. "We are distributing the Pfizer vaccine at NRG [Stadium] and the Moderna vaccine at our sites, so if folks have an appointment, please keep the appointment."

Similarly, Dallas County Judge Clay Jenkins tweeted distribution at Fair Park on April 13 will be Moderna and Pfizer vaccines during the pause. Previously, Jenkins said, the county was scheduled to distribute the Johnson & Johnson vaccine.


Hannah Zedaker contributed reporting to this story.