VACCINE ROLLOUT
One in a million?
Comparing the side effects and potential risks of the COVID-19 vaccines
UPDATED APRIL 13
U.S. federal health agencies have recommended pausing the use of Johnson & Johnson’s COVID-19 vaccine after six recipients developed a rare disorder involving blood clots, in a fresh setback to global efforts to tackle the pandemic.
The move comes a week after European regulators said they had found a possible link between AstraZeneca’s COVID-19 vaccine and a rare blood clotting problem that had led to a small number of deaths.
The U.S. Food and Drug Administration (FDA) said one person had died from the rare blood clotting condition after taking the single-dose J&J vaccine and another was in a critical condition. Immunology experts stressed the risk posed by the vaccine appeared extremely low, but they acknowledged the need for health officials to proceed with caution to understand the best ways to mitigate any risk.
In general, common side effects from vaccines include those that affect the injection area, such as pain, redness or swelling, and those that affect the rest of the body, like fatigue, headache, muscle pain, chills, fever or nausea. These are usually normal signs that the vaccine is working as the body is building protection.
Swelling and redness at the injection site, nausea
Pain at injection site,
fatigue, headache, muscle pain, chills, joint pain, fever
Rash, redness or hives at the injection site
Pain or swelling at the injection site, tenderness and swelling of the underarm glands, headache, nausea, vomiting, muscle and joint aches, stiffness, fatigue, chills, fever
Swelling, redness or a lump at the injection site, fever, vomiting, diarrhoea, flu-like symptoms
Tenderness, pain,
warmth, itching or bruising where the injection is given,
fatigue, chills or feeling feverish, headache, nausea,
joint pain or muscle ache
Pain at the injection site,
fatigue, headache,
muscle ache,
nausea
Fever, redness and
swelling at the injection
site
Source: U.S. Food and Drug Administration; U.K. Medicines & Healthcare products
Regulatory Agency; REUTERS
Swelling and redness at the injection site, nausea
Pain at injection site,
fatigue, headache, muscle pain, chills, joint pain, fever
Rash, redness or hives at the injection site
Pain or swelling at the injection site, tenderness and swelling of the underarm glands, headache, nausea, vomiting, muscle and joint aches, stiffness, fatigue, chills, fever
Tenderness, pain,
warmth, itching or bruising where the injection is given,
fatigue, chills or feeling feverish, headache, nausea,
joint pain or muscle ache
Swelling, redness or a lump at the injection site, fever, vomiting, diarrhoea, flu-like symptoms
Pain at the injection site,
fatigue, headache,
muscle ache,
nausea
Fever, redness and
swelling at the injection
site
Source: U.S. Food and Drug Administration; U.K. Medicines & Healthcare products Regulatory Agency; REUTERS
Swelling and redness at the injection site, nausea
Pain at injection site,
fatigue, headache, muscle pain, chills, joint pain, fever
Rash, redness or hives at the injection site
Pain or swelling at the injection site, tenderness and swelling of the underarm glands, headache, nausea, vomiting, muscle and joint aches, stiffness, fatigue, chills, fever
Tenderness, pain,
warmth, itching or bruising where the injection is given,
fatigue, chills or feeling feverish, headache, nausea,
joint pain or muscle ache
Swelling, redness or a lump at the injection site, fever, vomiting, diarrhoea, flu-like symptoms
Pain at the injection site,
fatigue, headache,
muscle ache,
nausea
Fever, redness and
swelling at the injection
site
Source: U.S. Food and Drug Administration; U.K. Medicines & Healthcare products Regulatory Agency; REUTERS
Pain at injection site,
fatigue, headache, muscle pain, chills, joint pain, fever
Swelling and redness at the injection site, nausea
Rash, redness or hives at the injection site
Pain or swelling at the injection site, tenderness and swelling of the underarm glands, headache, nausea, vomiting, muscle and joint aches, stiffness, fatigue, chills, fever
Swelling, redness or a lump at the injection site, fever, vomiting, diarrhoea, flu-like symptoms
Tenderness, pain,
warmth, itching or bruising where the injection is given,
fatigue, chills or feeling feverish, headache, nausea, joint pain or muscle ache
Pain at the injection site,
fatigue, headache,
muscle ache,
nausea
Fever, redness and
swelling at the injection
site
Source: U.S. Food and Drug Administration; U.K. Medicines
& Healthcare products Regulatory Agency; REUTERS
In the six J&J cases, a type of blood clot called cerebral venous sinus thrombosis (CVST) was seen in combination with low levels of blood platelets (thrombocytopenia). The recipients were women between the ages of 18 and 48, and the symptoms occurred six to 13 days after vaccination. J&J said it was delaying the rollout of the vaccine to Europe and it was working closely with regulators. The company noted that no clear causal relationship had been established between the events and the vaccine made by its Janssen unit.
As of April 12, more than 6.8 million doses of the J&J vaccine had been administered in the United States, compared with more than 180 million shots combined of the Moderna and Pfizer/BioNTech vaccines. Europe’s drugs regulator continues to recommend the use of AstraZeneca’s COVID-19 vaccine, saying the benefits outweigh the risks. Several EU countries, however, have limited its use to certain age groups.
Number of serious disorders registered in Europe
Blood and lymphatic disorders
Gastrointestinal disorders
Respiratory system disorders
Note: Data as of April 12. These symptoms were observed following the use of the vaccine,
but no causal link has been established.
Source: European database of suspected adverse drug reaction reports
Number of serious disorders registered in Europe
Blood and lymphatic disorders
Gastrointestinal disorders
Respiratory system disorders
Note: Data as of April 12. These symptoms were observed following the use of the vaccine,
but no causal link has been established.
Source: European database of suspected adverse drug reaction reports
Number of serious disorders registered in Europe
Blood and lymphatic disorders
Gastrointestinal disorders
Respiratory system disorders
Note: Data as of April 12. These symptoms were observed following the use of the vaccine,
but no causal link has been established.
Source: European database of suspected adverse drug reaction reports
Number of serious disorders
registered in Europe
Note: Data as of April 12. These symptoms were
observed following the use of the vaccine, but no
causal link has been established.
Source: European database of suspected adverse drug
reaction reports
Although Johnson & Johnson’s and AstraZeneca’s vaccines are the focus of recent attention, other illnesses have also been occasionally observed following the use of vaccines by other drug makers. More research is needed to determine whether there is a link between those conditions and the vaccines – experts say the number of cases seen so far could be in line with background rates in the general population with or without vaccination.
“Even if all of the cases were caused by the vaccine, the risk of less than one in a million would have to be set against the benefits of protection from COVID-19 disease; a disease which, in itself, causes clotting in many cases,” said Peter English, a retired consultant in communicable disease control and a vaccine expert.
Anaphylaxis
among those who get
the Hepatitis B vaccine
Severe pulmonary embolism is a type of deep vein thrombosis (DVT). It is extremely rare after flights that are shorter than 8 hours. Following flights over 12 hours, the rate is 5 cases per million.
Pulmonary embolism
among passengers who take
a flight over 12 hours long
CVST is a rare form of stroke that affects about 5 people in 1 million each year. The risk can be higher for newborns during the first month.
Cerebral venous sinus
thrombosis (CVST) in
common population
Low platelet count, causing bruising or bleeding, occurs after the first dose of MMR vaccine (measles, mumps, rubella), at a rate of about 1 case in 20,000 to 30,000
Platelet disorders
after taking Rubella vaccine
The risk of developing a blood clot among women using other hormonal contraceptives is about 6 women in 10,000.
The risk of developing a blood clot among women using drospirenone-containing oral contraceptives would be about 10 in 10,000
Venous thromboembolism
among women taking other
hormonal contraceptives
Venous thromboembolism
among women taking
drospirenone-containing
oral contraceptives
Clotting disorders may affect up to 1 in 1,000 people. In the same proportion other blood disorders such as reduction in platelets, white blood cells and neutrophils in the blood, and the abnormal breakdown of red blood cells
Clotting disorders after
taking paracetamol
Coronavirus-related deaths
in the U.S. as of April 13
The overall prevalence of thromboembolic events during pregnancy is approximately 2 per 1,000 deliveries
About 1 in 10 cases could experience an increase in the number of nose bleeds and/or longer bleeding time
Bleeding disorders
after taking aspirin
Anaphylaxis
among those who get
the Hepatitis B vaccine
Severe pulmonary embolism is a type of deep vein thrombosis (DVT). It is extremely rare after flights that are shorter than 8 hours. Following flights over 12 hours, the rate is 5 cases per million.
Pulmonary embolism
among passengers who take
a flight over 12 hours long
CVST is a rare form of stroke that affects about 5 people in 1 million each year. The risk can be higher for newborns during the first month.
Cerebral venous sinus
thrombosis (CVST) in
common population
Low platelet count, causing bruising or bleeding, occurs after the first dose of MMR vaccine (measles, mumps, rubella), at a rate of about 1 case in 20,000 to 30,000
Platelet disorders
after taking Rubella vaccine
The risk of developing a blood clot among women using other hormonal contraceptives is about 6 women in 10,000.
The risk of developing a blood clot among women using drospirenone-containing oral contraceptives would be about 10 in 10,000
Venous thromboembolism
among women taking
drospirenone-containing
oral contraceptives
Venous thromboembolism
among women taking other
hormonal contraceptives
Clotting disorders may affect up to 1 in 1,000 people. In the same proportion other blood disorders such as reduction in platelets, white blood cells and neutrophils in the blood, and the abnormal breakdown of red blood cells
Clotting disorders after
taking paracetamol
Coronavirus-related deaths
in the U.S. as of April 13
The overall prevalence of thromboembolic events during pregnancy is approximately 2 per 1,000 deliveries
About 1 in 10 cases could experience an increase in the number of nose bleeds and/or longer bleeding time
Bleeding disorders
after taking aspirin
Anaphylaxis
among those who get
the Hepatitis B vaccine
Pulmonary embolism
among passengers who take
a flight over 12 hours long
Severe pulmonary embolism is a type of deep vein thrombosis (DVT). It is extremely rare after flights that are shorter than 8 hours. Following flights over 12 hours, the rate is 5 cases per million.
Cerebral venous sinus thrombosis
(CVST) in common population
CVST is a rare form of stroke that affects about 5 people in 1 million each year. The risk can be higher for newborns during the first month.
Platelet disorders
after taking Rubella vaccine
Low platelet count, causing bruising or bleeding, occurs after the first dose of MMR vaccine (measles, mumps, rubella), at a rate of about 1 case in 20,000 to 30,000
Venous thromboembolism
among women taking
drospirenone-containing
oral contraceptives
The risk of developing a blood clot among women using drospirenone-containing oral contraceptives would be about 10 in 10,000
The risk of developing a blood clot among women using other hormonal contraceptives is about 6 women in 10,000.
Venous thromboembolism
among women taking other
hormonal contraceptives
Clotting disorders after
taking paracetamol
Clotting disorders may affect up to 1 in 1,000 people. In the same proportion other blood disorders such as reduction in platelets, white blood cells and neutrophils in the blood, and the abnormal breakdown of red blood cells
Coronavirus-related deaths
in the U.S. as of April 13
The overall prevalence of thromboembolic events during pregnancy is approximately 2 per 1,000 deliveries
Bleeding disorders
after taking aspirin
About 1 in 10 cases could experience an increase in the number of nose bleeds and/or longer bleeding time
Anaphylaxis
among those who get
the Hepatitis B vaccine
Severe pulmonary embolism is a type of deep vein thrombosis (DVT). It is extremely rare after flights that are shorter than 8 hours. Following flights over 12 hours, the rate is 5 cases per million.
Pulmonary embolism
among passengers who take
a flight over 12 hours long
CVST is a rare form of stroke that affects about 5 people in 1 million each year. The risk can be higher for newborns during the first month.
Cerebral venous sinus
thrombosis (CVST) in
common population
Low platelet count, causing bruising or bleeding, occurs after the first dose of MMR vaccine (measles, mumps, rubella), at a rate of about 1 case in 20,000 to 30,000
Platelet disorders
after taking Rubella vaccine
The risk of developing a blood clot among women using other hormonal contraceptives is about 6 women in 10,000.
The risk of developing a blood clot among women using drospirenone-containing oral contraceptives would be about 10 in 10,000
Venous thromboembolism
among women taking other
hormonal contraceptives
Venous thromboembolism
among women taking
drospirenone-containing
oral contraceptives
Clotting disorders after
taking paracetamol
Clotting disorders may affect up to 1 in 1,000 people. In the same proportion other blood disorders such as reduction in platelets, white blood cells and neutrophils in the blood, and the abnormal breakdown of red blood cells
Coronavirus-related deaths
in the U.S. as of April 13
The overall prevalence of thromboembolic events during pregnancy is approximately 2 per 1,000 deliveries
About 1 in 10 cases could experience an increase in the number of nose bleeds and/or longer bleeding time
Bleeding disorders
after taking aspirin
Sources
U.S. Food and Drug Administration; Centers for Disease Control and Prevention; European Medicines Agency; U.K. Medicines & Healthcare products Regulatory Agency; Department of Health of the Government of Australia; American Heart Association; U.K. Electronic Medicines Compendium; Johns Hopkins Medicine; Watson HG, Baglin TP. Guidelines on travel-related venous thrombosis. Br J Haematol; REUTERS
Graphics by
Samuel Granados
Edited by
Tiffany Wu and Jon McClure