Vacunas Covid-19

COVID-19 Vaccines: J&J Clinical Considerations / Polysorbate / Post-Vaccine COVID

By Amy Orciari Herman

Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS

The CDC has updated its interim clinical considerations for use of the COVID-19 vaccines authorized in the United States. 

Among the biggest changes, the agency now offers guidance on the newly authorized, adenovirus-vectored, single-dose vaccine from Johnson & Johnson (Janssen). Many of the recommendations, detailed at the first link below, are similar to those for the mRNA vaccines (Pfizer-BioNTech, Moderna). The CDC notes that people with a contraindication to the mRNA vaccines have a precaution to the J&J vaccine, and vice versa. Accordingly, people with a contraindication to one vaccine type may consider getting the other. However, because there could be cross-reactive hypersensitivity to the ingredients in the two vaccine types, referral to an allergist-immunologist before vaccination should be considered. Of note, if a person has received one dose of mRNA vaccine and the second is contraindicated, the J&J vaccine may be considered — but should not be given until at least 28 days after the mRNA vaccine.

The CDC also downgraded polysorbate allergy from a contraindication to a precaution for the mRNA vaccines. Polysorbate allergy is a contraindication to the J&J vaccine.

In addition, the agency updated its recommendations regarding SARS-CoV-2 infection in people who are fully vaccinated — that is, who test positive 2 or more weeks after completing their vaccine series. Healthcare providers should ask that such specimens be held and report the cases to their state health department, which will work with the CDC to investigate the cases. These cases should also be reported to the Vaccine Adverse Event Reporting System (linked below).

Finally, the CDC notes that people who've recovered from COVID-19 may opt to delay vaccination temporarily given that the risk for reinfection in the following months is low. The agency does not advise a particular minimum interval between SARS-CoV-2 infection and vaccination.

CDC's interim clinical considerations (Free)

Vaccine Adverse Event Reporting System (Free)

NEJM COVID-19 Vaccine Resource Center (Free)

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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