Vaccine hesitancy among senior living and skilled nursing staff members took another hit Tuesday after federal health officials recommended a pause on the use of the Johnson & Johnson COVID-19 vaccine after reports of blood clots in six women.

“The federal pause on the Johnson & Johnson vaccine is most unfortunate and will almost certainly add to the challenge of convincing hesitant staff to be vaccinated with any of the approved and available vaccines,” American Seniors Housing Association President David Schless told McKnight’s Senior Living.

Although long-term care resident vaccination rates are well over 80%, the Centers for Disease Control and Prevention estimated last month that only 37.5% of staff members nationwide had received their first dose of a COVID-19 vaccine through the federal Pharmacy Partnership for Long-Term Care Program, which served assisted living and skilled nursing facilities. Not all long-term care facilities participated in the program, but staff vaccination rates ranged from 10% in Arkansas to 81% in New Hampshire as of March 15, according to NPR. A Kaiser Family Foundation and Washington Post survey found that safety, efficacy and the newness of the vaccine, as well as distrust of the government, were among the major factors long-term care and healthcare workers cited for not receiving a coronavirus vaccine.

Argentum said it was thankful that most senior living residents already have been vaccinated.

“We are continuing to encourage vaccination for all who work in or reside at senior living communities across the industry, which is why it is critical that our communities, residents and staff continue to be prioritized for access to the Pfizer and Moderna vaccines,” John Schulte, Argentum vice president of quality improvement, told McKnight’s Senior Living.

A LeadingAge spokesperson said that the organization continues to support vaccination.

“Today’s news about the Johnson & Johnson COVID vaccine shows that our vaccine quality review process is working as it should, and that health authorities are operating from a place of transparency and caution,” the spokesperson told McKnight’s Senior Living. “It is important that older adults and the people who care for them continue to have adequate access to vaccines even as distribution on J&J’s vaccine is paused.”

During a media call on Tuesday, acting Food & Drug Administration Director Janet Woodcock said that vaccines are a “really important tool to get this pandemic under control.” Anyone who has not been vaccinated should take advantage of the other vaccines available, because the risks from COVID-19 are “significant,” Woodcock said, emphasizing that the federal government is committed to patient safety.

“I want to remind clinicians and the public that 121 million people have been vaccinated with at least one dose of one of the three vaccines, and the vast majority were the other two products,” meaning the Moderna and Pfizer vaccines, said Anne Schuchat, M.D., principal deputy director at the CDC. She added that the blood clot syndrome has not been detected among the other vaccines. “We have real-world evidence now of the vaccines’ effectiveness in the United States. We’re taking this pause and precautions around the Johnson & Johnson product in the context of a large, robust and highly effective vaccination effort.”

The CDC’s Advisory Committee on Immunization Practices will meet today to review the blood clot cases in the context of risks and benefits. It’s possible the vaccine could be approved for use in subsets of populations in different categories, including older adults. 

All six reported cases of blood clots involved women ranging in age from 18 to 48. Several states, as well as CVS Health and Walgreens, heeded the recommendation to pause vaccinations with the Johnson & Johnson vaccine. 

Chad Worz, PharmD, chief executive of the American Society of Consultant Pharmacists, said that the pause is a recommendation, not a mandated stoppage. Most pharmacies are being cautious and are waiting for now, however, he added.

“The issue seems to be in younger, female patients, and it may be that guidance from FDA will make that more clear, reopening the vaccine to older adults in a few days,” Worz said. “Some long-term care pharmacies receive the other vaccines, and the pause is not expected to last long, so the impact may not be significant in long-term care.”

Meanwhile, long-term care industry officials have raised concerns about vaccine supplies for assisted living communities and nursing homes, calling on the federal government to allocate Pfizer and Moderna vaccines to these settings to fill a potential gap left with the Johnson & Johnson vaccine pause.

“Unfortunately, today’s development essentially halts vaccinations in long-term care, as the federal government was primarily allocating the Johnson & Johnson vaccine to nursing homes and assisted living communities,” David Gifford, M.D., MPH, the chief medical officer for the American Health Care Association and National Center for Assisted Living, said Tuesday morning in a statement. “Without swift action to replace these vaccines, we could see tragic consequences.”

The move comes after AHCA / NCAL last week sent letters to the White House and the National Governors Association asking that long-term care residents and staff members remain a priority for vaccination.