cdc.gov/coronavirus

Benefits and Risks of COVID-19 

Vaccines: Work Group Interpretation

Sarah Mbaeyi, MD MPH

Centers for Disease Control and Prevention

July 22, 2021
After a period of decline, COVID-19 cases rising again

Majority of cases due to Delta variant

Delta

As of July 21, 2021

https://covid.cdc.gov/covid-data-tracker/#trends_dailytrendscases

https://covid.cdc.gov/covid-data-tracker/#variant-proportions 2
Over two-thirds of U.S. adults have received at least one 

COVID-19 vaccine dose

59.6%

68.4%

Fully vaccinated

At least one dose

COVID-19 vaccination coverage 

among persons aged ≥18 years

Race/ethnicity

State

Age

Coverage varies by

As of July 21, 2021

https://covid.cdc.gov/covid-data-tracker/#vaccinations
Low COVID-19 vaccination coverage puts individuals and 

communities at risk

https://www.cdc.gov/coronavirus/2019-ncov/images/communication/covid-data-tracker/Vaccinations_By_Case_Rate_FINAL_07072021.pdf 4
mRNA vaccines account for majority of doses 

administered in the United States

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0 50,000,000 100,000,000 150,000,000 200,000,000

Vaccine type

56%

40%

4%

Moderna

137,121,107

Pfizer-BioNTech

188,601,917

Janssen

13,092,976

Janssen accounts for 4% of total doses administered 

(8% of fully vaccinated)

As of July 21, 2021.

https://covid.cdc.gov/covid-data-tracker/#vaccinations
Willingness to receive Janssen vaccine remains lower 

since the April pause

Pause

Results shown are among those who haven’t received a vaccine but plan to get one
90% 88% 85% 83%

70% 70%

13%

33%

0%

20%

40%

60%

80%

100%

Rural

populations

Mobile clinics Corrections

populations

Persons

experiencing

homelessness

Primary care

providers

College

students

Homebound Other

Proportion (%)

Most jurisdictions report Janssen vaccine used in a variety of 

populations and settings

Includes migrant and 

seasonal workers, 

hospital discharge, 

travers/cruise ships, 

state-operated mass 

vax sites, tribes

Janssen vaccine: Patient choice, access, and vaccine equity

Findings from survey of jurisdictions – July 16, 2021

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83%

Yes

17%

No

Most vaccination sites offer 

more than one type of vaccine 

Source: CDC Jurisdictional Pulse Survey 07/16-2021 1700, N=40 

Responding to question: Do most of the vaccinations sites in 

your jurisdiction offer more than one type (Pfizer, Moderna, 

Janssen) of COVID vaccine?

Responding to question: Which populations or settings in your jurisdiction are utilizing the Janssen vaccine?
Benefits of COVID-19 vaccines are unequivocal

 All COVID-19 vaccines currently authorized in the United States are effective against 

COVID-19, including serious outcomes like severe disease, hospitalization, and death

 Available evidence suggests that currently authorized vaccines offer protection 

against known circulating variants, including the Delta variant

 A growing body of evidence indicates that people fully vaccinated with an mRNA 

vaccine are less likely to have asymptomatic infection or to transmit SARS-CoV-2 to 

others

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https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/fully-vaccinated-people.html

Nasreen S, et al. "Effectiveness of COVID-19 vaccines against variants of concern, Canada." medRxiv (2021).

Stowe J, et al. ”Effectiveness of COVID-19 vaccines against hospital admission with the Delta (B.1.617.2) variant.” Public Health England. 2021.

Sheikh A, et al. "SARS-CoV-2 Delta VOC in Scotland: demographics, risk of hospital admission, and vaccine effectiveness." The Lancet (2021).
Rare serious adverse events have been reported after 

COVID-19 vaccination

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Thrombosis with 

thrombocytopenia 

syndrome (TTS)

Guillain-Barré

syndrome (GBS)

Myocarditis

Janssen mRNA
Benefits of COVID-19 vaccination continue to outweigh risks

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Janssen COVID-19 vaccine mRNA COVID-19 vaccine

Age 

Prevented COVID-19 

hospitalizations/ 

ICU admissions/deaths

GBS 

Cases

TTS 

Cases

Prevented COVID-19 

hospitalizations/

ICU admissions/deaths

Myocarditis

Cases

FEMALES

18-29 years 700 50 5 1 4-5 750 50 5 3-4

30-49 years 900 140 20 6-7 8-10 950 140 20 1-2

50-64 years 1600 350 120 7-8 3-4 1,700 375 125 1

65+ years 5,900 1250 840 8-10 0 6,200 1300 900 <1

MALES

18-29 years 300 60 3 2 2-3 300 60 3 22-27

30-49 years 650 150 25 7-8 1-2 700 160 25 5-6

50-64 years 1,800 480 140 14-17 1-2 1,900 500 150 1

65+ years 11,800 3300 2300 7-8 0 12,500 3500 2400 <1

For every million doses of vaccine given with U.S. exposure risk and hospitalization rates from June 19, 2021
Work Group interpretation

 Vaccination continues to be critical during this period of rapidly increasing cases and 

spread of variants of concern

 The reported adverse events (TTS, GBS, and myocarditis) are potentially serious and 

should be transparently communicated with the public

 Even with new GBS safety signal, benefits of Janssen vaccination continue to 

outweigh risks

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Benefits and risks of COVID-19 vaccination
Work Group interpretation

 In addition to benefit-risk profile, the Work Group discussed:

–

–

–

–

–

Importance of patient choice in vaccine product

Access to vaccines for disproportionately affected populations

Confidence in patients and providers to understand benefits and risks of 

vaccines and make informed decisions

Need for communication and educational materials

Implications of any change in vaccine recommendations on global vaccine 

confidence and use

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Additional considerations for use of Janssen COVID-19 Vaccine
Work Group interpretation

 Work Group reaffirms that all eligible persons should receive a COVID-19 vaccine

 Patients and providers should be aware of both the benefits and risks of COVID-19 

vaccination when choosing a vaccine product

 Work Group members expressed strong support for continued use of Janssen 

vaccine according to the current recommendations

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Use of Janssen COVID-19 Vaccine after reports of GBS in vaccine recipients
Updates to CDC Clinical 

Considerations

 Persons with a prior history of GBS:

–

–

Can receive any of the authorized vaccines

Given possible association between Janssen 

vaccine and GBS, patients with a history of 

GBS and their clinical team should discuss 

the availability of mRNA vaccines to offer 

protection against COVID-19

 Information on signs and symptoms of GBS

14 Updates will be posted at: https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html
Updates to additional 

clinical resources

15 Updates will be posted at: https://www.cdc.gov/vaccines/covid-19/info-by-product/janssen/index.html
Planned CDC communication 

materials

 Updated materials for providers on talking to 

patients about Janssen vaccine safety

 Updated frequently asked questions

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Discussion

 What is the ACIP’s interpretation of the benefits and risks of COVID-19 vaccines?

 Does ACIP agree with the Work Group’s interpretation that Janssen COVID-19 

Vaccine should continue to be used according to the current recommendations?

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