The odds of a person developing a rare blood clot after receiving the Johnson & Johnson vaccine are long. When the clots were first identified, the chances of developing one were one in a million.
But Morgan Wolfe learned the hard way that even if the odds miss 999,999 times, there's still that one time they hit.
Wolfe had been counting down the days until she could get vaccinated; all of her friends had gotten it, as had her husband. In early April, she received her one-dose Johnson & Johnson vaccine at an east Denver pharmacy. She had 24 hours of classic flu-like side effects. They subsided but were replaced a few days later by a headache, which worsened. She described it as "the worst pain I've ever felt."
She became dizzy. After drugs prescribed for a sinus infection didn't abate the pain, she went to the University of Colorado Hospital's emergency room.
As she put on her coat and slipped her phone into her pocket, the device lit up with an alert: Six women had developed a rare form of blood clot after receiving the same vaccine she had, and the U.S. Centers for Disease Control and Prevention was pausing the distribution of Johnson & Johnson.
"At that point, it was like, 'I guess it could be that,'" she said Tuesday.
The federal government called for a pause of administration of the Johnson & Johnson vaccine last month, after several cases of a rare clot were reported in women. A CDC panel would later clear the vaccine for continued use, though it added a label warning of the potential for clots. In all, 25 cases were identified.
Fortunately, the doctors at the hospital had also seen the news and had already done some work to review it. In some of the other reactions, physicians had turned to a standard blood thinner, said R. Todd Clark, an emergency medicine physician and professor at the university. But that thinner, heparin, also has a rare side effect that could actually exacerbate the clot.
The CDC had warned of this eventuality, and Clark and other physicians had studied clotting concerns raised about another vaccine, the one developed by AstraZeneca. In a first-of-its-kind response, doctors at the hospital instead gave Wolfe Bivalirudin, an alternative to heparin.
"She came in, in the morning," Clark said of Wolfe. "We did afternoon blood tests and it had already started getting better."
Her condition wasn't critical, but it was serious, Clark said. Her platelet count was 20; the normal range begins at 150. The use of the alternative medication helped reverse that test result rapidly.
Such was the success that Clark has since published a paper describing the positive effects of the drug on this type of rare clot. He said it will give other physicians options, where before there were none other than educated guesses. The whole clotting saga, he continued, also proved the sound nature of the United States' vaccine monitoring system.
"I would want to fill you with confidence that the system we have in place is working," Clark said. The clotting was identified quickly, the vaccine was temporarily pulled, and now doctors have an idea on how to treat the next rare event.
After a six-day stay in the hospital, Wofle is home and recovering now. She's not fully back to herself yet, Clark said, but she's improved significantly.
As she watched the news in the hospital and saw the reaction to the handful of blood clots caused by the millions of Johnson & Johnson vaccines that had been distributed, it was surreal.
It was overwhelming, she said, "to feel like, 'OK, I'm one of these people they're talking about.'"