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Steve E. Bishop, M.D.

By: Steve E. Bishop, M.D. on April 28th, 2021

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COVID-19 Update 4/28: Johnson & Johnson Unpaused, CDC's Masks Guidance, and More

COVID-19 | Facebook Live Recap

On this week's COVID-19 update, Dr. Steven Bishop discusses the unpause of the Johnson & Johnson vaccine, the CDC's masks update, immunity, India, and more. Watch below and read on for that full recap. 

Looking for the latest vaccine information? Check out our COVID-19 Vaccines resource page, as well as our resource pages for Virginia, Maryland, South Carolina, and Georgia. You can also find all of our COVID-19 update recaps here or follow us on our Facebook page to watch each week.

Johnson & Johnson Unpaused

The major update is that they allowed the Johnson & Johnson vaccine to go back on the market after reviewing the data. Here's the updated webpage from the CDC about the Johnson & Johnson vaccine, and essentially what they found is that, overall, the benefits outweigh the risks of letting the Johnson & Johnson vaccine go back on the market.

There are several cases of what's being termed, basically, blood clots in the setting of low platelets. So thrombosis with thrombocytopenia. There are similar syndromes that we see in reaction to other medicines like heparin and some blood thinners, things of that nature, that do happen from time to time, so this is sort of a similar reaction to that.

Now what they are saying is that yes, that's happening, but it's at a low enough rate across the population that the benefits still outweigh the risk.

That being said, in their information, and you can go through this whole page they put together about the safety concerns and this and that, they are still saying women under the age of 50 should be aware of the rare but increased risk of blood clots with low platelets after this vaccination. And there are other vaccines available where this risk has not been seen.

So what they're saying is that, especially for women of younger ages, essentially my read on this is, if you're a woman under the age of 50, and you can get another vaccine other than the J&J vaccine, that's probably what you should do.

But all other things being equal, don't avoid getting a J&J vaccine if it's the only one that's available to you or if you're over 50 male, female, or if you're a male under 50, the J&J vaccine is just as safe as the Pfizer and the Moderna vaccines.

It's a pretty good update. I would encourage you to read through this whole webpage that they put together, answering a lot of common questions about the pause that happened and why the pause ended and the data that they reviewed.

It's really a good piece of information. So read through that page, check that out and see what you're thinking.

CDC Updates Outdoor Mask Guidelines

Other major updates this week are the updates to the CDC's mask guidelines for being outdoors. They have put out a new chart and some updated information saying, essentially, if you've been vaccinated, you do not need to wear a mask when you're outdoors, as long as you're not within a certain feet of other people.

So in general, that is a good update. You can read all about that update to the mask guidelines. Find the nice chart. So that'll be a chart you guys can look through.


I know you guys have probably seen what's going on in India. That's another big development in the COVID world of things right now. The cases and fatalities in India have gotten very high.

My suspicion about what's going on with that is A) they just haven't had enough vaccination yet. You have to think a lot of people don't realize that the population of India is over a billion people. Much, much larger than the United States. So they just haven't been able to vaccinate as many people as we have.

And the second thing is that, despite a lot of what a lot of people think, there's a lot of diabetes in that population in India. They have a pretty high rate of that, and it's putting them at risk for bad COVID outcomes, which is a lot of what's going on there.

I do hope that things turn around, and it sounds like we're going to be sending some vaccine supplies, of the AstraZeneca vaccine, which we're not currently using, but is licensed in other places. It sounds like we're going to send some of that over there for them.

I think that that is a good thing. That's what they've been using in the UK and in Europe up until recently. So that will be a benefit to them, which is good. And hopefully, that will start to turn the tide in India. So really, really unfortunate turn of events going on in India right now.

Immunity Update

"When might we expect another update on how long immunity is lasting with these vaccines?"

There were a couple of updates just a couple of weeks ago with updated studies coming out saying that they think the immunity is going to last at least six months. And I think about every three months, you're probably going to see an update come out with more studies and more data saying, okay, now we're good to nine months and then we're good to 12 months.

And then they'll probably do it for up to two years would be my guess. And then they'll probably stop following it so closely at that point. That's my guess. So probably every three months, we'll hear an update about how long the immunity lasts, but at this point, it seems to be lasting at least six months from the vaccines, which is great news. Really good news.

Now, I think the CDC hasn't updated their guidelines yet on who needs to quarantine and isolate after exposure. I think they're still saying 90 days after vaccination, but my guess is after they finish digesting this data, they'll update that if you've been vaccinated within six months you don't need to isolate or quarantine after being exposed. But that's an excellent question. 

J&J Boosters

"I already received J&J. As a woman under 50, should I seek out a different vaccine in the future?"

I'm guessing you're talking about in terms of a booster vaccine. Probably, I would. I would do that. I would seek out either the Moderna or the Pfizer booster. But that's an untested question as of yet.

I suspect we're going to need to see some guidance from FDA and CDC about how to handle boosters in people who have gotten the original vaccine with one company and then are getting a booster with another one. So probably yes, but we're not sure.

I'm not sure how to give you further guidance in terms of which one just yet. I'll be interested to see in the next few months which boosters are going to cover which variants. The only ones that I believe are not covered well by J&J are the South African variants. So whichever booster comes out covering that one is probably the one to go for. Moderna, I think, is working on one and Pfizer, too. So probably either is fine, but more to come on that, but it's a great question.

Oral Health and COVID

"I saw something about the relationship of oral health to COVID. Any thoughts there?"

I didn't see that, so I'm not sure. That being said, what I'm guessing we're seeing there is that there is a really close link between poor oral health and things like heart disease, metabolic syndrome, diabetes.

All of those entities are very closely linked, which increases your risk of doing poorly with COVID. I'm guessing that the link with oral health is tied to that underlying metabolic syndrome problem.

And that's where you're seeing that relationship. It's not really necessarily that your oral health, if it's bad, it means you're going to do poorly with COVID. It just means that people who are going to do poorly from COVID, tend to have not only heart disease, diabetes, etc., but also oral health problems, lots of cavities, tooth infections, tooth decay, that sort of thing.

Boosters Refrigerated

"Will the booster shots have to be refrigerated?"

Most likely,  because they're still going to, at least from Pfizer and Moderna, they're still going to be mRNA vaccines. And so those do have to be kept cold in order to be stable. So, yes.

That being said, Pfizer, actually, there was one other update. Pfizer has come out with news. They're developing a pill treatment, not a vaccine, but they're developing an oral drug to treat COVID.

I have not seen any of the data yet on it or exactly what it is. That is what molecule it is, but it's going to be a protease inhibitor, which is similar to the drugs that are used to treat HIV. If that's the case and it works well, that's going to be fantastic news as well.

Scheduling Update

Just a little bit of an update about these updates. We're going to go to an every other week format.

I consider this good news. There are fewer new things coming out on a weekly basis, which is great.

So we're going to space these updates out to every other Wednesday. Next week we won't have an update, but then we'll have an update the following week, so May 12 will be our next update after today.

You can certainly still check us out every two weeks, send in the questions in the comments. You can keep adding new questions to this thread if they come up between now and then. That's totally fine and we'll answer them, but we're just going to space out a little bit.

We're starting to direct some of our energies toward launching a lot of our new wellness programs here at PartnerMD to help people improve their resilience, not only to COVID, but a lot of other things. So we're spending a lot more time in those areas, which is good news, because again, our vaccines are working and overall things are improving, which is good.