(NEW YORK) -- Of the roughly 7 million people who have been safely vaccinated and protected from COVID-19 with the single-dose vaccine from Johnson & Johnson, there have been six confirmed cases of developing a rare but severe blood clot disorder after taking the shot.
Though it's not yet known whether the vaccine has a direct causative effect on the clots, an independent Centers for Disease Control and Prevention panel adjourned Wednesday without a vote, leaving a pause on the Johnson & Johnson vaccine in place until the panel fills out a more robust understanding of these adverse events.
All of the reported and confirmed cases so far were observed in women between 18 and 48 years old.
A seventh possible case, in a 28-year-old woman, was included Wednesday as the Advisory Committee on Immunization Practices debated whether to recommend lifting the pause or giving the shot to only certain groups. The committee said it needed more information on all of the cases and will continue to monitor for more before making a recommendation.
"Everybody is at risk," Dr. Sarah Long, a pediatrics professor at Drexel University, said at the meeting. "And although it's a very small risk -- it is so serious."
Here's some of what we know about the cases so far.
Of the six known cases so far, all are white females, with a median age of 33. Within a week or two of taking their shot, they began getting headaches, some of them also had muscle aches, chills, fever, back pain and labored breathing.
Some of these are typical side effects of the vaccine, but the increasing severity of symptoms was not. The clotting in the brain found in these women -- clots that form in the brain's sinus veins and clog its drainage system -- was also different.
Three women remain hospitalized, with two in intensive care.
A 45-year-old woman living in Virginia has died. She got the J&J vaccine in early March, and 11 days after taking the shot, she was hospitalized with serious adverse symptoms. She died a week later, on March 18.
In Nebraska, a 48-year-old woman with an "unremarkable" past medical history was taken to the ER after three days of malaise and abdominal pain. She remains critically ill.
Another woman, 38, also presented with cerebral venous sinus thrombosis, or CVST. She has not recovered.
A 59-year-old woman with no known coronary artery disease who had taken the J&J vaccine presented with extensive deep venous thrombosis on her left side seven days after taking the shot. She has not recovered.
An 18-year-old in Nevada with unknown risk factors got the shot, and two weeks later presented with CVST with hemorrhage. She has not yet recovered.
A 26-year-old woman with obesity in the New Jersey-Pennsylvania area got the shot and seven days later presented with symptom onset. She has since been discharged from the hospital.
As Johnson & Johnson shots remain on hold, pending a deeper understanding of who may be at risk, panel members acknowledged the delicate balance between racing forward to beat the virus and its variants, but doing so safely.
"This is so challenging because the impact of ACIP decisions on the global stage is clear," said Dr. Grace Lee, co-chair of a panel on the committee. "I continue to feel we're in a race against time and the variants but we need to do so in the safest possible way."
The CDC says anyone who recently got the J&J vaccine should be aware of oncoming severe headaches, severe abdominal pain, or shortness of breath within a week to three weeks after Injection, and to seek medical attention and mention your vaccine if that happens. They should have diagnostic tests to see if they should avoid the blood thinner heparin during your treatment.
(NEW YORK) -- Blood donations and supply levels have reached alarming lows, as blood centers say they see increased demand from hospitals.
Getting donations has been a challenge throughout the pandemic, with blood drives at schools and workplaces -- the bread and butter of blood centers -- largely canceled. The American Red Cross saw its lowest blood donor turnout last week since the pandemic began, with an 11% drop compared to its average during this time.
Dr. Pampee Young, chief medical officer for the American Red Cross, told ABC News the drop was "quite unusual," even for pandemic standards.
"This is extremely concerning," Young said. "This is occurring at a time when we're seeing a very, very strong demand for blood products. In fact, greater demands than before the pandemic."
Young posits the increased demand may be due to hospitals catching up on elective surgeries and critical care that have been postponed due to the pandemic, or possibly increasing organ transplants. The decrease in turnout is less clear to her.
"This is a time where a lot of people go on spring break and that could be a part of it. But we don't suspect it is because it appears to be more pronounced than in prior years," she said. "It could be just a harbinger of challenges coming down the pike. We are emerging from the pandemic and that could be influencing donor behavior."
The Red Cross believes some donors may be "self-deferring" donating blood after getting a COVID-19 vaccine dose. The organization has seen confusion on social media in particular around donating after getting the now-suspended Johnson & Johnson vaccine. It has been working to clarify that people do not need to defer donating to the Red Cross after getting one of the three COVID-19 vaccines currently authorized in the U.S., including the J&J vaccine.
Whatever the reason, "as we try to meet patient needs, this decrease in donor turnout is a big concern for us," Young said.
Versiti, which operates blood centers in four Midwestern states, has also seen increasing demand from hospitals as blood supply levels in some regions reach a "crisis situation."
"We are seeing an uptick in regular surgical procedures," Dr. Dan Waxman, vice president of transfusion medicine and senior medical director at Versiti, told ABC News. "But at the same time, now that we're getting into better weather, unfortunately, we're seeing more vehicular trauma and in certain parts of our service area we're unfortunately seeing more trauma from guns."
Waxman said blood supply levels have been tight, particularly in Indiana and Michigan, where they've dropped to critically low levels. In general, Versiti aims to have a three-day supply of blood available to its partner hospitals, which include over 90 in Indiana and over 80 in Michigan. In both states, that has dropped to less than a day's supply, the company said Tuesday.
The supply rarely gets that low, Waxman said.
"We're filling our orders so the hospitals have blood in their refrigerators and there's plasma in the freezers, but it's very difficult," he said. "We have to kind of get ahead of ourselves on this, and the only way to do that is to have people come to us and donate."
Waxman believes spring break, and people getting out more as COVID-19 restrictions loosen, may be impacting donor availability.
"The people who have been our donors and continue their donors, at the moment there, they may be traveling for the first time in a year," he said.
For over a year, blood centers, which tend to reach people out in the community, have been working to bring people to their sites.
The majority of blood donations to Versiti -- around 70% -- would typically come through mobile drives at places like high schools, universities, places of worship and businesses, Waxman said. In the first quarter of 2021, the number of donations to Versiti blood centers from schools and businesses has dropped by 40%, or nearly 20,000 units of blood, the company said.
The Red Cross has seen its number of school and university drives drop by 50% during the pandemic, Young said. That drop has also had "significant implications" on meeting the needs of patients with sickle cell disease, as much of its African-American donor base would be reached through those types of drives, Young said.
Amid the increased need, blood centers are urging eligible individuals who are feeling well to donate.
"We're hoping that our donors will do what they've always done, which is to come out and help us," Waxman said. "It's going to be an ongoing challenge I think for some time."
(NEW YORK) -- When he was 36, Brian Kozera heard a word he never expected to hear from a doctor: cancer.
Six years later, Kozera, a police officer and dad, is now preparing to fulfill his lifelong dream of competing in the Ironman World Championship in Kona, Hawaii. Calling the opportunity “a dream,” Kozera reflected on the tough years since he first learned he had cancer.
Kozera, a lifelong athlete, was in training for a Half Ironman triathlon when he sustained a hernia. During surgery for his hernia, doctors found an irregular lymph node that turned out to be cancer.
“It was devastating. How could this happen?” Kozera said in an interview with ABC News' Good Morning America.
After going through several doctors, Kozera landed at Fox Chase Cancer Center in Philadelphia, where he found out he had a rare form of lymphatic cancer called lymphocyte deficient Hodgkin lymphoma.
The cancer had spread to his abdomen, hip, chest and spine. He underwent 16 rounds of outpatient chemotherapy but was later admitted into the hospital to undergo more chemotherapy and a bone marrow transplant.
As an athlete, Kozera said walks around the hospital floor weren’t enough to keep him active, so he decided to bring in his own exercise bike.
“Staying in shape is what I could control,” he added.
It was there in his hospital room that Kozera started training for his next Ironman race.
Following months of intensive treatment, Kozera was in remission.
He now gets blood tests every six months but said, “It’s always in the background that it [the cancer] can come back.”
Since leaving the hospital Kozera, now 42, has competed in six Ironman races, including Ironman Austria in 2016. Now he's ready to fulfill his dream of competing in the Ironman World Championship.
He was chosen by Team in Training of the Leukemia and Lymphoma Society (LLS) as one of six athletes to participate in the race in October.
“It’s the dream I never dreamed of happening,” Kozera said.
To prepare for the big race, Kozera is going through intense training and aiming to raise $100,000 for LLS.
“I get to raise money for people who were in my situation,” he said.
An independent Centers for Disease Control and Prevention panel that convened Wednesday to review Johnson & Johnson vaccine data adjourned without voting on a new recommendation, leaving a pause in place until they get more information.
Several doctors on the committee indicated they were not comfortable recommending the pause be lifted or recommending it be given only to specific age groups without more data. CDC Dr. Amanda Cohn said they will try to meet again in a week to 10 days.
The panel convened the day after the CDC and Food and Drug Administration recommended a pause on all distribution of the J&J vaccine after discovering a total of six patients who suffered rare blood clots after getting the one-dose shot. The six cases were out of a total of nearly 7 million doses given since March, meaning the CDC and FDA assumed the chances of the blood clot were around 1 in 1 million.
All six cases were in women between the ages of 18 and 48. Their symptoms happened between six and 13 days after they received their shot, and were separate from any side effects during the first 48 hours after getting the shot, which is common.
CDC Director Rochelle Walensky and the White House coronavirus response team, including Dr. Anthony Fauci, the nation's chief infectious disease expert, said the pause was intended as a precaution and to ensure confidence in the vaccine.
"Right now, we believe these events to be extremely rare, but we are also not yet certain we have heard about all possible cases as this syndrome may not be easily recognized as one associated with the vaccine," Walensky said at a White House briefing on Wednesday.
"CDC and FDA are working rapidly to investigate each case and understand whether there is a causal relationship between these blood clots and vaccine administration," she continued.
Walensky said she was confident that finding these cases proved the system was working.
"Jointly, CDC and FDA were able to identify these rare events and act quickly to alert health care providers and the public," Walensky said.
She explained that the initial decision on Tuesday to recommend all states hold off on giving the J&J shot was for three main reasons: to alert health care providers on how to treat any clots, as they shouldn’t be treated by the common blood-clot medicine Heparin; to find any additional cases of blood clots after receiving the vaccine; and to give the independent panel of CDC experts time to review the data.
J&J was approved by emergency authorization in late February. The U.S. contracted 100 million doses of the vaccine. It has only accounted for 5% of all vaccine shots administered in the U.S. so far, according to the White House. Pfizer and Moderna, the two-shot mRNA vaccines that were approved in December, have supplied more doses over time and make up the bulk of the U.S. vaccine supply.
The White House maintained on Wednesday that the pause in J&J would not affect Biden's goal to have all American adults vaccinated by the end of May, despite the role J&J played in achieving that timeline.
(NEW YORK) -- The miracle of life was just quadrupled for this family in northern California.
Haley Andrews, Katie DeAngelis, Amy Gossett and Caroline Toth are four sisters close in age -- Andrews and DeAngelis, twins, are 33; Gossett is 32; and Toth is 30. They're also pregnant at the same time. To make the experience even more special, their due dates are essentially a month apart.
"Being able to find out that my three sisters were also pregnant was just beyond any dream I could have imagined," Toth said Good Morning America.
The announcement and journey was made all the more memorable because they're going through it together.
"It's nice to have somebody who's going through it at the exact same time," Andrews said. "We kind of swap experiences just like, 'Oh, are you feeling like this today? Has that started yet?' And it's been really great."
"It's just been really neat to walk this journey together," Toth said. "We all talk pretty much every single day, talking about different symptoms and what everyone is experiencing."
Constant contact with each other is not a new concept for the sisters, who are all extremely close. Growing up, the sisters would often see their relatives and formed bonds not only with each other, but with their cousins as well.
"Your cousins and your siblings are your best friends. You unite on a whole different level," Gossett said.
The four newborns will grow up in the same environment their parents did, with a big, tight-knit family around them.
"They'll all have each other, which is a big blessing," Gossett added.
The sisters' parents, Beth and Ted Gaines, a former California state senator, are thrilled and looking forward to having all of their grandchildren together soon.
They're also no strangers to having a big family to manage. They have a total of six children and already have three grandchildren. Once the four newborns have all arrived, they'll have a total of seven grandchildren.
"Them being pregnant together has really just been wonderful," Beth Gaines said. "Two of them -- the twins -- have never been pregnant before. So it's really fun watching their relationships blossom."
She and her husband have already started shopping for their incoming family members and have purchased a large swing set, toys and cribs.
With so many family members in the mix, get-togethers occur on a frequent basis.
"It's a pretty traditional family," Gossett said. "We all spend Christmas together. We all spend Thanksgiving together. Every birthday is celebrated together."
The first of the four sisters to give birth, DeAngelis, did so earlier this month, and now the rest of the family is eagerly awaiting the other newborns which are due in June and July.
(NEW YORK) -- For colleges and universities, the one-shot Johnson & Johnson COVID-19 shot has been the simplest solution for quickly and fully vaccinating students who will soon disperse around the country in early May, otherwise risking both infection and transmission as they go.
But when it was paused on Tuesday in order for the Centers for Disease Control and Prevention and Food and Drug Administration to further investigate rare blood clots in a very small percentage of patients, those schools had to temporarily return to the drawing board.
Schools that had other vaccine options on hand said they would reschedule students to get Pfizer or Moderna shots -- but students would then have to figure out how to get their second shot in three to four weeks if they planned to be home for the summer by then. While this could be a potential inconvenience for students, finding a second dose elsewhere is also likely possible as vaccine supply continues to increase nationwide.
Still, many schools hoped the pause would be lifted soon so they could continue administering the J&J vaccine.
"Our concern, and what we're going to work through now, is ... we like the Johnson and Johnson vaccine ... because it was one and done," SUNY Chancellor James Malatras said on Tuesday. "It is very easy for a residential student to get one shot and then go home for the semester."
Though the White House coronavirus response team has said it hopes the pause won't last longer than days or weeks, more concrete guidance is expected to come on Wednesday, when an independent panel of CDC experts will meet to review the data and recommend next steps.
At the same time, most schools are fighting a time crunch, attempting to vaccinate as many students as possible in the short time frame between when students become eligible -- which, in most states, has been over the last few weeks -- and when they leave for the summer in early May.
Recent data shows that cases are rising among young, unvaccinated people, even as cases drop among the most high-risk, elderly groups who are mostly vaccinated. And public health experts worry that college students could carry the virus home with them.
"One of the last risks is the idea of hundreds of thousands of kids flying back and forth," Connecticut Gov. Ned Lamont said on Tuesday, when asked about the path forward for colleges who intended to vaccinate students with J&J.
In order to get ahead of that risk, Lamont pushed for students to get an mRNA vaccine, either Pfizer or Moderna, at college, even if they had to schedule their second shot elsewhere. Lamont said they would work with other states to make sure students could get their second dose and urged schools to get students at least some degree of protection before traveling home for the summer.
"Remember, Pfizer and Moderna are 85% effective after the first shot," Lamont said, referring to early data from clinical studies.
"We're going to try and get all of our college kids at least that first shot of vaccine and we want all the other governors to do the same with their colleges," he said.
Chief operating officer for Connecticut Josh Geballe said he thought it would be increasingly easy for students to find second shot appointments in May because, by that time, states will likely have more supply than demand.
"We'll certainly be hosting many second dose clinics here in Connecticut, making it very easy for students who are returning to Connecticut, if they got their first dose somewhere else, to get their second dose here," Geballe said.
Students were also urged to take advantage of alternative vaccines at the Ohio State University, home to around 45,000 students. The university's Wexner Medical Center began offering the Pfizer shot in place of cancelled J&J shot appointments on Tuesday.
For students who would need a second dose in a different location, a spokesperson for the medical center said they would be advised to either track down an appointment for a second dose in the place they'd be in three weeks, or wait to get their first dose until they return home.
Similarly, at the University of Michigan, students were offered Pfizer or Moderna instead of J&J, but were told that they should keep their summer plans in mind when making their appointments.
"If you've chosen an appointment at any vaccination clinic because of the one-dose J&J vaccine, please note that clinics will now be administering only the Pfizer and Moderna vaccines, which require a second shot three or four weeks later. Getting a first dose this week would put your second dose -- depending on which vaccine -- in early-to-mid May, so please plan accordingly based on your availability," the University of Michigan president and other leaders wrote to students in a community-wide email.
But at smaller schools that were only offering J&J, the only option was to temporarily cancel shots.
Findlay College, a small school in northwest Ohio that had recently been given 1,200 J&J vaccines by the state, still had 800 shots on hand when they temporarily halted vaccinations on Tuesday.
"At this point we're just waiting on guidance from the state and the CDC," said Natasha Lancaster, a communications specialist for the college. "Once we're given permission or any direction on if we can resume, we will be scheduling some more time and dates for vaccination clinics."
Findlay College planned to vaccinate about one-third of its 3,800 students with the J&J vaccine.
In New York, the nation's largest state school system, SUNY, had just been allocated 21,000 doses of J&J on Monday, before the CDC and FDA called for a pause on the vaccine.
The chancellor, Malatras, called the decision a "COVID curveball," but said they would work to get students an alternative option.
"We might have to just change how we approach this a little bit, give different alternatives for our students, but I still think we'll be able to get most of our vaccinations in before they go home, and if not, while they're at home for summer break," Malatras said.
Malatras said he remains hopeful that they will be able to start administering J&J vaccines in the coming days.
All appointments for the 21,000 J&J doses announced Monday were filled, he said, so the "demand is there."
(NEW YORK) -- A mother of two has come up with a unique solution for when her kids are squabbling over the same toy.
Mariko Fairly is a California-based parent coach and board certified behavior analyst who helps families tackle challenges like sleep, aggression, sibling interactions and play skills. Recently, she's shown parents an innovative way of getting kids to stop arguing over shared toys. She's named it "the toy draft."
"In my clinical practice, I've used preference assessments to identify toys and objects that would motivate kids to learn," Fairly told ABC News' Good Morning America. "I took that idea and adapted it to the toy draft with my own kids."
When Fairly's children, Logan, 6, and Boden, 4, would disagree on toy-sharing, she'd lay out several items for a toy draft -- aka a preference assessment -- to identify what kids like and rank them in order of desire.
Fairly places the bin of toys in the middle and each child picks one toy. Flip a coin on who goes first and everyone gets three turns each.
"They may not love their choice, but they do have a choice," Fairly said. "There is power and control in having a choice."
On March 19, Fairly posted an Instagram video of her kids engaging in a toy draft. She offered them different types of superhero capes, masks, dolls and toy vehicles.
Instead of arguing, they enjoyed doing it.
Farily offered more unique tips for parents when kids are arguing over toys:
Narrate instead of intervening
Be the sportscaster instead of the referee. Instead of taking sides, describe what's happening.
Fairly suggests saying, "You took the toy, and now your sister is crying." This way, you're not taking sides. They then have the opportunity to work it out themselves. If they can't, then decide how you'll get a little more involved.
Don't put the toys away
Teach some alternative methods, like the toy draft. If the toys get put away and the kids hear, "Now, no one gets to play," then they aren't learning.
Set up a 'crash zone'
If one child is building or creating, parents will often see a sibling or another playmate wreck the scene.
Set up a "crash zone" or other area with the same building toys. That area is for crashing, separate from the area that's reserved for building.
Pay attention to and praise the behaviors that you want to see more of
Call attention to when they take turns, when they swap or share toys. Say things like, "I love the way you're playing."
"What you pay attention to is what you're going to keep seeing," Fairly explained.
Use the term 'take turns' instead of 'share'
Fairly said it varies for kids, though sharing is a practice that's not likely learned until age 3 or older. An alternative to sharing is taking turns for kids between ages 2 and 3.
"The more practice, the more they'll learn," Fairly said. "Sharing to them means, 'You want me to give up this thing I love, to this other person.'"
Try using a timer to introduce the idea of taking turns with one toy.
What works for some may not work for all
What works for siblings might not work with their cousin or peer. Once kids learn strategies like toy drafts, they'll start attempting them on their own and introduce them to each other.
(NEW YORK) -- Federal health officials on Tuesday ordered a temporary stop on administering COVID-19 vaccine produced by Johnson & Johnson after reports of six people experiencing a blood clotting disorder.
The Centers for Disease Control and Prevention and the Food and Drug Administration said in a joint statement the agencies were "recommending a pause" while more data pertaining to the single-shot vaccine is collected and reviewed.
Nearly 7 million people in the U.S. have received J&J shots, and roughly 9 million more doses have been distributed for future use, according to CDC data.
There have been no blood clotting cases reported so far tied to the Pfizer or Moderna vaccines, but if you've received the J&J single-dose vaccine -- and are concerned over potential side effects -- here's what you need to know.
If you're one of those individuals -- and concerned over potential side effects -- here's what you need to know.
Clotting? Do I need to be worried?
To date, only six cases have been reported -- all women, aged 18 to 48.
"I don't think people should be alarmed," Dr. William Schaffner, a professor of preventative medicine and infectious diseases at Vanderbilt University in Nashville, told ABC. "This is -- at the moment -- an association that is going to be further investigated."
Extrapolated, that very limited data set shows that a person's odds -- at least so far -- of similar complications are less than 1 in 1 million. Another study estimated that roughly 1 in 6 people hospitalized with COVID-19 experienced some kind of clotting.
Cerebral venous sinus thrombosis, or CVST, and low platelet counts were seen in individuals who've received the J&J vaccine. CVST is rare and seen in the draining venous sinuses of the brain. It's often associated with pregnancy, rare clotting disorders and hormonal contraception.
I got the J&J vaccine and have a headache. Now should I be worried?
Experiencing a headache within a few hours, or even days, after getting the shot is often a common side effect -- not a serious issue.
Headaches are "much more likely to be from a more common entity ... like a vaccine side effect," said Dr. Todd Ellerin, an instructor at Harvard Medical School and an infectious disease doctor at Boston's South Shore Medical Center..
In Johnson & Johnson's February 2021 briefing with the FDA, one of the most commonly reported adverse effects to the vaccine was headache. But, as Ellerin noted, you should alert a health care professional if you "develop persistent headaches or chest pain, or shortness of breath or abdominal pain."
Medical professionals said symptoms associated with this type of blood clotting will be severe, and, as Ellerin noted, you should alert a health care professional if you "develop persistent headaches or chest pain, or shortness of breath or abdominal pain."
What's the difference between 'normal' side effects and blot clots?
Vaccine side effects typically are felt within the first 24 to 48 hours after receiving a shot. If you're feeling what may be a severe or persistent new side effect outside of those first few days, contact a doctor, experts said.
Unlike the typical flu-like symptoms people experience after the vaccine, this "should be distinguishable," CDC Director Dr. Rochelle Walensky said on a call Tuesday with state governors. "Every one of these cases have presented at or after six days. ... What we're talking about is severe headaches that occur in the six-to-13-day period."
Experts time and again have emphasized that vaccines are overwhelmingly safe, but did advise keeping tabs on how you're feeling -- "anything that feels different in movements, strength, that's asymmetric on one side of the body vs. another," Dr. Deepak Srivastava, president of the Gladstone Institutes and a cardiologist, told ABC News. "But it's such a rare event that I wouldn't want millions of people to be alarmed."
Should I take any medication to prevent clots?
There's no reason to take painkillers or do anything else to reduce your risk because it's already so small, experts agreed.
"If you're not having any symptoms, there isn't a prophylactic measure to take," said Dr. Laura Finn, director of hematology and bone marrow transplant at Ochsner Health. In fact, Finn said it's best to avoid painkillers like aspirin until the FDA and CDC determine what caused the rare clotting events.
Why are the FDA and CDC telling us about this now -- and what's next?
Experts interviewed by ABC News applauded the FDA and CDC for being transparent about a potential safety concern.
Next, the CDC will convene its outside advisory committee to investigate whether there's a true link and offer recommendations.
FDA acting Commissioner Dr. Janet Woodcock said Americans can expect an update in "a matter of days."
"While it's concerning," said Dr. Jennifer Haythe, an associate professor of medicine, co-director of Columbia Women's Heart Center and a critical care cardiologist, "it's still overwhelmingly safe."
Should someone who's received the J&J jab feel "any symptoms of stroke -- blurry vision, difficulty talking, loss of strength in your arms or legs, fainting or loss of consciousness," they should call a doctor or 911 immediately.
While this specific instance of CVST has been rare -- again, fewer than 1 in 1 million vaccine recipients -- CVST is a risk of medication many Americans ingest daily: oral contraceptives.
"Oral contraceptive therapy is a known risk factor for CVST," Finn said. "This type of blood clot by location is actually rare, but it is more likely to occur in women than in men."
Olivia Davies, a fourth-year student at the Medical College of Wisconsin and who will be starting her residency at Massachusetts General Hospital this summer, is a contributor to the ABC News Medical Unit. ABC News' Sasha Pezenik contributed to this report.
(NEW YORK) -- Federal health agencies called for a pause on the one-dose Johnson & Johnson vaccine Tuesday after six people in the United States developed a rare blood clot disorder in the weeks after receiving it. But that alarm being sounded, experts told ABC News, could prove to be a good sign.
"In a sense, this means our safety monitoring system, which is very comprehensive, is working," said Dr. William Schaffner, a professor of preventive medicine and infectious diseases at Vanderbilt University Medical Center. "Twenty years ago, we wouldn't have found this."
One piece of that network, the United States' Vaccine Adverse Event Reporting System, was established in 1990 and serves as an early warning system for detecting potential safety problems with vaccines.
"We can process and analyze the data in a much more rapid fashion," Schaffner said of VAERS and other U.S. monitoring systems.
Pausing J&J vaccinations gives the Centers for Disease Control and Prevention and the Food and Drug Administration time to review more data on that vaccine and make a recommendation about how to move forward. So far, there's been no causal link established between the vaccine and the blood clot disorder, and the government is acting "out of an abundance of caution," according to top health officials.
The FDA and CDC expect the pause to be resolved within days, officials said during a Tuesday press conference.
More than 6.8 million doses of the Johnson & Johnson vaccine have been administered in the U.S., according to the CDC, and while the number of blood clot disorder reports may rise as clinicians and patients are increasingly aware of the possibility, six reports out of 6.8 million represents an exceptionally rare event. Clinical trials, which don't include millions of people, likely wouldn't capture such a rare event, experts said.
"The way I put this in perspective: 1 in 1 million is about the chance of being struck by lightning," said Dr. Alex Spyropoulos, a blood clot specialist and professor at the Feinstein Institutes for Medical Research. By comparison, he added, "The chances of an adult being hospitalized with COVID is 1 in 100."
The blood clot disorder in question, cerebral venous sinus thrombosis, "is a blood clot in the sinuses of your brain," Spyropoulos explained, and can be associated with low blood platelet counts, according to the CDC. General blood clots are much more common and can be a symptom of COVID-19.
"Your chance of getting a blood clot with the virus is 16%," said Dr. Paul Offit, director of the Vaccine Education Center and an attending physician in the division of infectious diseases at Children's Hospital of Philadelphia. "CVST is a much more serious clot and a much rarer clot. You're seeing a collection of an ultra-rare events."
Spyropoulos said U.S. health agencies should be applauded for being transparent about these concerns.
"As soon as they are finding out about these rare events, they are alerting the public," he said.
The FDA and CDC also are alerting doctors, who should ask patients with blood clots or low platelet counts whether they've recently been vaccinated, Dr. Peter Marks, director of the FDA's Center for Biologics Evaluation and Research, said during the Tuesday press conference. That's important because a standard treatment for blood clots, the blood thinner heparin, may not be appropriate for these vaccine-associated cases and could be dangerous to administer in such instances.
"We are committed to an expeditious review of the available information, and to an aggressive outreach to clinicians so they know how to diagnose and treat [reactions]," Dr. Anne Schuchat, principal deputy director at the CDC, said during the press conference.
"If we give heparin, in theory, we would exacerbate or worsen this condition," Spyropoulos said. "The public can be reassured that we have alternate ways to treat this."
Spyropoulos said "if these are real, and I'm not convinced," referring to any causal link between the vaccine and blood clots, symptoms like significant headache pain, abdominal pain, leg pain or shortness of breath would pop up likely within three weeks of vaccination.
"If you've been vaccinated more than two weeks, you probably don't have this," he said. "If you are within two weeks, be very wary of the signs and symptoms of blood clots. Treat them seriously and go see your doctor."
People who received the Johnson & Johnson vaccine should not be worried about flu-like symptoms that occur in the first few days after vaccination, which are common side effects of the vaccine and normal signs that the body is building protection against the virus.
ABC News' Sony Salzman, Eric Strauss and Anne Flaherty contributed to this report.
(NEW YORK) -- As the rate of COVID-19 vaccinations accelerates, millions of Americans are planning for life after the pandemic. But for people with lingering symptoms -- patients known as "long haulers" -- that day may never come.
Now, clinics are springing up across the country with a mandate to study the long-term impacts of COVID-19 and treat people who suffer from symptoms that include memory loss, overwhelming fatigue, and difficulty breathing.
The creation of clinics devoted entirely to helping those who have not fully recovered from COVID-19 is likely to become one of the enduring legacies of a disease that's killed more than half a million people in the U.S.
"While I'm very hopeful that the number of 'Long COVID' patients decreases dramatically over time, I do expect that there will be a smaller subset of people that continues to have some lingering issues over the next few years," Benjamin Abramoff, director of Penn Medicine's Post-COVID Assessment and Recovery Clinic, told ABC News.
Dr. Georgia Lea, a neurologist who lives in New Orleans, counts herself among the unlucky Americans who suffer from lingering symptoms of the virus.
In June of last year, Dr. Lea started feeling the symptoms of COVID-19 exposure. So she took what she believed would be a short break from her busy hospital practice.
A few weeks later, Dr. Lea tried to return to work, and even started seeing patients via telemedicine.
"I thought I should be better," she said.
But instead, she found herself overwhelmed by fatigue.
"It was becoming very difficult to see patients and do charting, and stay awake," she said.
Dr. Lea's condition is not unique. While the majority of people fully recover after contracting COVID-19, studies indicate that up to a third of people who test positive for COVID-19 may develop Long COVID.
According to the National Institutes of Health (NIH), the symptoms of Long COVID, which the NIH calls "Post-Acute Sequelae of SARS-CoV-2 infection," or PASC, can vary. PASC is not a "syndrome," which indicates a collection of symptoms or physical findings due to a single disease, says Dr. Jerry Krishnan, a pulmonologist at the University of Illinois Hospital & Health Sciences System in Chicago.
"PASC is most likely several different diseases, depending on the type of virus that caused COVID, our body's ability to fight the infection, and the social determinants of health," Dr. Krishnan told ABC News.
The social determinants of health -- the conditions under which people are born, grow, live, work and age -- can affect health outcomes, he said.
Symptoms of Long COVID often include fatigue, shortness of breath, brain fog, sleep disorders, fevers, gastrointestinal symptoms, anxiety and depression. Sometimes the symptoms are mild; in other cases, as Dr. Lea discovered, they can be incapacitating.
Dr. Sritha Rajupet, a preventive and family medicine physician who helps lead the Post-COVID Clinic at Stony Brook Medicine, said that of the approximately 30 million people in the U.S. who have had COVID-19, between three and nine million of them will go on to have persistent symptoms. With this in mind, Congress in December allocated $1.15 billion to support the study of Long COVID.
But the results of that research are far off, and in the meantime, the U.S. health system is being forced to pivot.
"We need to be thinking about how our health systems will begin to care for these individuals and the additional resources we will need to support those who have had an exacerbation of their underlying medical conditions since having COVID," said Rajupet.
Rajupet said that from her experience, treating people with Long COVID can be both complicated and costly.
"We have been seeing higher rates of depression, anxiety and PTSD in COVID long haulers," she said. "Access to mental health services is essential in supporting their recovery."
Humboldt Park Health, a health system based in Chicago, recently set up a post-COVID clinic specifically to address the Long COVID needs of the low-income communities it serves.
"As the long term effects of COVID-19, known as post-COVID or Long COVID, become more apparent, these communities will likely bear the greater burden of Long COVID as well," said Chief Medical Officer Dr. Abha Agrawal.
Another concern is whether employers will continue to provide health coverage to employees who can't work due to their Long COVID symptoms -- especially since about half of Americans get their health insurance from their employer. Experts told ABC News they're especially concerned about young people who are now suffering from Long COVID, because scientists don't know what the long-term effects will be.
Some experts believe that Long COVID could lead to a rash of disability claims, and many employers are still trying to figure out whether chronic COVID-19 symptoms should qualify for disability.
Complicating these questions is the nature of Long COVID symptoms which, according to the NIH, sometimes arise well after the time of infection -- and can even change over time.
"In order to ensure that people have access to the health resources they need to regain the vitality of their pre-COVID lives, it's essential that insurers work together with employers and health officials to better understand this syndrome and the true cost of treating it," said Dr. Sachin Jain, president and CEO of SCAN Health Plan, a Medicare Advantage insurer.
In New Orleans, Dr. Lea has stopped working -- though her employer continues to pay her salary and maintain her health benefits. She says that some days she has 50% of her normal energy, but on others it drops to just 20%.
Other symptoms are harder to quantify. Dr. Lea said she used to enjoy a glass of wine with dinner, but now just one sip leaves her "confused, tired and thick-headed." However some experts, like Dr. Abramoff, caution against studying this kind of association.
Dr. Rajupet said people suffering from Long COVID symptoms shouldn't give up hope, as treatments are constantly evolving. Health care providers, for example, are learning to help people reverse their loss of smell, which is a common symptom of COVID-19, she said.
Dr. Lea, however, didn't sound so hopeful.
"In hindsight, I should have taken more time off to be fully rested" after initially contracting the virus, she said. "[But] I don't know if it would have made a difference."
(NEW YORK) -- By sharing her C-section journey, a mom of two is hoping to raise conversations on the stigma behind delivery methods while amplifying more support for women.
"I guess I didn't realize how much C-section shaming there was until I got shamed myself," Jesse Truelove of Guymon, Oklahoma, told ABC News' Good Morning America. "I had a doula, who was a birth support person, [say] I was 'too good for labor and labor was beneath me' and that's why [I was] opting for a C-section."
"Labor was not beneath me. I did that. I tried that for 26 hours," she added. "However women choose to birth their kids, at the end of the day, we're just moms trying to get out of the hospital with a healthy baby and there's no shame in that -- no matter how you do it."
Truelove recently posted a series of clips onto Instagram from when she gave birth to her daughter, River -- born March 11, 2021. River was delivered via elected C-section. The reel resonated with thousands of women.
"If you had a C-section it's OK to mourn the delivery you didn't get," read the on-screen video text. "You are a warrior. You made life. You brought that life into the world, the best way for you and that baby. There is no room for judgement or shame around that. Only love, support and pride. There is no EASY way to birth a human. I'm proud of you. Of all mothers. Of myself."
Truelove is a prenatal and postpartum core and pelvic floor exercise specialist. She's also head coach of the Move Your Bump app and a Postpartum Ab and Rehab workout course.
Her career choice was sparked by her experiences delivering her two daughters, she said.
"I didn't know what women needed until I needed those things," Truelove explained.
Truelove also said she noticed the pressure on moms to "bounce back" and she feels the terminology surrounding C-sections and labor is already setting moms up to believe they're failing.
"There's 'failure to progress, incompetent cervix'...those words carry a heavy weight for a mom trying to bring a baby into the world," Truelove said.
"The first birth was very traumatic and an emergency situation after 26 hours of labor, a uterine infection ... it was everything I didn't want. It took me a long time to process and digest that birth," she added. "I definitely felt like my body had failed me."
Truelove said she had her first C-section when welcoming her 2-year-old daughter, Radley.
She said that post-birth, she found herself feeling like a "stranger" in her own body, and yet she was often being told that she should be grateful for what her body had accomplished.
"Whether you have a C-section or a vaginal delivery -- which is major trauma to the body -- moms are given no support," Truelove said. "The standard for care for moms is so low and the societal expectation is so high."
According to 2019 data from the Centers for Disease Control and Prevention, there was a total of 2,558,882 vaginal deliveries in the U.S. and 1,186,397 deliveries by cesarean or C-section. The percent of all deliveries by C-section was 31.7%.
Rates of vaginal birth after previous cesarean (VBAC) increased from 12.4% in 2016 to 12.8% in 2017 and 13.3% in 2018.
Dr. Jessica Shepherd, an OB/GYN at Baylor University Medical Center in Dallas, Texas, and chief medical officer of Verywell Health, said the goal is to create an environment that harbors safety for both mom and baby.
"The delivery process depends on many factors we can't control [such as] fetal indication, maternal indication or maternal choice," Shepherd told GMA. "All three of those are still really valid reasons on why someone can have vaginal and or C-section."
Shepherd said many birth plans often don't go according to plan, and there's a social responsibility that comes with respecting a mother's plan and journey. Because of this, there should be no judgement in what someone's story is, she added.
Shepherd said recovery time for a vaginal delivery is six weeks and up to 12 weeks for a C-section.
"[Though] recovery is a broad term because I tell moms it could take up to a year for their full recovery," she explained.
Truelove said her job now is about helping women gain control over their bodies. She offers workouts tailored to what the body has experienced through vaginal or C-section deliveries.
Here are Truelove's wellness tips for before, during and after giving birth:
Communicate with doctors
You're mentally and emotionally going through this, not just physically.
"Speak with your doctors about your choices and risks with repeat C-sections and VBAC," Truelove said.
Control what you can
Go into the delivery with the mindset that "anything can happen." Whether delivering vaginally or via C-section, let those accompanying you know how the recovery room should be set up (maybe you'd like an oil diffuser).
"The way you feel will make you calm, and sets up the vibe for the rest of your stay there," Truelove noted.
Ask your partner to help you stay positive
Ask them to recite a list of mantras to ensure you'll remain in a good place.
Be aware of society's pressure for "self care"
Postpartum recovery looks different for everyone, and doesn't necessarily mean a vacation without the kids. Try 10 minutes of breath work, or sitting in the sun with an iced coffee.
"Sometimes time away from kids adds more stress," Truelove said. "It can be 10 minutes for a little workout -- if you got 5 minutes in, that's good."
Don't compare yourself to what you see on social media
Social media can be powerful but it can also be very dangerous for moms, Truelove said. Postpartum can be a vulnerable place, especially for first time moms or someone who had a big expectation of how the birth was supposed to go.
Be mindful of what you see and take in on social platforms. Not everything is what it seems.
As for parenting advice, "take what you need and ditch what you don't"
With unsolicited advice comes parents who are scared to ask questions because they now feel unsupported in their choices.
Truelove said, "You don't have to do things just because your mom did it, your friend did it or just because someone on social media said it. Listen to your intuition."
And be empowered in saying "no" to those who try making decisions for you and your child. Don't sacrifice your own needs to make someone feel comfortable.
Remember, "being a mom is a fight"
Truelove said that fight includes facing any post-birth guilt a mother may feel.
"The moms who have C-sections or complicated vaginal deliveries, we carry this guilt and we don't talk about it because we don't want to hear something from someone that will crush us," she said. "They don't know the weight their words can carry."
If you undergo a C-section, try not to trivialize it. And like Truelove's video, the images captured are "equally as powerful and moving," she said.
"You did something amazing, even if it wasn't how you expected the birth to go," she said.
(NEW YORK) -- Naomi, a 37-year-old Black woman from Portland, Oregon, will have a doula by her side when she gives birth to her seventh child, a daughter, later this month.
By using a doula -- a trained professional who provides support to moms before, during and after childbirth -- Naomi is part of a growing trend of Black women who see having a doula, particularly a Black doula, as a potentially lifesaving advocate during birth.
"I know the intensity of what's happening can lead to a lot of complications," Naomi, who asked that only her first name be used, told ABC News' Good Morning America. "When you're tapped out because you're having contractions that take your breath away, you want someone who can step in and knows what to do and knows what you want."
As a Black woman in the U.S. -- which continues to have the highest rate of maternal mortality among developed nations -- Naomi is more than twice as likely to die during childbirth or in the months after than white, Asian or Latina women, according to the U.S. Centers for Disease Control and Prevention (CDC).
Black women like Naomi are also more likely than white, Asian or Latina women to die from pregnancy-related complications regardless of their education level or their income, data shows.
Naomi said she only learned about doulas eight years ago, when she was pregnant with her sixth child and needed someone to be a support person in the delivery room. She was able to access a doula free of cost thanks to a local nonprofit organization, Black Parent Initiative (BPI), that matches Black women with Black doulas in hopes of improving their odds during pregnancy and delivery.
"All those times I gave birth, I wish I would have had a doula," said Naomi, who had her first child in her late teens. "I wish it was available 20 years ago like it is now."
Linda Bryant-Daaka, a labor and postpartum doula who started BPI's doula program in 2016, said interest in the program has increased year by year, and especially during the coronavirus pandemic, which both disproportionately impacted Black people and put a glaring spotlight on racial disparities in health care.
"What we've heard from women is that there was so much stress around the pandemic and they had so many family members pass away, they now want to use these services," said Bryant-Daaka. "And they want someone who has that shared, common background or lived experience as them."
How doulas can help Black pregnant women
Why Black women die at a higher rate than any other race during childbirth is the result of a web of factors, experts say.
Pregnancy-related deaths are defined as the death of a woman during pregnancy or within a year of the end of pregnancy from pregnancy complications, a chain of events initiated by pregnancy or the aggravation of an unrelated condition by the physiological effects of pregnancy, according to the CDC.
One reason for the disparity is that more Black women of childbearing age have chronic diseases, such as high blood pressure and diabetes, which increases the risk of pregnancy-related complications like preeclampsia and possibly the need for emergency C-sections, according to the CDC.
But there are socioeconomic circumstances and structural inequities that put Black women at greater risk for those chronic conditions, data shows. And Black women often have inadequate access to care throughout pregnancy which can further complicate their conditions, according to a 2013 study published in the American Journal of Obstetrics and Gynecology.
Anecdotal reports also show that the concerns of Black women experiencing negative symptoms during pregnancy and postpartum are specifically ignored by some physicians until the woman's conditions significantly worsen, at which point it may be too late to prevent a deadlier outcome.
That is where doulas come in, according to Tracie Collins, a doula and CEO and founder of the National Black Doulas Association (NBDA), a nonprofit organization that connects Black birthing families with Black doulas.
"Black women hire doulas because they want to make sure that they live," said Collins. "It's not a status quo for us."
"It's about, 'I'm getting ready to go into an experience that I know I need support in and I'm unfamiliar with processes. I'm unfamiliar with what I'm about to face. I'm unfamiliar with bureaucracy and the hospital procedures. I'm unfamiliar with the personnel. I'm just unfamiliar and I want to make sure that not only are my voice and my wishes respected, but that I have somebody there to help advocate so everybody can be healthy on the other side,'" she said.
Dr. Ashanda Saint Jean, a board-certified OBGYN and chair of OBGYN for the Health Alliance Hospitals and Westchester Center Medical Health Network in New York, notes that doulas are a source of non-medical support for pregnant women before, during and after childbirth.
"A doula is a support person who has been trained and educated in labor and delivery," said Saint Jean. "I've had a number of Black patients feel that having a doula is an extra layer of support where they're able to more ask questions about their birthing experience and explore all measures to ensure a healthy outcome."
In Naomi's experience, she and her doula created a birthing plan so that Naomi's doctors and partner would know what she wanted, and the doula made sure the plan was executed during labor.
"With a doula, I can relax and focus on labor," said Naomi. "She can even tell my partner things like, 'Rub her back right here.'"
Dr. Jacquelyn McMillian-Bohler, a certified nurse-midwife and assistant professor in Duke University's school of nursing, describes doulas as bridging the communication gap between health care providers and Black female patients.
"Our health literacy is poor across the board, and then when you add racism on top of that, it just creates another layer," she said. "That's what we're doing with the doula, we're trying to attack that health literacy piece that really affects outcomes."
Studies show that continued support like doulas for pregnant women can help reduce the rate of C-sections, which are higher among Black women.
The postpartum care offered by doulas also helps to increase the rates of breastfeeding, which improves health outcomes for new moms and babies, and decreases the rates of postpartum complications, like blood clotting and blood hemorrhaging, both of which impact Black postpartum women, data shows.
Stephanie Devane-Johnson, Ph.D., an assistant professor in Vanderbilt University's school of nursing, said she sees doulas as filling a lifesaving role in the birthing process for Black women.
"It takes a village not only to raise a child, but also to give birth," said Devane-Johnson. "What we're trying to accomplish here is to create the village to support Black mothers."
An effort to get more Black doulas for Black women
Devane-Johnson and McMillian-Bohler are among the health experts leading the fight to get more Black doulas trained to meet the need of expectant Black women.
They and other experts point to the issue of racial bias in medicine and say it is critical to have doulas who understand and share the same lived experiences as their clients.
"It's very important that we have health care providers that look like the community we serve and birth workers that look like the community that we serve," said Devane-Johnson. "I still actively practice at Vanderbilt University and it's amazing how Black patients, whenever I walk into a room they're like, 'Where did you come from?'"
"It gives them a sense of comfort," she said.
Venus Standard, assistant clinical professor in the University of North Carolina-Chapel Hill's School of Medicine's department of family medicine, recently received a $75,000 grant to train Black doulas, a program she is working on alongside Devane-Johnson and McMillian-Bohler.
The funding will allow the trio to recruit and train 20 Black women to earn doula certification -- which can cost hundreds of dollars and is often a barrier to entry for Black women -- and also provide business and marketing seminars to "help the newly-trained doulas establish viable businesses," according to UNC.
"There's a lack of trust in within the Black community toward the medical community," said Standard. "There is a better trust value when [a Black pregnant woman] knows that you're going to give them accurate information and information that's needed for them and their particular situation, especially if her provider team does not look like her."
McMillian-Bohler pointed out the trust factor between doulas and patients is especially important because the birthing process is so personal.
"You think about someone being in your intimate space, being with you in your home and potentially coming to the hospital and and sitting in a room with you for 20 hours," she said. "It can be a hard sell so that's why this grant is so important and projects like this are important, so that not only do people know doulas are out there, but that we're growing the body of doulas that look like the people we are caring for."
A help, but not a complete solution to the maternal mortality crisis
Health care providers who are on the front lines of helping Black pregnant women describe a heartbreaking situation of watching women live in fear during what it supposed to be a joyous time.
"I cannot have another Black patient come to me and say, 'I'm scared I'm going to die having this baby,'" said Saint Jean, the OBGYN in New York. "It breaks my heart that in 2021 we still have women in the United States afraid that they will die in childbirth."
And while having a doula is helpful for Black mothers, it is not a cure-all for the maternal mortality crisis in the U.S., experts say.
For one, doulas can cost upwards of $1,000 per birth. While there are efforts to have doulas funded by Medicaid and more insurance plans and there are initiatives like the Black Parent Initiative (BPI) in Oregon that offers doulas free of charge, the access is not equal, according to BPI's Bryant-Daaka.
"Everyone should be able to have a doula, no matter what the cost is," she said. "If we know that these services are helpful and are going to save lives and reduce cost on the backend, why would you not want them offered to women who are giving birth?"
Having doulas present is also not going to eliminate all of the underlying issues that put Black pregnant women in more danger, according to McMillian-Bohler.
"Black doulas are not going to fix the oppression and discrimination and those things that are still happening," she said. "Because what you hear [from Black women] that's very consistent is, 'I don't feel heard, 'I'm not listened to;' 'I don't feel comfortable explaining how I'm feeling because I'm not taken as seriously as someone else.'"
"We have example after example after example of where that has happened, and until we get to that issue, it's not going to go away," she said.
(NEW YORK) -- Prince Harry traveled solo to the United Kingdom over the weekend to attend the funeral of his grandfather, Prince Philip, who died at the age of 99.
Harry's wife, Duchess Meghan, who is expecting the couple's second child, is staying home in California, reportedly due to her pregnancy and at the advice of her doctor.
Harry -- who is staying at his family's Frogmore Cottage in Windsor as he follows COVID-19 protocols after traveling overseas -- will see his family in person for the first time since he and Meghan stepped down from their senior royal roles last year.
While Meghan's decision not to travel to the U.K. for Philip's funeral raised more speculation on the divide between the Sussexes and Harry's family, royal experts say her decision should not be seen as a snub.
"If there’s one thing that has remained constant throughout all of the turbulence of the past year it’s Harry and Meghan’s close relationship with the queen and Prince Philip," ABC News royal contributor Omid Scobie said Monday on Good Morning America. "Although Meghan isn’t here, she is of course supporting Harry. Her mind is very much on the situation over here."
Meghan is expected to give birth this summer, although her exact due date has not been announced. She and Harry announced their pregnancy publicly on Valentine's Day, and confirmed last month that they are expecting a girl.
Pregnant women are generally advised against air travel after 36 weeks of pregnancy, and even earlier than that for women who have high-risk pregnancies, such as twins or triplets, according to Dr. Jessica Shepherd, a Chicago-based OBGYN.
She advises pregnant women traveling at any stage in their pregnancy to make sure they have contingency plans in place should they run into complications while away from their primary medical team.
"It can be a light discussion but definitely think ahead to, ‘If I were to have any issues, where would I go? Could I contact my doctor? What type of care would I be able to get?" Shepherd, who does not treat Meghan, told GMA. "And if you’re going to another continent where they may have diseases, think ahead that you may need more vaccinations before you go."
Had Meghan decided to travel to attend Prince Philip's funeral, she would have faced an approximately 10-hour flight from Los Angeles to London. That is a long and taxing flight for a pregnant woman during normal circumstances, but especially amid the coronavirus pandemic, according to Shepherd.
In addition to the risks on long flights currently posed by the pandemic, pregnant women, especially those with preexisting conditions, have to be careful on long flights about the risk of developing deep vein thrombosis (DVT), or when a blood clot forms in a deep vein, noted Shepherd.
Pregnant women are five times more likely to experience a blood clot compared with women who are not pregnant, according to the Centers for Disease Control and Prevention.
The CDC advises pregnant women against traveling a distance of more than four hours and to take precautions to keep their legs moving, including doing seated leg stretches and getting up and walking when possible.
Shepherd said pregnant women can also wear compression stockings to help improve blood flow and reduce pain and swelling during long periods of inactivity, like sitting on a flight.
With the decision on whether or not to travel being a very personalized one, Shepherd emphasized that pregnant women must have conversations with their doctors and ask as many questions as needed to feel confident in their decision.
"Every individual is different and those are discussions that need to be had in order for both the provider and the patient to feel safe in decisions that are made," she said. "This is a matter of their health and they should feel empowered by wanting to do the best things for themselves and their babies, so it is worthy to have that conversation."
(LONDON) -- Two new British studies suggest that the B.1.1.7 variant is more transmissible than the original COVID-19 variants; however, it does not appear to be more deadly or cause more severe symptoms.
One of the studies, published in The Lancet Public Health, also reported a low rate of reinfection with B.1.1.7 in those who have recovered from previous COVID infections.
As was predicted, the Centers for Disease Control and Prevention is now reporting the B.1.1.7 strain to be the most dominant variant in the U.S., accounting for over 30% of cases in some states.
But B.1.1.7 isn't the only new, more contagious variant to emerge in recent months. Other so-called "variants of concern" include a variant first identified in South Africa (B.1.351) and a variant first identified in Brazil (P.1), according to the CDC.
Both B.1.351 and P.1 have taken over in South Africa and Brazil, respectively, and both have been found in low numbers in the United States. So why is the B.1.1.7 U.K. variant sweeping the country?
Experts say it's possible that B.1.1.7 is spreading in the U.S. because it is more contagious than original strains. It's also likely that B.1.1.7 had a head-start in the U.S., effectively edging out the other more contagious variants before they had a chance to take hold.
"What we have seen across the globe is that more easily transmissible variants will ... outcompete those variants that don't spread as easily," said Dr. John Brownstein, the chief innovation officer at Boston Children's Hospital and an ABC News contributor.
According to Brownstein, B.1.1.7 was able to spread quickly because it entered the country before immunization became widespread.
In terms of whether B.1.1.7 will outcompete other major variants, epidemiologist Dr. Emily Martin, of the University of Michigan, said, "It depends on which variant reaches a group of people first, for example B.1.1.7 was the first to start spreading in Michigan,"
Experts still aren't sure why some viral variants are more contagious than others.
One idea is that they can create a more significant viral load, meaning they can produce higher levels of virus in your nose, creating a greater opportunity for the virus to spread. It's also possible that these variants are better at latching onto or getting into cells, meaning someone exposed to the virus is more likely to become infected.
The good news, experts say, is that current vaccines and public health measures appear to be effective against B.1.1.7.
"We can develop vaccines that are closer to the variants, but it seems that so far we have effective vaccines," said Dr. Gigi Gronvall, an immunologist and associate professor of environmental health and engineering at Johns Hopkins University.
"There is nothing magical about these variants. All the things that everyone knows how to do -- wearing masks, good ventilation, distance, etc. -- all these things are still effective," Gronvall said. "It is a bit of a race with vaccination, because these variants are more transmissible, which is blunting the effect of the vaccination."
According to Brownstein, it's possible that in the years ahead, specialized booster shots may offer even better protection against any new variants that emerge in the future.
"As we let viruses evolve, there may be variants that can evade current vaccines, which is where boosters will be helpful," Brownstein said.
Scientists are already testing booster shots. But so far, all evidence indicates that currently available vaccines protect against the B.1.1.7 like they protect against the others.
"I think we should see a booster in the U.S. in the next 1-2 years, but this will all come down to hospitalization and mortality data," Brownstein said. "We don't know yet if the booster will be based on B.1.1.7 or another variant."
Karine Tawagi, M.D., a hematology and oncology fellow at Ochsner Medical Center in New Orleans, is a contributor to the ABC News Medical Unit.
(NEW YORK) -- The first real-world study pitting COVID-19 variants against the Pfizer vaccine showed that the variant first detected in South Africa may be able to evade some vaccine protection, new research conducted in Israel found.
While "breakthrough" COVID-19 cases, meaning people who get infected or sick despite being vaccinated, are extremely rare, health experts have been monitoring a handful of virus variants to see if current vaccines offer robust protection against them.
The new study, which has not yet been published in a peer-reviewed journal, took place in Israel, which has fully vaccinated 57% of its population, according to Our World in Data, almost exclusively using the Pfizer vaccine. The research, which was conducted by Tel Aviv University and Clalit, Israel’s largest health care provider, and released on Sunday, analyzed data from roughly 400 people who had tested positive for COVID-19 after receiving at least one dose of the Pfizer vaccine. In the study, 149 participants tested positive at least one week after their second vaccine dose.
The B.1.1.7 variant first identified in the United Kingdom was the dominant strain detected during the study period, while the variant first detected in South Africa, B.1.351, made up less than 1% of cases.
The good news, experts said, is that the Pfizer vaccine appeared to work well against all the variants circulating in Israel. But the vaccine isn't 100% effective, meaning a small number of people became infected after getting their shots. These breakthrough infections were more likely with the South Africa B.1.351 variant.
Among people who received both doses of the vaccine, the prevalence of the B.1.351 variant was 5.4% in breakthrough cases compared to 0.7% in the unvaccinated population, meaning it was eight times more prevalent among the vaccinated study participants.
"Our study indicates that vaccine effectiveness is lower against the South African variant," Adi Stern, study author and professor at Tel-Aviv University's Shmunis School of Biomedicine and Cancer Research, told ABC News. Researchers couldn't pinpoint how much lower that effectiveness might be, but Stern said she did not believe the reduction to be dramatic.
"This variant remains very rare in Israel, where vaccination percentage is very high," she added.
For the B.1.1.7 variant first detected in the U.K., "vaccine effectiveness remains high" among the fully vaccinated, according to the study.
But experts say that for the small number of people who experience breakthrough infections, vaccines protect against severe illness.
"What we do know, when breakthrough infections do occur, they tend to occur with fewer symptoms," CDC director Rochelle Walensky said during a Monday press briefing.
Limitations of the study include its sample size, which was small because the South Africa variant is so rare in Israel. The study, which looked at infections in people who had been vaccinated rather than overall infection rates, was not designed to measure vaccine effectiveness against different variants.
"I don’t think this should worry us unduly," said Dr. Richard Lessells, an infectious disease expert researching the variant in South Africa. "These findings seem to provide some support to what we currently understand -- that while the neutralizing antibody response is still developing post-vaccination and has not yet reached peak, there is still a risk of infection."
If the B.1.351 variant is circulating in a given location, "infection at that time may be a bit more likely with B.1.351," Lessells added.
In the United States, the B.1.351 variant is rare, making up roughly 0.5% of cases, according to the Centers for Disease Control and Prevention.
Pfizer and Moderna have been testing boosters specifically targeted against B.1.351 and evidence suggests that the three vaccines authorized in the U.S. work equally well against the B.1.1.7 variant, which is now dominant in the U.S. People who do become sick after being fully vaccinated should still have partial protection, experts say. Instead of going to the hospital or dying, they may have less severe symptoms, like feeling run down or developing a slight fever.
A spokesperson for Pfizer pointed ABC News to the pharmaceutical company's clinical trial data from South Africa. On April 1, Pfizer released a press release stating that the vaccine was "100% effective in preventing COVID-19 cases in South Africa, where the B.1.351 lineage is prevalent."
In the small clinical trial in South Africa, which included 800 participants, nine tested positive for COVID-19, all of whom were in the placebo group and did not receive the Pfizer vaccine.
"Our results do indicate that there is some reason for concern, but definitely no reason for unnecessary alarm," Stern said. "It is always important to keep in mind that vaccine protection is never 100%," she added. "As long as case counts are high, even fully vaccinated individuals should take precautions."
ABC News' Sony Salzman, Eric Strauss and Brian Hartman contributed to this report.