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Following federal guidance, Washington health care providers are temporarily pausing Johnson & Johnson shots while experts educate hospital systems on how to treat a rare side effect that may be linked to the single-dose vaccine. Of the nearly 7 million people nationwide who have received the Johnson & Johnson vaccine, officials have identified six cases of brain blood clots. “This action is being taken out of extreme caution,” said state Secretary of Health Dr. Umair Shah during a news conference. “This rarity of a side effect, one in a million, while it is serious, it has to be reminded to people that this is rare.”