A Virginia woman died after receiving the Johnson & Johnson vaccine in March, and the Atlanta-based Centers for Disease Control and Prevention is investigating to see whether her death was caused by adverse side effects, according to the Virginia Department of Health.

The 45-year-old woman reportedly died within two weeks of receiving the one-shot J&J vaccine, according to the CDC. That case is part of the investigation that prompted states, including Georgia, to halt their emergency use of the vaccine.

On Tuesday night, Johnson & Johnson said it was pausing its vaccine clinical trials after blood clotting issues “while we update guidance for investigators and participants.”

The U.S. Food & Drug Administration and the CDC said Tuesday morning they are recommending a pause in using the Johnson & Johnson COVID vaccine after six people suffered “rare” and “severe” blood clots after receiving the vaccine.

Dr. Peter Marks, director of the FDA center for biologics evaluation and research, said one of those who suffered such a reaction has died, while another is in critical condition. Almost 7 million people have been given the J&J vaccine.

“We are recommending a pause in the use of this vaccine out of an abundance of caution,” the agencies said, while The New York Times is reporting federal health officials are also urging states to stop using the J&J vaccine.

All six cases occurred among women between the ages of 18 and 48, and symptoms occurred six to 13 days after vaccination, according to Marks.

Several mass vaccination sites in major cities across the U.S. announced they were stopping the J&J vaccine’s administration, including Jacksonville and Orlando, Florida; and Arlington, Texas. Ohio Gov. Mike DeWine is advising all Ohio vaccine providers to temporarily pause using the vaccine.

Shortly after 9 a.m., New York announced it was pausing the vaccine’s administration, a move that New York City Councilman Mark Levine called “a big setback for vaccination” in his city. “Key components of our program here rely on J&J,” he said on Twitter.

New York Gov. Andrew Cuomo said all appointments for the Johnson & Johnson vaccine will be honored using Pfizer’s vaccine.

President Joe Biden’s coronavirus coordinator, Jeff Zients, said the pause “will not have a significant impact on our vaccination plan” because J&J’s vaccine “makes up less than five percent of the recorded shots in arms in the United States to date.”

The U.S. military also announced Tuesday morning it was pausing the vaccine’s distribution. “The safety of our force and their families is a top priority for the department,” Pentagon press secretary John Kirby told a Fox News reporter.

“We are aware that thromboembolic events including those with thrombocytopenia have been reported with COVID-19 vaccines,” Johnson & Johnson said immediately after the government’s announcement. “At present, no clear causal relationship has been established between these rare events and the Janssen COVID-19 vaccine.”

An official with the U.S. Department of Health and Human Services told a CBS News correspondent that Secretary Xavier Becerra was informed of the decision to temporarily halt the use of the vaccine Monday night.

Georgia health officials said last week they are pausing using the Johnson & Johnson COVID-19 vaccine at one Cumming vaccination site after multiple people experienced adverse reactions after being vaccinated this week.

The Georgia Department of Public Health said eight people experienced an adverse reaction after being vaccinated at the Cumming Fairgrounds site. According to health department officials, one person was sent to a nearby hospital for evaluation before being released. The other seven were sent home after being monitored at the site, health officials said.

While health officials say the reactions were “consistent with common reactions in adults being vaccinated with any vaccine,” the site stopped the vaccinations due to the number.

“There is no reason to believe there is anything wrong with the vaccine itself, and other individuals who have received the J&J vaccine should not be concerned,” Kathleen E. Toomey, commissioner of the Department of Public Health, said in a statement. “We are looking into what happened and what may have caused the reactions, including the conditions at the fairgrounds such as heat and the ability to keep the site cool.”

Georgia is one of three states the CDC is evaluating after incidents involving the Johnson & Johnson vaccine. A similar case north of Denver stopped vaccinations the same day due to adverse reactions.

Deliveries of Johnson & Johnson’s vaccine doses are expected to drop by more than 80% this week, The Wall Street Journal said, citing state officials and federal data.

About 700,000 doses of J&J’s vaccine have been allocated to states, territories and certain cities and federal agencies this week, according to the Journal. About 4.9 million doses were allocated last week, according to information posted online by the CDC.

It isn’t clear why this week’s supply has fallen off so sharply, but federal officials have cautioned states there might be fluctuations week to week.

Johnson & Johnson recently had a production problem at a contract manufacturer’s plant in Baltimore, but that plant has not been authorized by United States regulators to supply doses for the nation.

On Thursday, use of Johnson & Johnson’s vaccine was temporarily halted in Raleigh, North Carolina, after 18 people experienced adverse reactions after receiving the vaccine at PNC Arena. Four were hospitalized as a precaution.

On Tuesday, the Australian government said it had decided against buying the single-dose Johnson & Johnson coronavirus vaccine and identified a second case of a rare blood clot likely linked to the AstraZeneca shot.