Thrombosis With Thrombocytopenia After the Messenger RNA–1273 Vaccine

Sangli, Swathi; Virani, Ahmed; Cheronis, Nicholas; Vannatter, Brittany; Minich, Corbyn; Noronha, Shaun; Bhagavatula, Rama; Speredelozzi, Daniel; Sareen, Meera; Kaplan, Robert

doi:10.7326/l21-0244

Cited by 102 publications

(105 citation statements)

References 4 publications

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“…Vaccine Adverse Event Reporting System (VAERS) database (last accessed 20 June 2021) contains dozens of reports of unusual site venous thrombosis after vaccination with Comirnaty® or with Spikevax®, and cases have also been reported to the EMA and in the literature. 6,7 In a (preprint) study in the U.S., the incidence of cerebral venous sinus thrombosis (CVST) and of portal vein thrombosis (PVT) in the two weeks following a diagnosis of Covid-19 was around 10-fold the incidence following an mRNA Covid-19 vaccine (44 per 100 000 compared to 4•5 per 100 000). 8 Surprisingly, however, the incidence rate of CVST and PVT with the mRNA vaccines was 10 times higher than the incidence of CVST following vaccination with VaxZevria® reported by the EMA (5 cases per million vaccinated people) and than the latest reported incidence of CVST following vaccination with the Ad26.COV2.S Janssen vaccine (0•9 per million).…”

Section: Introductionmentioning

confidence: 99%

Vaccines against Covid-19, venous thromboembolism, and thrombocytopenia. A population-based retrospective cohort study

Laporte

Coma

Fina

et al. 2021

Preprint

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Background Covid-19 vaccines may increase the risk of venous thromboembolism (VTE), thrombocytopenia (TCP), and VTE associated with TCP. We aimed at estimating this risk by age and sex, after the first dose of both adenovirus vector-based and mRNA-based Covid-19 vaccines, and after the second dose of m-RNA vaccines. Methods In this population-based retrospective cohort study, we examined three groups: 1 662 719 people 10 years of age and over vaccinated with the first dose of a Covid-19 vaccine, 622 778 with the second dose, and 190 616 diagnosed of Covid-19 in the same period (between1 January 2021 and 18 April 2021). The rates of various clinical presentations of VTE and TCP were compared with those in the reference population (7 013 040 people served by the health care system in 2919). The two primary outcomes were the observed 21 day rate of a composite variable of cerebral venous sinus thrombosis, mesenteric thrombosis, portal vein thrombosis, or any venous thromboembolism (VTE) associated with thrombocytopenia (TCP), and the rate of any VTE associated with TCP (VTE+TCP). Analyses were standardised by age and sex. Findings The 21 day rate per 100 000 of the primary composite variable was 2.15 in the reference population, 5.65 following the first vaccine dose (standardised difference, 2.53 (95 percent confidence interval, 1.04-4.00), and 7.23 following the second dose (standardised difference, 4.07 (95 percent confidence interval, 1.43-6.70). The event rates of VTE+TCP and of all the secondary variables showed the same patterns. Excess event rates were higher in men than in women, and they were not especially increased in any particular age group. All Covid-19 vaccines were associated with increased rates of the outcome variables. Excess event rates were many-fold higher in the Covid-19 cohort. Interpretation We observed small increases of rates of venous thromboembolism in usual and unusual anatomical sites and of thrombocytopenia in recipients of both adenovirus vector and mRNA vaccines against Covid-19. Excess rates were higher in men than in women and they were not particularly elevated in any specific age group.

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Section: Introductionmentioning

confidence: 99%

Vaccines against Covid-19, venous thromboembolism, and thrombocytopenia. A population-based retrospective cohort study

Laporte

Coma

Fina

et al. 2021

Preprint

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“…This means that at least some clinically diagnosed episodes of VITT are not causally related to the vaccination. Adding to the difficulties in understanding VITT and its association with adenoviral vector vaccines is a patient who had VITT following an mRNA vaccine 8 . It remains uncertain whether this was a causal or a coincidental association.…”

Section: Towards An Understanding Of Vittmentioning

confidence: 99%

Lessons from vaccine-induced immune thrombotic thrombocytopenia

2021

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“…So far only one case of possible VITT has been reported after the second dose of a mRNA vaccine (Moderna) in a 65 y.o. man with multiple vein thromboses, including cerebral veins and thrombocytopenia [134]. However, the number of Moderna COVID-19 vaccine doses administered in the United States as of 22 July 2021 was 137 million (source: Centers for Disease Control and Prevention) and the risk of VITT should be considered associated only to viral vector-based vaccines.…”

Section: Prevention Of Sars-cov2 Infection In Mpn Patients: What Vaccines To Use When and With What Precautions?mentioning

confidence: 99%

Philadelphia-Negative Chronic Myeloproliferative Neoplasms during the COVID-19 Pandemic: Challenges and Future Scenarios

Palandri

Breccia

Stefano

et al. 2021

Cancers

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An outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) started in December 2019 in China and then become pandemic in February 2020. Several publications investigated the possible increased rate of COVID-19 infection in hematological malignancies. Based on the published data, strategies for the management of chronic Philadelphia-negative chronic myeloproliferative neoplasms (MPNs) are provided. The risk of severe COVID-19 seems high in MPN, particularly in patients with essential thrombocythemia, but not negligible in myelofibrosis. MPN patients are at high risk of both thrombotic and hemorrhagic complications and this must be accounted in the case of COVID-19 deciding on a case-by-case basis. There are currently no data to suggest that hydroxyurea or interferon may influence the risk or severity of COVID-19 infection. Conversely, while the immunosuppressive activity of ruxolitinib might pose increased risk of infection, its abrupt discontinuation during COVID-19 syndrome is associated with worse outcome. All MPN patients should receive vaccine against COVID-19; reassuring data are available on efficacy of mRNA vaccines in MPNs.

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Thrombosis With Thrombocytopenia After the Messenger RNA–1273 Vaccine

Cited by 102 publications

References 4 publications

Vaccines against Covid-19, venous thromboembolism, and thrombocytopenia. A population-based retrospective cohort study

Vaccines against Covid-19, venous thromboembolism, and thrombocytopenia. A population-based retrospective cohort study

Lessons from vaccine-induced immune thrombotic thrombocytopenia

Philadelphia-Negative Chronic Myeloproliferative Neoplasms during the COVID-19 Pandemic: Challenges and Future Scenarios

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