mRNA-1273

Abstract

Immune thrombocytopenia and exposure of vaccine during pregnancy: case reportA 32-year-old pregnant woman developed immune thrombocytopenia (ITP) following the administration of the mRNA-1273 Covid-19 vaccine.The woman with G1P0 was hospitalised at 8 6/7 weeks of gestation due to acute-onset bruising and petechiae. Thirteen days before the admission, she had received the first injection of mRNA-1273 vaccine [Moderna vaccine, route and dosage not stated], and 11 days after the vaccination, she developed a petechial rash. She had no familial or personal history of autoimmune disease. On admission, her platelet count was low. Her other laboratory test results were as follows: white blood cell count: 8000 /mL, haemoglobin: 13.1 g/dL and hematocrit: 38.2%. Comprehensive laboratory examinations were within normal limits. A peripheral smear was significant only for thrombocytopenia. The upper abdominal ultrasound showed normal size and sonographic appearance of the spleen. Based on findings, a diagnosis of ITP was suspected.Hence, the woman was treated with oral prednisone 1 mg/kg/day (85mg). No episode of spontaneous bleeding was observed. On days 2 and 3 of hospitalisation, her platelet counts improved. Hence, she was discharged from the hospital with a week of full-dose steroid treatment, followed by a 6-week taper. After 19 days of vaccination, her platelet counts fully recovered.