No apparent association between mRNA COVID-19 vaccination and venous thromboembolism

Nicholson, Matthew C.; Goubran, Hadi; Chan, Noel; Siegal, Deborah

doi:10.1016/j.blre.2022.100970

Cited by 16 publications

(14 citation statements)

References 58 publications

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“…mRNA vaccines are expected to induce thrombosis by a different mechanism than adenovirus vector vaccines, but the mechanism of mRNA vaccine-associated DVT remains unclear. Many large trials have shown that mRNA vaccines do not increase the risk of DVT [11]. Our patient developed DVT due to BNT162b2 vaccination and six months after the second dose (11 months after the rst dose), and the course of the disease did not t the description of VITT.…”

Section: Discussionmentioning

confidence: 62%

A case of an adolescent with antiphospholipid syndrome and persistently high PF4 levels with recurrent late thrombotic complications after mRNA SARS-CoV-2 vaccine

Haga

Ohara

Yakuwa

et al. 2022

Preprint

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Background: Anti-phospholipid syndrome (APS) is an autoimmune disease causing arteriovenous thrombosis in the presence of antiphospholipid antibodies. Pediatric APS develops at less than 18 years of age. Various factors exacerbate pediatric APS. Herein, we report a case of a patient with pediatric APS who developed deep vein thrombosis (DVT) 6 months after second vaccination due to persistent platelet activation caused by exacerbation of APS after administration of the BNT162b2 vaccine. Case presentation: A 17-year-old female developed DVT at the age of 6 years. She had no family history of thrombophilia. The thrombus was found in the right common iliac vein to the inferior vena cava, with concomitant left pulmonary infarction. After treatment with warfarin, the pulmonary infarction resolved, but the thrombus from the right common iliac vein to the inferior vena cava became organized and remained until now. The patient was treated with anticoagulants for 6 years after the onset of DVT and then without treatment for 5 years without recurrence of thrombosis. The first dose of the BNT162b2 vaccine was administered 1 week before a routine outpatient visit. However, PF4 levels were elevated after vaccination and even after 5 months, but without thrombotic symptoms. A second dose of the BNT162b2 vaccine was administered; 6 months later, the patient developed recurrent deep vein thromboembolism in the right common iliac vein and was treated with direct oral anticoagulants. Conclusions: The persistence of high PF4 levels after vaccination in a patient with DVT may indicate an association between the vaccine and DVT due to the exacerbation of APS by the BNT162b2 vaccine. After vaccination of patients with a predisposition to thrombosis, the state of coagulation, including platelet activation markers, should be monitored to prevent the development of DVT.

show abstract

Section: Discussionmentioning

confidence: 62%

A case of an adolescent with antiphospholipid syndrome and persistently high PF4 levels with recurrent late thrombotic complications after mRNA SARS-CoV-2 vaccine

Haga

Ohara

Yakuwa

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…Although mRNA vaccines are expected to induce thrombosis by a different mechanism than adenovirus vector vaccines, mRNA vaccine-associated DVT mechanism remains unclear. Many large trials have shown that mRNA vaccines do not increase the risk of DVT [5]. Our patient developed DVT due to BNT162b2 vaccination six months after the second dose (11 months after the rst dose), and the disease course could not be described as VITT.…”

Section: Discussionmentioning

confidence: 67%

Persistently high platelet factor 4 levels in an adolescent with recurrent late thrombotic complications after SARS-CoV-2 mRNA vaccination: A case report

Haga

Ohara

Yakuwa

et al. 2023

Preprint

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Background Thrombosis after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination is a serious complication for patients with a thrombophilic predisposition. Factors that predict the risk of post-vaccination thrombosis should be explored. We report a case in which a patient with pediatric antiphospholipid syndrome (APS) developed deep vein thrombosis (DVT) six months after receiving a second dose of the BNT162b2 vaccine. Case presentation: A 17-year-old girl with no family history of thrombophilia developed DVT at six years of age. The thrombus was found in the right common iliac vein and the inferior vena cava, with concomitant left pulmonary infarction. After treatment with warfarin, the pulmonary infarction was resolved, but the thrombus became organized and persisted for the next 11 years. The patient was treated with anticoagulants for six years after DVT onset, with subsequent cessation of treatment for five years without thrombosis recurrence. She received the BNT162b2 vaccine at 17 years of age, one week before a routine outpatient visit. Elevation of platelet factor 4 level was detected 14 days after the first vaccination and remained for five months after that, but without thrombotic symptoms. A second dose of the BNT162b2 vaccine was administered; six months later, the DVT in the right common iliac vein recurred and was treated with a direct oral anticoagulant. Conclusions The BNT162b2 vaccine exacerbated her antiphospholipid antibody syndrome by activating the coagulation system, thereby exacerbating her thrombosis. Platelet factor 4 may be a useful indicator of the coagulation system. The persistence of high platelet factor 4 levels after vaccination suggests that the vaccine caused DVT by exacerbating the patient’s APS. After vaccination of patients with a predisposition to thrombosis, coagulation status and platelet activation markers should be monitored to prevent the development of DVT.

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“…A retrospective, nationwide cohort study in Danish on 355,209 individuals vaccinated with AZD1222 or BNT162b2 showed a significant risk difference for DVT (8.35 per 100,000 vaccinations, 95% CI, 0.21 to 16.49) in the recipients of AZD1222 compared with in those with no vaccination; of note, no statistically significant association was seen for thrombotic events and BNT162b2 vaccination [ 10 ]. In addition, after analyzing the available data, Matthew Nicholson et al concluded that mRNA vaccines, including BNT162b2 and mRNA-1273, were not apparently associated with venous thromboembolism (VTE) [ 11 ].…”

Section: Hematological Questions Following Covid-19 Vaccinationmentioning

confidence: 99%

Hematological Questions in Personalized Management of COVID-19 Vaccination

et al. 2023

JPM

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Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been causing a worldwide pandemic since 2019. Many vaccines have been manufactured and have shown promising results in reducing disease morbidity and mortality. However, a variety of vaccine-related adverse effects, including hematological events, have been reported, such as thromboembolic events, thrombocytopenia, and bleeding. Moreover, a new syndrome, vaccine-induced immune thrombotic thrombocytopenia, following vaccination against COVID-19 has been recognized. These hematologic side effects have also raised concerns about SARS-CoV-2 vaccination in patients with preexisting hematologic conditions. Patients with hematological tumors are at a higher risk of severe SARS-CoV-2 infection, and the efficacy and safety of vaccination in this group remain uncertain and have raised attention. In this review, we discuss the hematological events following COVID-19 vaccination and vaccination in patients with hematological disorders.

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No apparent association between mRNA COVID-19 vaccination and venous thromboembolism

Cited by 16 publications

References 58 publications

A case of an adolescent with antiphospholipid syndrome and persistently high PF4 levels with recurrent late thrombotic complications after mRNA SARS-CoV-2 vaccine

A case of an adolescent with antiphospholipid syndrome and persistently high PF4 levels with recurrent late thrombotic complications after mRNA SARS-CoV-2 vaccine

Persistently high platelet factor 4 levels in an adolescent with recurrent late thrombotic complications after SARS-CoV-2 mRNA vaccination: A case report

Hematological Questions in Personalized Management of COVID-19 Vaccination

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