COVID‐19 mRNA‐1273 vaccine induces production of vaccine‐induced immune thrombotic thrombocytopenia antibodies

Abstract

All participants gave informed consent on Fred Hutch IRB-approved protocols for the use of their medical data and protected health identifiers in research.

Human papilloma virus vaccine and VITT antibody induction

“…The nine‐valent HPV vaccine is based on virus‐like particle technology and does not utilize adenoviral vectors 10 . This case is consistent with our recent report on a case of fatal VITT after administration of a non‐adenoviral vector‐based vaccine (mRNA 1273, Moderna) where patient antibodies strongly recognized un‐complexed PF4 11 . Additional COVID‐19 mRNA vaccine‐associated thrombosis and thrombocytopenia reactions are currently under investigation by the CDC 12 .…”

“…10 This case is consistent with our recent report on a case of fatal VITT after administration of a non-adenoviral vector-based vaccine (mRNA 1273, Moderna) where patient antibodies strongly recognized uncomplexed PF4. 11 Additional COVID-19 mRNA vaccine-associated thrombosis and thrombocytopenia reactions are currently under investigation by the CDC. 12 While this study suggests that our patient may have had VITT, more data are needed to conclusively assess the specificity of the un-complexed PF4 ELISA for VITT diagnosis.…”

Vaccine-induced immune thrombotic thrombocytopenia

“…However, given the recent development of the more specific un-complexed PF4 ELISA for VITT, we tested a suspected VITT patient vaccinated with an mRNA-based vaccine in this ELISA. Results demonstrated very strong reactivity to un-complexed PF4 ELISA targets, consistent with VITT([ 62 ]).…”

“…Rare cases of VITT have been reported after administration of mRNA-1273 (Moderna) or BNT162b2 (Pfizer) mRNA-based vaccines [ 8 ] [ 36 , [59] , [60] , [61] , [62] ]. The incidence of mRNA vaccine-associated VITT is extremely infrequent, with an estimated incidence rate of less than one case per 100 million vaccine doses [ 8 ].…”

Guidelines on the Use of Therapeutic Apheresis in Clinical Practice – Evidence‐Based Approach from the Writing Committee of the American Society for Apheresis: The Ninth Special Issue

“…VITT was also identified in patients receiving the Ad26.COV2.S (Johnson & Johnson/Janssen) vaccine at an incidence of 1 case per 263,000. Two potential cases have been attributed to the mRNA-1273 (Moderna) vaccine (Su, 2021;Padmanabhan 2022); with the second found to have platelet-activating VITT antibodies with high optical density. Another case related to the BNT162b2 (Pfizer-BioNTech) vaccine has been reported (Bissola, 2022).…”