Thrombocytopenia following Pfizer and Moderna <scp>SARS‐CoV</scp>‐2 vaccination

Lee, Eun‐Ju; Cines, Douglas B.; Gernsheimer, Terry; Kessler, Craig M.; Michel, Marc; Tarantino, Michael D.; Semple, John W.; Arnold, Donald M.; Godeau, Bertrand; Lambert, Michele P.; Bussel, James B.

doi:10.1002/ajh.26132

Cited by 355 publications

(459 citation statements)

References 16 publications

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“…In addition to VITT, some cases of “typical” ITP with or without bleeding, but without thrombosis, have been reported as induced by or revealed after exposure to the messenger RNA (mRNA)–based vaccines as those produced by Moderna (mRNA-1273) and Pfizer–BioNTech (BNT162b2). 44 , 48 This is not of major surprise, considering that similar rare cases have been observed after “traditional” vaccine administration against other infectious agents and could thus be expected. In this regard, a study is ongoing in Italy to better evaluate the frequency and severity of isolated thrombocytopenia with or without bleeding occurring after COVID-19 vaccination.…”

Section: Caveatmentioning

confidence: 79%

Practical Recommendations for the Management of Patients With Itp During the Covid-19 Pandemic

Rodeghiero

Cantoni

Carli

et al. 2021

Mediterr J Hematol Infect Dis

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The current COVID-19 pandemic requires revisiting our current approach to major blood disorders, including ITP (Immune Thrombocytopenia), stirring up the production of several disease-specific practical guidelines. This report describes an updated version of consensus-based practical guidelines on the management of ITP, adapted to the Italian health system and social context. It highlights the role of the hematologist in offering guidance for choosing differentiated approaches in relation to specific circumstances and is intended to provide them with a useful tool for sharing the decision-making process with their patients. Probably, the greatest risk to avoid for a patient with suspected, ongoing or relapsed ITP - that is not severe enough to place him or her at risk for major bleeding - is to be infected in non-hospital and hospital healthcare settings. This risk must be carefully considered when adapting the diagnostic and therapeutic approach. More in detail, the document first addresses the appropriate management for COVID-19 negative patients with newly diagnosed ITP or who experience a relapse of previous ITP, according to first and second-line lines of treatment s and then the management of COVID-19 positive patients according to their severity, from paucisymptomatic to those requiring admission to Intensive Cure Units (ICU). The pros and cons of the different treatments required to correct platelet count are discussed, as are some specific situations, including chronic ITP, splenectomy, thromboembolic complication and anti COVID-19 vaccination.

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Section: Caveatmentioning

confidence: 79%

Practical Recommendations for the Management of Patients With Itp During the Covid-19 Pandemic

Rodeghiero

Cantoni

Carli

et al. 2021

Mediterr J Hematol Infect Dis

View full text Add to dashboard Cite

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“…US Food and Drug Administration and Centers for Disease Control and Prevention have said that the incidence of ITP post-COVID-19 vaccination was not higher than that of the general population. Favorable response was noted in most of these patients treated with corticosteroids and intravenous immunoglobulin (IVIG) [10]. Hence, taking into consideration the increased risk of ITP after administration of various vaccines as well as patient response to standard ITP therapy, there is a possibility that that there may be an association between ITP and COVID-19 vaccine.…”

mentioning

confidence: 99%

Vigilance regarding immune thrombocytopenic purpura after COVID-19 vaccine

et al. 2021

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Introduction: Based on the severity of thrombocytopenia, patients with immune thrombocytopenic purpura (ITP) are at an increased risk of mucocutaneous or major bleeding. Discussion: There has been an increased risk of ITP after administration of various vaccines like influenza, measles-mumpsrubella, hepatitis B, and diphtheria-tetanus-pertussis. The pathogenesis of vaccine-related thrombocytopenia is not completely clear and is probably caused by molecular mimicry. Till date, there have been few reported cases of thrombocytopenia in the pharmacovigilance databases after patients received the Pfizer and Moderna coronavirus disease-19 (COVID-19) vaccines. Conclusion: Emergency physicians should be aware of the occurrence of vaccine-induced ITP in patients who present with bleeding manifestations, especially after the current boost in COVID-19 vaccination drive worldwide.

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“…Contraindications and precautions for patients with known hypersensitivity to ingredients of the vaccine (e.g., PEG) must be listed and explained before administration [123], and treatments, such as epinephrine injections to ameliorate post-vaccination anaphylaxis, must be available according to practical guidelines [124]. Public alarm was raised when rare thrombocytopenic events were reported in response to both the Moderna and Pfizer vaccines, but the FDA judged the benefits of vaccination to outweigh the risks [125].…”

Section: Safety and Efficacymentioning

confidence: 99%

An Updated Review of SARS-CoV-2 Vaccines and the Importance of Effective Vaccination Programs in Pandemic Times

et al. 2021

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Since the worldwide COVID-19 pandemic was declared a year ago, the search for vaccines has become the top priority in order to restore normalcy after 2.5 million deaths worldwide, overloaded sanitary systems, and a huge economic burden. Vaccine development has represented a step towards the desired herd immunity in a short period of time, owing to a high level of investment, the focus of researchers, and the urge for the authorization of the faster administration of vaccines. Nevertheless, this objective may only be achieved by pursuing effective strategies and policies in various countries worldwide. In the present review, some aspects involved in accomplishing a successful vaccination program are addressed, in addition to the importance of vaccination in a pandemic in the face of unwillingness, conspiracy theories, or a lack of information among the public. Moreover, we provide some updated points related to the landscape of the clinical development of vaccine candidates, specifically, the top five vaccines that are already being assessed in Phase IV clinical trials (BNT162b2, mRNA-1273, AZD1222, Ad26.COV2.S, and CoronaVac).

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Thrombocytopenia following Pfizer and Moderna SARS‐CoV‐2 vaccination

Cited by 355 publications

References 16 publications

Practical Recommendations for the Management of Patients With Itp During the Covid-19 Pandemic

Practical Recommendations for the Management of Patients With Itp During the Covid-19 Pandemic

Vigilance regarding immune thrombocytopenic purpura after COVID-19 vaccine

An Updated Review of SARS-CoV-2 Vaccines and the Importance of Effective Vaccination Programs in Pandemic Times

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