Immune thrombocytopenia following immunisation with Vaxzevria ChadOx1-S (AstraZeneca) vaccine, Victoria, Australia.
Autor: | Gordon SF; Surveillance of Adverse Events Following Vaccination In the Community (SAEFVIC), Murdoch Children's Research Institute, 50 Flemington Rd, Parkville, Vic 3052, Australia; Victorian Department of Health, 50 Lonsdale St, Melbourne, Vic 3000, Australia., Clothier HJ; Surveillance of Adverse Events Following Vaccination In the Community (SAEFVIC), Murdoch Children's Research Institute, 50 Flemington Rd, Parkville, Vic 3052, Australia; Victorian Department of Health, 50 Lonsdale St, Melbourne, Vic 3000, Australia., Morgan H; Surveillance of Adverse Events Following Vaccination In the Community (SAEFVIC), Murdoch Children's Research Institute, 50 Flemington Rd, Parkville, Vic 3052, Australia., Buttery JP; Surveillance of Adverse Events Following Vaccination In the Community (SAEFVIC), Murdoch Children's Research Institute, 50 Flemington Rd, Parkville, Vic 3052, Australia; Centre for Health Analytics, Melbourne Children's Campus, 50 Flemington Rd, Parkville, Vic 3052, Australia., Phuong LK; Surveillance of Adverse Events Following Vaccination In the Community (SAEFVIC), Murdoch Children's Research Institute, 50 Flemington Rd, Parkville, Vic 3052, Australia., Monagle P; Sydney Children's Hospital, High St, Randwick, NSW 2031, Australia; The University of Melbourne, Parkville, Vic 3010, Australia., Chunilal S; Monash Health, 246 Clayton Rd, Clayton, Vic 3168, Australia., Wood EM; Monash Health, 246 Clayton Rd, Clayton, Vic 3168, Australia; Monash University is School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne 3004, Australia., Tran H; Alfred Health, 55 Commercial Rd, Melbourne, Vic 3004, Australia; Monash Health, 246 Clayton Rd, Clayton, Vic 3168, Australia., Szer J; Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne, Vic 3000, Australia; The Royal Melbourne Hospital, 300 Grattan St, Parkville, Vic 3050, Australia; The University of Melbourne, Parkville, Vic 3010, Australia., Crawford NW; Surveillance of Adverse Events Following Vaccination In the Community (SAEFVIC), Murdoch Children's Research Institute, 50 Flemington Rd, Parkville, Vic 3052, Australia; Victorian Department of Health, 50 Lonsdale St, Melbourne, Vic 3000, Australia. |
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Jazyk: | angličtina |
Zdroj: | Vaccine [Vaccine] 2021 Nov 26; Vol. 39 (48), pp. 7052-7057. Date of Electronic Publication: 2021 Oct 30. |
DOI: | 10.1016/j.vaccine.2021.10.030 |
Abstrakt: | Emerging evidence suggest a possible association between immune thrombocytopenia (ITP) and some formulations of COVID-19 vaccine. We conducted a retrospective case series of ITP following vaccination with Vaxzevria ChadOx1-S (AstraZeneca) and mRNA Comirnaty BNT162b2 COVID-19 (Pfizer-BioNTech) vaccines and compare the incidence to expected background rates for Victoria during the first six months of the Australian COVID-19 vaccination roll-out in 2021. Cases were identified by reports to the Victorian state vaccine safety service, SAEFVIC, of individuals aged 18 years or older presenting with thrombocytopenia following COVID-19 vaccination without evidence of thrombosis. Twenty-one confirmed or probable cases of ITP were identified following receipt of AstraZeneca (n = 17) or Pfizer-BioNTech (n = 4) vaccines. This translates to an observed incidence of 8 per million doses for AstraZeneca vaccine, twice the expected background rate of 4.1 per million. The observed rate for Pfizer-BioNTech was consistent with the expected background rate. The median time to onset for the cases post AstraZeneca vaccination was 10 days (range 1-78) and median platelet nadir 5 × 10 9 /L (range 0-67 × 10 9 /L). Hospital presentations or admissions for management of symptoms such as bleeding occurred in 18 (86%) of the cases. The majority of cases (n = 11) required intervention with at least 2 therapy modalities. In conclusion, we observed a substantially higher than expected rate of ITP following AstraZeneca vaccination. ITP is the second haematological adverse event, distinct from that of thrombosis with thrombocytopenia syndrome (TTS), observed following AstraZeneca vaccination. Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (Copyright © 2021 Elsevier Ltd. All rights reserved.) |
Databáze: | MEDLINE |
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