Abstract

We report findings in five patients who presented with venous thrombosis and thrombocytopenia 7 to 10 days after receiving the first dose of the ChAdOx1 nCoV-19 adenoviral vector vaccine against coronavirus disease 2019 (Covid-19). The patients were health care workers who were 32 to 54 years of age. All the patients had high levels of antibodies to platelet factor 4-polyanion complexes; however, they had had no previous exposure to heparin. Because the five cases occurred in a population of more than 130,000 vaccinated persons, we propose that they represent a rare vaccine-related variant of spontaneous heparin-induced thrombocytopenia that we refer to as vaccine-induced immune thrombotic thrombocytopenia.

Keywords

MedicineThrombosisVaccinationHeparinPlateletHeparin-induced thrombocytopeniaAntibodyVenous thrombosisImmunologyPlatelet factor 4PopulationCoronavirus disease 2019 (COVID-19)Internal medicineDiseaseInfectious disease (medical specialty)

MeSH Terms

AdultAutoantibodiesAutoimmune DiseasesBlood Chemical AnalysisCOVID-19 VaccinesChAdOx1 nCoV-19Enzyme-Linked Immunosorbent AssayFatal OutcomeFemaleHumansMaleMiddle AgedPlatelet AggregationPlatelet CountPlatelet Factor 4ThrombocytopeniaThrombosis

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Publication Info

Year
2021
Type
article
Volume
384
Issue
22
Pages
2124-2130
Citations
1471
Access
Closed

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Cite This

Nina Haagenrud Schultz, Ingvild Hausberg Sørvoll, Annika E. Michelsen et al. (2021). Thrombosis and Thrombocytopenia after ChAdOx1 nCoV-19 Vaccination. New England Journal of Medicine , 384 (22) , 2124-2130. https://doi.org/10.1056/nejmoa2104882

Identifiers

DOI
10.1056/nejmoa2104882
PMID
33835768
PMCID
PMC8112568

Data Quality

Data completeness: 86%