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26 April 2021: Editorial

Editorial: SARS-CoV-2 mRNA Vaccines and the Possible Mechanism of Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT)

Dinah V. Parums *

DOI: 10.12659/MSM.932899

Med Sci Monit 2021; 27:e932899

Abstract

ABSTRACT: During 2020 and 2021, the global pandemic of coronavirus disease 2019 (COVID-19) due to severe acute respi- ratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in high death rates and acute and chronic morbidity in all countries. The rapid development of new mRNA vaccines to SARS-CoV-2 brings hope that the spread of this virus can be controlled. The ChAdOx1 nCoV-19 vaccine developed by a collaboration between the University of Oxford and AstraZeneca showed efficacy in clinical trials, with a good safety profile. However, there have been recent reports of the rare development of thrombotic events in young women following vaccination with ChAdOx1 nCoV-19, particularly of the rare condition of cavernous sinus thrombosis. Studies have begun to in- vestigate whether antibodies to the SARS-CoV-2 spike cross-react with platelet factor 4 (PF4/CXLC4) and mim- ic autoimmune heparin-induced thrombocytopenia. This Medical Science Monitor Editorial aims to briefly update the current status of studies on a possible rare complication of using new mRNA vaccines to prevent COVID-19.

Keywords: Editorial, Thrombotic thrombocytopenic purpura, acquired, Adverse Drug Reaction Reporting Systems, platelet factor 4, vaccin, COVID-19, severe acute respiratory syndrome coronavirus 2

Conclusions

SARS-CoV-2 vaccines represent hope for reducing the prevalence and severity of acute COVID-19 and possibly ‘long COVID.’ Population epidemiological monitoring in countries that established early and full vaccination programs have shown reduced mortality rates from SARS-CoV-2. However rare, the mechanism for VITT requires urgent investigation to identify risk factors that may guide the use of alternative vaccines and reduce concerns that may deter compliance with global vaccination programs.

References

1. :: Center for Systems Science and Engineering (CSSE)

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3. Polack FP, Thomas SJ, Kitchin N: Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine: N Engl J Med, 2020; 383(27); 2603-15

4. Voysey M, Clemens SAC, Madhi SA: Oxford COVID Vaccine Trial Group: Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: An interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK. Lancet, 2021; 397(10269); 99-111

5. Schultz NH, Sørvoll IH, Michelsen AE: Thrombosis and thrombocytopenia after ChAdOx1 nCoV-19 vaccination: N Engl J Med, 2021; [Online ahead of print]

6. Schultz NH, Sørvoll IH, Michelsen AE: Joint CDC and FDA Statement on Johnson & Johnson COVID-19: Vaccine, 2021

7. Chauhan N, Soni S, Gupta A, Aslam M, Jain U: Interpretative immune targets and contemporary position for vaccine development against SARS-CoV-2: A systematic review: J Med Virol, 2021; 93(4); 1967-82

8. Chauhan N, Soni S, Gupta A, Aslam M, Jain U:: MHRA issues new advice, concluding a possible link between COVID-19 vaccine AstraZeneca and extremely rare, unlikely to occur blood clots, 2021

9. Greinacher A, Thiele T, Warkentin TE: Thrombotic thrombocytopenia after ChAdOx1 nCov-19 vaccination: N Engl J Med, 2021; [Online ahead of print]

10. Oldenburg J, Klamroth R, Langer F: Diagnosis and management of vaccine-related thrombosis following AstraZeneca COVID-19 vaccination: Guidance statement from the GTH: Hamostaseologie, 2021; [Online ahead of print]

Errate

Med Sci Monit 2021; 27:e932986     https://www.medscimonit.com/abstract/index/idArt/932986
ABSTRACT The Oxford-AstraZeneca vaccine, ChAdOx1 nCoV-19 (AZD1222), uses double-stranded DNA, while the Pfizer-BioNTech and Moderna vaccines include single-stranded RNA to encode the SARS-CoV-2 spike protein. Reference: Parums DV. Editorial: SARS-CoV-2 mRNA Vaccines and the Possible Mechanism of Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT). Med Sci Monit 2021; 27:e932899; 10.12659/MSM.932899

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750