An 18-year-old girl is admitted to the San Martino hospital in Genoa and has undergone two urgent surgeries after being diagnosed with cerebral venous thrombosis following vaccination with AstraZeneca. The girl had voluntarily vaccinated herself before taking her final exams.
The story of the 18-year-old girl with cerebral venous thrombosis after the AstraZeneca vaccine
The 18-year-old had received the vaccine during the Open day with no age limit for bookings wanted by the Liguria Region on 25 May last in her local ASL. Then on June 3 she had the first symptoms: headache and photophobia. After undergoing brain scan and neurological examination, both negative, she was discharged with the recommendation to repeat the blood tests after 15 days. On 5 June she returned to the emergency room with a motor deficit to an emilate. Subjected to cerebral CT scan with hemorrhagic outcome, she was immediately transferred to the Neurosurgery of San Martino.
La Stampa says today that the girl was operated on to remove a thrombus. The second surgery served to relieve the intracranial pressure resulting from the hemorrhage. The San Martino management activated the required reports in the context of pharmacovigilance procedures against Aifa. And he also indicated the drugs taken after vaccination, since it is not excluded that it may have been the interaction with a drug that had been prescribed to complicate the situation.
The president of the Liguria Region, Giovanni Toti, spoke about the 18-year-old on Facebook: “We pray and we are close to the 18-year-old girl hospitalized in neurosurgery at the San Martino hospital in Genoa a few days after the voluntary administration of the AstraZeneca vaccine. contact with our doctors who are working tirelessly in the operating room to save her life: after a first operation to remove the thrombus, a second operation is now underway. The whole of Liguria tightens around the girl’s family, who has remained constantly at his side in the hospital “.
AstraZeneca and the risk of thrombosis
In the case of the 18-year-old, awaiting the response of the experts, it could be, as recounted in recent days by the Aifa report, of those rare cases characterized by thrombosis of the cerebral venous sinuses (TSVC) and / or thrombosis of the splanchnic veins, often associated the presence of thrombus in multiple sites and thrombocytopenia, with severe bleeding and sometimes signs of disseminated intravascular coagulation (DIC). These events were almost exclusively observed within approximately three weeks of vaccination in healthy subjects less than 60 years of age, predominantly women. And with a very low frequency: for the Vaxzevria vaccine, a total of 169 cases of cerebral venous sinus thrombosis and 53 cases of splanchnic vein thrombosis, often associated with thrombocytopenia, have been reported, out of a total of 34 million doses administered between the EU and UK.
For events of venous thrombosis in atypical sites associated with thrombocytopenia, a rate of approximately one case per 100,000 vaccinated has been estimated. The cases reported in the UK pharmacovigilance systems in the latest report published on 20 May are also in line with this figure (309 cases for 23.9 million first doses with Vaxzevria vaccine). In Italy as of April 26, 34 cases of venous thrombosis in atypical sites have been reported, 18 of which associated with thrombocytopenia4. Compared to the administrations carried out with Vaxzevria, therefore, 0.45 cases per 100,000 vaccinated are observed, since it could be affected by the lower representativeness of the Italian sample compared to European and Anglo-Saxon data.
According to research by German scientists there is a specific cause of blood clots and thromboembolic complications that have emerged in some rare cases in vaccinations with Vaxzevria (ChAdOx1 nCov-19, AstraZeneca) or with COVID-19 Vaccine Janssen from Johnson & Johnson. And it is potentially solvable. According to Rolf Marschalek, a professor at the Goethe University of Frankfurt, the problem is related to the adenovirus vectors that both vaccines (AstraZeneca & J&J) use to deliver the genetic instructions for the SARS-Cov-2 spike protein in the body. The mRNA vaccines developed by Pfizer / BioNTech and Moderna are immune to it because they do not use this delivery system: for this reason there have been no cases of blood clotting related to them.
The solution to the problem of adverse reactions to AstraZeneca and J&J vaccines?
In the research published in pre-print (and therefore not yet peer-reviewed), scientists state that the problem lies in the moment of adenovirus entry into the cell nucleus. The life cycle of adenovirus includes “infection” of the cells and the entry of adenoviral DNA into the nucleus; subsequently the gene transcription takes place. And herein lies the problem: viral DNA, according to Marschalek and co-signers Eric Kowarz, Lea Krutzke, Jenny Reis, Silvia Bracharz and Stefan Kochanek, once inside the cell nucleus some parts of the spike protein join or divide , creating mutant versions, which are unable to bind to the cell membrane where immunization occurs. On the other hand, floating mutant proteins are secreted by cells in the body – according to Marschalek’s theory – and thus trigger blood clots in about one in 100,000 people.
Professor Marschalek argues that vaccines can be redesigned to avoid the problem. Indeed, J&J is already in contact with him and is trying to optimize the serum, while there have been no contacts with AstraZeneca yet. The way out of the research is to modify the sequence of the spike protein to prevent separation from occurring. And thus nullifying the possibility of side effects or adverse reactions.