Who is at risk of thrombosis? What are the symptoms to watch out for after the vaccine?

Who is at risk of thrombosis? What are the symptoms to watch out for after the vaccine?
Who is at risk of thrombosis? What are the symptoms to watch out for after the vaccine?

Although it has given an important impetus to the vaccination campaign globally, the AstraZeneca vaccine continues to be at the center of the storm. After the death of the 18-year-old Ligurian, Camilla Canepa, after receiving the first dose of AstraZeneca the alarm returns. And also the doubts and perplexities of the citizens.

Who is most at risk of developing thrombosis after the vaccine?

In April, the Italian Medicines Agency (Aifa) issued a recommendation, not a stringent obligation, for the use of viral vector vaccines in people over 60 years of age. Initially Vaxzevria was only recommended for people under 55. “Autoimmunity is more frequent in young women and the incidence of Vitt (vaccine-induced immune thrombotic thrombocytopenia) confirms this feature – he says. Pier Mannuccio Mannucci, haematologist and member of the Aifa commission for the evaluation of thrombosis risk associated with anti Covid vaccines interviewed by Corriere della Sera -. Autoimmune diseases generally have two peaks, in young and old age. In this case, however, except in rare cases, rare thrombosis does not affect the elderly ”.

The reason why there is a lot of confusion on this issue is probably due to the fact that up to now the scientific literature can make use of little data. The pandemic has accustomed us to understand things from time to time and the same goes for scientists. The certainties so far are few but solid. Experts point out that the risk of developing thrombosis is 1 in 100 thousand so not a common risk. Currently, the scientific literature has shown that those who have received the first dose and have had no reactions can do the second dose without problems. And this is also written in the AIFA guidelines.

Caution may be required for those with low platelets but, unless thrombophilia has already been ascertained, it is difficult to be certain that the vaccine will not trigger a thrombosis and there are currently no tests recommended prior to getting the vaccine.

What symptoms to watch out for after the vaccine?

Annalisa Capuano, Clinical Pharmacologist at AOU “Luigi Vanvitelli” in Naples, Full Professor (University of Campania “L. Vanvitelli”) and responsible for pharmacovigilance center of the Campania Region explained to the Riformista the symptoms of thrombosis. “According to the Italian Medicines Agency, you should see your doctor immediately if you experience any of the following symptoms within 3 weeks of the injection: shortness of breath, chest pain, leg swelling, leg pain, abdominal pain ( persistent abdominal pain) and neurological symptoms, such as severe and persistent headache, blurred vision, confusion or seizures, unusual skin bruising or petechiae found outside the injection site ”.

When can thrombosis symptoms occur after the vaccine?

The Ministry of Health explained in an information note the correlation between the AstraZeneca vaccine and the possibility that these can cause thrombosis. “Following the administration of Vaxzevria blood clots have been observed very rarely – the note reads – often in unusual sites (eg brain, intestine, liver, spleen), in association with low levels of platelets, in some cases with the presence of bleeding. This condition included severe cases with blood clots in different or unusual sites as well as excessive clotting or bleeding throughout the body ”. Most of these cases occurred in the first fourteen days following vaccination and occurred mainly in women under 60 years of age. In some cases this condition has resulted in death.

Are there effective treatments for thrombosis after the vaccine?

It is important that the disorder is treated quickly: the protocol provides for the administration of immunoglobulins and anticoagulants. Vitt is clinically very similar to “heparin-induced autoimmune thrombocytopenia”, which is why this drug cannot be used in post-vaccine thrombosis.

Can I change my vaccine after the first dose of AstraZeneca?

Those under 60 who received the first dose of the AstraZenca vaccine can also booster, again with the Anglo-Swedish company’s serum. The Italians were reassured by the Minister of Health Roberto Speranza during the Question time in the Senate by answering the question on the realization of the recent Open-days which reserved the AstraZeneca vaccine for young subjects.

“The EMA recommended that the use of AstraZeneca during national vaccination campaigns take into account the pandemic situation and the availability of vaccines in individual countries. On 7 April 2021 the Ministry of Health, through a circular in force today, recommended a preferential use of this vaccine in people over 60 years of age on the basis of current evidence and taking into account the low risk of adverse reactions of the thromboembolic type in the face of of the high mortality of Covid-19 in the most advanced age groups. At the end of April – he recalls – the EMA concluded a further evaluation by analyzing the benefits and risks of the vaccine in the different age groups and in different epidemiological scenarios. The results showed that the benefits of vaccination increase with increasing age and the level of circulation of the virus. These data were assessed by AIFA and it was reiterated that the benefit-risk profile is progressively more favorable with increasing age. The effect is all the more marked in a condition of decreased incidence of infection. In recent weeks Italy has now gone to a low level of circulation. These assessments will certainly be considered in the next CTS opinion “.

How many adverse reactions after the vaccine have been reported in Italy?

Pharmacovigilance has received reports of 45 cases of rare thrombosis on nearly nine million doses of Vaxzevria. According to the drug Agency’s fifth Covid vaccine surveillance report, there were 328 deaths in our country (data May 26), of which 53 after Vaxzevria, 4 after Janssen (Johnson & Johnson) and 58 after Moderna. Most (213) have been reported with Comirnaty (BioNTech / Pfizer), the first vaccine authorized and used in larger quantities than the others. But no thrombotic events were observed with mRna vaccines. In Italy, in total, over 40 million doses have been administered.

Graduated in Philosophy, born in 1990, she is passionate about politics and technology. She is in love with Naples whose thousand facets she tries to tell, telling people’s stories, trying to stay away from stereotypes.

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Elena Del Mastro

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