One of the most important inventions in recent months is the Covid-19 vaccine. Although at the beginning it seemed impossible to achieve it in such a short time, in the end it was possible. To achieve this, a millionaire investment was required and to comply with all health protocols. This involved submitting biological tests to clinical trials to verify their correct operation. Although some have shown correct operation, it has also been detected that they cause adverse effects. Within the list, the most serious and even fatal is Vaccine-Induced Immune Thrombotic Thrombocytopenia (TTIIV).
Probability of it happening
In that sense, all part of an investigation published in the New England Journal of Medicine. According to the figures presented, one case occurs for every 50 thousand people who receive the immunization in the group under 50 years of age. While when they are over that age the figure is one for every 100,000 people.
The cumulative incidence of this affectation after vaccination with an immunization based on non-replicating adenovirus vectors varies from 0.5 to 6.8 cases per 100,000 vaccinated people. Incidence rates differ by vaccine, age, sex, geographic distribution, and interpretation of the case definition. So far it has been confirmed that this syndrome occurs predominantly in women (more than 80 percent) and in those under 60 years of age, characterized by the presence of:
- Venous-predominant thrombosis, particularly in rare sites including intracerebral or intra-abdominal (splanchnic) veins.
- Moderate to severe thrombocytopenia, mean: 20,000 platelets / µL (range 9,000 to 113,000 / µL).
- Antibodies against Platelet Factor 4 (F4P) and / or specific functional tests of platelet activation.
So far there are two types of vaccines that are associated with TTIIV. On the one hand, the syndrome begins between 4 and 30 days after the application of the AZD1222 immunization of AstraZeneca and less frequently with Johnson & Johnson.
Why happens?
At the moment, it has been attributed to the interaction of an antigen made up of a component of the vaccine not yet specified and F4P (as occurs in Heparin-Induced Thrombocytopenia), a complex that induces the formation of anti-F4P antibodies, which bind to specific receptors. located in platelets, some inflammatory cells, and the inner lining of blood vessels. This leads to the activation of coagulation and the formation of thrombi in blood vessels, being in parallel, a decrease in the number of platelets in the circulation, due to the fact that they are trapped in the clots or that they are destroyed by anti-F4P antibodies. , which could lead to bleeding.
For all of the above, it is essential that all health professionals know the fundamentals about this side effect. Although its incidence is very low, it can occur at any time and even deaths have already been reported.
All of the above led the Ministry of Health (SSa) to publish the first Mexican guide for the detection of suspected cases in the medical units of first contact. The objective of the document is to propose operational definitions that contribute to the timely detection of suspected and / or probable cases of TTIIV. In this way, timely referral to the hospital centers where they will receive the appropriate treatment can be ensured.
Therefore, it is essential that you as a health professional know the following information. It does not matter which institution you work for because it is data of general interest. The document is freely accessible and you can download it at this link.