With the world grappling with the devastating impacts of the COVID-19 pandemic, the news that AstraZeneca has openly acknowledged the rare side effects of its vaccine can be both shocking and reassuring. While the revelation may spark concerns among the public, it also signifies a commendable level of transparency and accountability on the part of the pharmaceutical giant
In the midst of the global battle against the COVID-19 pandemic, vaccines have emerged as a beacon of hope, offering a pathway out of the crisis that has gripped the world for over two years. However, along with this ray of hope comes a spectrum of concerns and questions surrounding vaccine side effects. As we navigate the complexities of vaccination and public health, it's essential to explore both the promises and challenges presented by COVID-19 vaccines.
Recently, it
has been highlighted that the AstraZeneca COVID-19 vaccine, sold under the name
of "Covishield" in India, has been associated with a rare side effect
known as Thrombosis with Thrombocytopenia Syndrome (TTS). In 2021, during the
initial year of COVID-19 vaccination, the Government committee on Adverse
Events Following Immunisation (AEFI) reviewed a minimum of 36 cases of
Thrombosis with Thrombocytopenia Syndrome (TTS) and validated 18 fatalities
attributed to it.
Thrombosis
with Thrombocytopenia Syndrome (TTS) was initially reported by European
countries early in the pandemic, leading to the banning of the drug in several
countries; however, its occurrence in India remained extremely rare. According
to the data, the best estimate of the risk of VITT/TTS following the
administration of the first dose of the AstraZeneca/COVISHIELD vaccine stands
at approximately 1 case per 50,000 doses. The incidence of TTS after the second
dose of the AstraZeneca/COVISHIELD vaccine seems to be lower than that after
the initial dose; however, it has shown an increase over time. Current
estimates suggest a rate of around 1 case per 600,000 doses.
Though no
medical condition or non-clinical parameters can contribute to TTS, young
individuals face a heightened risk of TTS, with young women frequently
encountering a more severe manifestation of the condition.
It is
crucial to understand that the risk of Thrombosis with
Thrombocytopenia Syndrome (TTS) is infrequent and highest within the first
few weeks after the initial vaccination dose. With the majority of the populace
having already received three doses and considerable time elapsed since then,
the risk diminishes significantly.
Thrombosis
with Thrombocytopenia Syndrome (TTS), also termed vaccine-induced immune
thrombotic thrombocytopenia (VITT), is a rare but severe condition
characterized by blood clots forming in unusual locations, such as the brain,
abdomen, or legs, along with low levels of platelets in the blood
(thrombocytopenia). Symptoms indicative of Thrombosis with Thrombocytopenia
Syndrome (TTS) include:
·Severe and
persistent headache
·Vision
impairment
·Speech difficulties
·Fatigue
·Seizures or
cognitive disorientation
·Breathing
difficulties
·Chest
discomfort
·Swelling in
the legs
·Persistent
abdominal pain
·Petechiae
(small red or purple spots on the skin)
The symptoms
of TTS typically occur within 4 to 28 days after receiving the vaccine.
Individuals who experience symptoms consistent with TTS after receiving a
COVID-19 vaccine are advised to seek medical attention promptly.
Like other
clinical conditions, early detection is crucial. Utilizing diagnostic
modalities such as blood tests and CT scans can aid in detection.
However, this can be challenging, especially in centers with limited prior
experience and resources.
The treatment requires a specialized
therapeutic approach due to its distinctive characteristics from conventional
blood clotting disorders. Continuous monitoring of patients and prompt
intervention, whether surgical or conservative, are imperative to enhance
patient survival rates. The treatment regimen for TTS encompasses several
modalities:
·
Administration
of anticoagulant medications, excluding heparin, to prevent clot formation.
·
Intravenous
immunoglobulin (IVIG) therapy - infusion of a blood-derived product containing
antibodies to stabilize and improve the patient's condition.
·
Prescribing
high-dose prednisone, a form of steroid medication, to alleviate symptoms and
mitigate the inflammatory response.
While
vaccine side effects have raised concerns and prompted vigilance, they must be
viewed within the broader context of the remarkable achievements vaccines have
brought forth. Simultaneously, continued monitoring, research, and
collaboration with regulatory agencies must be carried out to mitigate risks
and address any concerns that may arise. Formulating strategies to enhance
vaccine safety and efficacy can pave the way for improved formulations and
novel approaches to combat the virus.
By remaining steadfast in our commitment to vaccination, coupled with proactive measures to mitigate risks and address concerns, we can navigate the road ahead with resilience and determination, ultimately emerging stronger in our fight against COVID-19.
1.
Jain N, Chaudhary P,
Shrivastava A, Kaur T, Kaur S, Brar HS, Jindal R. Thrombosis with
Thrombocytopenia Syndrome (TTS) After ChAdOx1 nCoV-19 Immunization: An
Investigative Case Report. Am J Case Rep. 2023 Mar 18;24:e938878. doi:
10.12659/AJCR.938878. PMID: 36932639; PMCID: PMC10037117.
3. Thrombosis with
Thrombocytopenia Syndrome (TTS) [Internet]. Healthdirect Australia. Available
from: https://www.healthdirect.gov.au/thrombosis-with-thrombocytopenia-syndrome-tts#:~:text=Treatment%20for%20TTS%20included%3A,a%20type%20of%20steroid%20medicine.
4. COVID-19 Vaccinations
[Internet]. British Columbia Centre for Disease Control. Available from: http://www.bccdc.ca/health-professionals/clinical-resources/covid-19-care/covid-19-vaccinations/thrombosis-with-thrombocytopenia-syndrome.