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The European Medicines Agency has said that, as of April 20, there have been 287 reports of rare blood clots with low platelets after administration of the AstraZeneca vaccine, eight with Johnson & Johnson, 25 with Pfizer, and five with Moderna.
Two Distinct Processes Lead to Low Platelets
In general, two distinct processes can result in thrombocytopenia, or low platelets. The first process involves platelet clearance, and it's an immune process. "With clearance, the body's immune system actually destroys the platelets, which brings the platelet count down and can lead to bleeding," Gaddh said.
The second process involves consumption of platelets when they become activated, and go about their normal job of stimulating the clotting system and aggregating to form blood clots. If the consumptive process gets out of control, platelets get used up and their numbers drop.
"In consumption, platelets are actually getting activated. That activates the clotting system to make the platelets aggregate together, which brings down the platelet count and favors clotting in the body," Gaddh said.
When it comes to management, because of the similarity of VITT to HIT, experts are advising IV immunoglobulin, use of non-heparin anticoagulants, and avoidance of platelet transfusions. The International Society on Thrombosis and Haemostasis has provided guidance for the diagnosis and treatment of VITT, as has the American Society of Hematology.
The European Union’s drug regulator said on Tuesday there had been more than 300 cases worldwide of rare blood clotting incidents combined with low platelet counts after use of COVID-19 vaccines.
There were 287 occurrences with the AstraZeneca vaccine, eight with Johnson & Johnson’s shot, 25 for Pfizer and five for Moderna, said Peter Arlett, Head of Data Analytics at the European Medicines Agency (EMA).