ABSTRACT
Patients rely on healthcare providers as their most credible and frequent source of vaccine information. It is therefore crucial that healthcare providers are informed and have evidence-based, objective and clear guidance on vaccine efficacy and specific adverse events following immunisation (AEFI). Reported serious AEFIs are extremely rare for the COVID-19 vaccines. This article discusses the main AEFIs attributed to COVID-19 vaccines, including neurological complications of Guillain-Barré syndrome (GBS) and acute transverse myelitis (ATM), thrombosis;cardiac complications, including myocarditis, pericarditis and cardiomyopathy;and allergic reactions such as anaphylaxis, urticaria and skin rashes. The benefits of COVID-19 vaccination outweigh the risks;however, it is important that healthcare providers are aware of the risks and know how to recognise and manage them.
ABSTRACT
The increased use of heparin during the current COVID-19 pandemic has highlighted the risk of a rare but potentially serious complication of heparin therapy, viz. heparin-induced thrombocytopenia (HIT). This is a short review on the pharmacology of heparin and its derivatives, and the pathophysiology of HIT. Guidance on laboratory testing for and clinical management of HIT is presented in accordance with international guidelines. There are important similarities and differences between HIT and the new entity of vaccine-induced immune thrombotic thrombocytopenia, also known as thrombosis with thrombocytopenia syndrome, which clinicians need to be aware of.
Subject(s)
Anticoagulants/adverse effects , COVID-19 , Heparin/adverse effects , Thrombocytopenia/chemically induced , Anticoagulants/administration & dosage , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/adverse effects , Heparin/administration & dosage , Humans , Thrombocytopenia/diagnosis , Thrombocytopenia/physiopathologyABSTRACT
There have recently been safety concerns regarding an increased risk of vaccine-induced immune thrombotic thrombocytopenia (VITT) following administration of SARS-CoV-2 adenoviral vector vaccines. The Southern African Society of Thrombosis and Haemostasis reviewed the emerging literature on this idiosyncratic complication. A draft document was produced and revised by consensus agreement by a panel of professionals from various specialties. The recommendations were adjudicated by independent international experts to avoid local bias. We present concise, practical guidelines for the clinical management of VITT.