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An observational study to identify the prevalence of thrombocytopenia and anti-PF4/polyanion antibodies in Norwegian health care workers after COVID-19 vaccination.
Sørvoll, Ingvild Hausberg; Horvei, Kjersti Daae; Ernstsen, Siw Leiknes; Laegreid, Ingvild Jenssen; Lund, Svetlana; Grønli, Renathe Henriksen; Olsen, Magnus Kringstad; Jacobsen, Hege Karine; Eriksson, Anna; Halstensen, Anne Marie; Tjønnfjord, Eirik; Ghanima, Waleed; Ahlen, Maria Therese.
  • Sørvoll IH; Norwegian National Unit for Platelet Immunology, Department of Laboratory Medicine, University Hospital of North Norway, Tromsø, Norway.
  • Horvei KD; Norwegian National Unit for Platelet Immunology, Department of Laboratory Medicine, University Hospital of North Norway, Tromsø, Norway.
  • Ernstsen SL; Norwegian National Unit for Platelet Immunology, Department of Laboratory Medicine, University Hospital of North Norway, Tromsø, Norway.
  • Laegreid IJ; Norwegian National Unit for Platelet Immunology, Department of Laboratory Medicine, University Hospital of North Norway, Tromsø, Norway.
  • Lund S; Norwegian National Unit for Platelet Immunology, Department of Laboratory Medicine, University Hospital of North Norway, Tromsø, Norway.
  • Grønli RH; Norwegian National Unit for Platelet Immunology, Department of Laboratory Medicine, University Hospital of North Norway, Tromsø, Norway.
  • Olsen MK; Department of Research, Østfold Hospital, Grålum, Norway.
  • Jacobsen HK; Department of Research, Østfold Hospital, Grålum, Norway.
  • Eriksson A; Department of Research, Østfold Hospital, Grålum, Norway.
  • Halstensen AM; Department of Research, Østfold Hospital, Grålum, Norway.
  • Tjønnfjord E; Department of Emergency Medicine, Østfold Hospital, Grålum, Norway.
  • Ghanima W; Department of Medicine, Hematology and Research, Østfold Hospital, Grålum, Norway.
  • Ahlen MT; Department of Haematology, Institute for Clinical Medicine, University of Oslo, Oslo, Norway.
J Thromb Haemost ; 19(7): 1813-1818, 2021 07.
Article in English | MEDLINE | ID: covidwho-1205972
ABSTRACT

BACKGROUND:

The COVID-19 vaccine from AstraZeneca (AZD1222) is one of several vaccines introduced to provide immunity against SARS-CoV-2. Recently, more than 50 cases have been reported presenting a combination of thrombosis, thrombocytopenia, and remarkably high levels of anti-platelet factor 4 (PF4)/polyanion antibodies post-AZD1222 vaccination. Now linked to the vaccine, the condition is referred to as vaccine-induced immune thrombotic thrombocytopenia. The European Medicines Agency still recommends vaccination with AZD1222, but several European countries have temporally paused and/or restricted its use because of the perceived risk of this severe side effect. Because there is no description of PF4/polyanion antibody testing in the clinical trials, knowledge about the prevalence of such antibodies in a vaccinated cohort is needed.

OBJECTIVES:

To investigate prevalence of thrombocytopenia and anti-PF4/polyanion antibodies in a population recently vaccinated with AZD1222. PATIENTS/

METHODS:

Four hundred and ninety-two health care workers recently vaccinated with the first dose of AZD1222 were recruited from two hospitals in Norway. Study individuals were screened for thrombocytopenia and the presence of anti-PF4/polyanion antibodies with a PF4/PVS immunoassay. Side effects after vaccination were registered.

RESULTS:

The majority of study participants had normal platelet counts and negative immunoassay. Anti-PF4/polyanion antibodies without platelet activating properties were only detected in six individuals (optical density ≥0.4, range 0.58-1.16), all with normal platelet counts. No subjects had severe thrombocytopenia.

CONCLUSIONS:

We found low prevalence of both thrombocytopenia and antibodies to PF4/polyanion-complexes among Norwegian health care workers after vaccination with AZD1222.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thrombocytopenia / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Vaccines Limits: Humans Country/Region as subject: Europa Language: English Journal: J Thromb Haemost Journal subject: Hematology Year: 2021 Document Type: Article Affiliation country: Jth.15352

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thrombocytopenia / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Vaccines Limits: Humans Country/Region as subject: Europa Language: English Journal: J Thromb Haemost Journal subject: Hematology Year: 2021 Document Type: Article Affiliation country: Jth.15352