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The question had been asked for weeks: what are the real risks of clots forming after inoculation with the Oxford-AstraZeneca vaccine?
The European Medicines Agency (EMA) finally shed light on the subject on Wednesday: the conclusion of thrombi should be included rare side effect that may appear in some recipients of this covid-19 vaccine.
The risk of dying from a disease like this is as low as one in a million. On the contrary, covid-19 kills one in eight infected people over the age of 75, and one in 1000 infected symptomatically with about 40 years.
For this reason, authorities and scientists have insisted that the benefits of AstraZeneca outweigh the risks.
But what is the explanation behind the appearance of these thrombi? What causes this immune fluid in a few people that causes them to develop blood clots?
Although the answer is not entirely clear yet as it is still under investigation, the European agency itself has provided some clues: A plausible explanation they say is that the vaccine can trigger an immune response leading to an immune response. atypical disorder similar to heparin-induced thrombocytopenia (HIT).
Heparin is an anticoagulant and TIH disorder, caused by the immune system, is an adverse drug reaction that activates platelets and clotting, resulting in increased thrombus formation.
In the scientific community, this theory was discussed a few weeks ago after a team of doctors in Germany suggested it. March 19 name it “vaccine-induced immune thrombotic thrombocytopenia”, abbreviated in VITT, for its acronym in English (or VIPIT, according to the first study of the German team).
Now, how did this conclusion come to be?
Investigations at the origin of these thrombus cases revealed that all patients with low number of platelets, blood cells that normally help repair bleeding in the body.
It was also concluded that patients had this particular antibody, similar to HIT, in their blood which activates platelets.
German scientists led by University of Greifswald coagulation specialist Andreas Greinache published the final results of their research on April 9 in the New England Journal of Medicine.
In this study, they analyzed the characteristics of 11 patients in Germany and Australia, who developed one or more thrombosis or thrombocytopenia events after surgery. vaccination with AstraZeneca.
Of these patients, nine were women, with an average age of 36 years.
Between 5 and 16 days after vaccination, all patients presented one or more thrombosis events, with the exception of one, who had an intracranial hemorrhage which resulted in death.
Of the patients who had more than one thrombosis event, nine had venous thrombosis; three had thrombosis in the abdomen (splanchnic vein thrombosis); three had pulmonary embolism; and four others had another type of thrombosis.
Of the 11 patients studied, six died.
None of them had received heparin before the onset of symptoms, but they produced the HIT-like antibody.
This antibody, which was activated by the AstraZeneca vaccine, causes platelets to clump together by mistake and form clots.
According to research by the German team, VITT is a “very rare” reaction and, if identified early, it is “treatable”.
“We know what to do: how to diagnose it and how to treat it,” said Greinacher. “And the sooner the treatment is done, the better,” he added.
At a press conference on Friday, the German scientist further said that although studies are still lacking, it is likely that individual factors in those affected are triggering this side effect.
“Otherwise, we would see this problem in many more people, which fortunately is not the case (…). This is excellent news for the vaccination program because otherwise it would have been the risk of many other vaccines immunizing. “, he assured.
However, although the European agency said that most of the reported thrombus cases had occurred in women under the age of 60, it was not possible to conclude whether age, gender or medical records may be additional risk factors.
But this risk seems to increase younger people.
In fact, UK authorities have decided that since healthy people under the age of 30 are less likely to become seriously ill from COVID-19, the balance between risks and benefits means that they should be offered a different vaccine from AstraZeneca.
Regarding the contraceptive pill – which, in general, increases the likelihood of developing a thrombus six times – Dr Greinacher said it was probably not an attenuator of the occurrence of thrombi.
The European regulatory agency said medical professionals can help those affected in their recovery and avoid complications. So, he called on people to seek medical assistance if symptoms develop.
Some of these symptoms are: shortness of breath, blurred vision, severe and persistent headache, chest pain, swelling of the legs, persistent abdominal pain, and small patches of blood under the skin, among others.
On the other hand, most of the cases studied show that the appearance of clots can occur between four days and a few weeks after a person has received the vaccine.
UK medical experts, if any, suggest that this rare condition should be considered in anyone with similar symptoms for up to a month after being inoculated.
The discovery of this disorder and its treatment can be very useful for the development of the mass vaccination campaign against covid-19 around the world.
Currently, several countries around the world are heavily dependent on AstraZeneca.
In the UK, for example, 31 million people were vaccinated with the first dose and for the most part AstraZeneca was used.
Other European countries, like Germany, France, Italy and Spain, have experienced delays in their vaccination campaigns and one of the reasons is precisely the suspension of AstraZeneca after it was decided to apply only to under 59 and first records. appearance of blood clots.
This caused several Hundreds of thousands of doses of AstraZeneca go unused. This is the case in Germany, where the Minister of Health himself, Jens Spahn, admitted in March that only 15% of the available doses had been administered.
However, in the coming weeks, the European regulatory agency plans to publish more information on thrombi caused by the vaccine.
Authorities and scientists hope that these doubts will be glimpsed and the most difficult mass vaccination campaign in history will continue.
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