“As a blood clot expert, I can tell you that it is the greatest blood clotting disease we have ever seen in our lives,” said Dr. Alex Spyropoulos, a professor at the Feinstein Institute for Medical Research in New York.
“I’ve been doing this for a quarter of a century. I’ve never seen these levels of blood clots.”
So they find it ironic that fears about a much rarer type of blood clot can now scare people away from getting vaccinated.
Last week, the U.S. Centers for Disease Control and Prevention and the U.S. Food and Drug Administration recommended a break in the administration of Johnson & Johnson Janssen coronavirus vaccine while experts Iinvestigate if it can cause blood clots and, if so, what to do about it.
The European Medicines Agency said on Tuesday it had found a possible link, but said the overall benefits of the vaccine outweigh the risks. For use in the EU, the agency said the vaccine should include a warning about “unusual blood clots with low blood platelets” as “very rare side effects”.
The CDC Advisory Committee on Immunization Practices met last week to discuss the issue and decided to wait for more information after discussing the cases of six women who developed a very unusual type of blood clot after receiving the J & V vaccine. J, as well as other possible cases. They will meet again on Friday to come up with recommendations, which could include an additional warning to help vaccine recipients and doctors look for symptoms or restrictions on who should receive the J&J vaccine.
Whatever the risk of vaccines, experts agree that it is extremely low.
“You run the risk of being struck by lightning as one of those rare blood clots,” Spyropoulos told CNN.
Multiple risk factors
Blood clots in general are extremely common – affecting 900,000 Americans a year, according to the CDC. About 100,000 people are killed each year. Particularly common are brain clots. About 795,000 people suffer from strokes each year in the United States, according to the American Heart Association. The group estimates that 10-15% of them are in adults under the age of 45.
Risk factors for regular blood clots include surgery, accidents, cancer treatments and even sitting for too long, said Dr. Mark Crowther, a hematologist and thrombosis expert for the American Society of Hematology.
“There are some weak risk factors – for example, airline travel if you’re flying from Hawaii to Los Angeles,” Crowther told CNN. “Prolonged car travel is a risk factor,” added Crowther, who is chair of the medical department at McMaster University in Canada.
And being infected with coronavirus greatly increases this already common risk.
The vaccine undoubtedly dramatically reduces the risk of any blood clots associated with Covid, Crowther said.
“The chances of getting what we call vaccine-induced thrombotic immune thrombocytopenia or VITT is one in a million,” Spyropoulos said.
“The chances of being hospitalized with Covid are about one in 100 for the adult population. The chances of having a blood clot once you’ve been hospitalized are probably one in five or one in six.” This risk increases to 1 in 3 for people in the ICU, Spyropoulos said.
“The benefits of any vaccine far outweigh the risks – the period,” he said.
“This vaccine complication is extremely rare. Certainly, more people will be killed with a gun in the United States than through these complications,” Crowther agreed.
Rare forms of blood clots related to vaccines are a type that becomes obvious. They block the veins that lead to the brain and cause severe headaches or severe abdominal pain.
But it grows slowly, giving people a chance to get the right treatment – if they look for it on time.
Now, media reports are beginning to appear about people suffering from more common blood clots after being vaccinated. They are unlikely to be caused by the vaccine, but it is difficult for people who are not trained in medicine to know the difference, Crowther said.
Vaccination, especially against Covid, is a memorable event and it is natural for people to suffer from a health problem shortly after they have been vaccinated so that they can associate it with that vaccine.
“Vaccination hesitation is a real problem. There is no way an ordinary person can understand the extent of the risks,” Crowther said. The results can be more deadly than blood clots.
Uncomplicated treatment
The good news is that VITT treatment is not complicated, experts agreed.
“Any hospital in the United States would be well positioned to manage these blood clotting complications,” Crowther said.
What is important at the moment is for doctors to avoid using another common blood thinner known as heparin. Heparin itself can cause the same antibody reaction seen in VITT – and, in fact, doctors familiar with the heparin-related reaction have noticed what could happen with vaccines and blood clots.
Narrative signs of this rare reaction include not only blood clots, but also low levels of platelets, which help the blood to clot.
This seems to be a contradiction, but Spyropoulos says that what is happening is an immune reaction in which antibodies target platelets. “They form a complex that causes platelet agglomeration,” he said.
Platelets disappear from circulation as they become blocked. “You see some kind of gunk,” Spyropoulos said.