COVID-19 Curbside Consults

Thrombotic thrombocytopenia due to SARS-CoV-2 vaccination

Keith R. McCrae, MD
Cleveland Clinic Journal of Medicine May 2021, DOI: https://doi.org/10.3949/ccjm.88a.ccc078

Article Figures & Data

Tables

  • TABLE 1

    Current SARS-CoV-2 vaccines

    VaccineNomenclatureType/vectorAntigenUS approvalEuropean approval
    ModernamRNA-1273mRNA in lipid nanoparticlesStabilized, prefusion spike proteinEmergency Use Authorization (EUA)Conditional Marketing Authorisation (CMA)
    Pfizer-BioNTechBNT162b2 (EU-Cominarty)mRNA in lipid nanoparticlesStabilized, prefusion spike proteinEUACMA
    Johnson & Johnson/JanssenAd26.COV2-SAdenovirus 26 (species A)Stabilized, prefusion spike proteinEUACMA
    Astra-ZenecaChAdOx1 nCoV19 (AZD1222, Vaxzevria)Chimpanzee adenovirus (species E)Unmodified spike protein–CMA
  • TABLE 2

    Indications for initiating treatment of suspected VITT

    Thrombocytopenia and a positive PF4-polyanion test in the presence of thrombosis
    High clinical suspicion of VITT based on the presence of thrombosis and thrombocytopenia after vaccination, even when PF4-polyanion ELISA results are pending
    Thrombocytopenia and a positive PF4-polyanion ELISA, with or without a very high or increasing D-dimer level, even in the absence of thrombosis

    • ELISA = enzyme-linked immunosorbent assay; VITT = vaccine-induced thrombotic thrombocytopenia

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