A physician died of severe thrombocytopenia (low platelets) a few weeks after #COVID19 vaccine

His death is currently being investigated and is not currently thought to be 2/2 the vaccine.

A 1/x https://www.nytimes.com/2021/01/12/health/covid-vaccine-death.html?smid=tw-share

The differential dx for severe thrombocytopenia includes ITP.

ITP has been reported (uncommonly) following vaccination and has also been seen with #COVID19 infection.

A systematic review of #COVID19 ITP in September included 45 cases (Bhattacharjee)
2/x

71% of cases were >50yo & 75% had mod-severe #COVID19. 31% had no COVID sx. One case was described of intracranial hemorrhage but severe life threatening bleeding was rare.

ITP is an autoimmune condition in which autoantibodies are formed against platelets & destroy them.

3/x

It can be idiopathic or associated with other conditions
(in kids, often infection).

ITP has been seen following vaccination w/MMR the most common offender.

It's been hypothesized to develop 2/2 molecular mimicry, epitope spreading, & polyclonal activation.

4/x

There are many treatments for ITP including splenectomy.

Splenectomy is generally reserved for refractory cases and would not commonly be done w/in the first few weeks.

ITP following vaccination is typically responsive to IVIG & can self resolve.

5/x

Although ITP related to vaccinations is reported, it more commonly occurs following natural infxn (O'Leary Pediatrics 2012, Rajantie 2007)

As stated in the article, millions of vaccines of many types are given each year & clusters of this platelet disorder do not occur.

6/x

I look forward to hearing the outcome of the investigation but hope this case does not deter anyone from receiving their #COVID19 vaccination & the protection it confers.

I myself feel confident & safe in my decision to be vaccinated.
7/fin