Hematology and Thrombosis Center, Hôpital Tenon, Hôpitaux Universitaires de l'Est Parisien, Assistance Publique Hôpitaux de Paris, Faculté de Médecine, Sorbonne Université, Paris, France.
Research Group "Cancer, Haemostasis and Angiogenesis," INSERM U938, Centre de Recherche Saint-Antoine, Institut Universitaire de Cancérologie, Faculty of Medicine, Sorbonne University, Paris, France.
Thromb Haemost. 2021 Aug;121(8):982-991. doi: 10.1055/a-1499-0119. Epub 2021 May 4.
Historically, the vaccination strategies developed in the second half of the 20th century have facilitated the eradication of infectious diseases. From the onset of COVID-19 pandemic to the end of April 2021, more than 150 million cases and 3 million deaths were documented worldwide with disruption of the economic and social activity, and with devastating material, physical, and psychological consequences. Reports of unusual and severe thrombotic events, including cerebral and splanchnic venous thrombosis and other autoimmune adverse reactions, such as immune thrombocytopenia or thrombotic microangiopathies in connection with some of the SARS-CoV-2 vaccines, have caused a great deal of concern within the population and the medical community. This report is intended to provide practical answers following an overview of our knowledge on these thrombotic events that are extremely rare but have serious consequences. Vaccine hesitancy threatens to reverse the progress made in controlling vaccine-preventable diseases. These adverse events must be put into perspective with an objective analysis of the facts and the issues of the vaccination strategy during this SARS-CoV-2 pandemic. Health care professionals remain the most pertinent advisors and influencers regarding vaccination decisions; they have to be supported to provide reliable and credible information on vaccines. We need to inform, reassure, and support our patients when the prescription is made. Facing these challenges and observations, a panel of experts express their insights and propose a tracking algorithm for vaccinated patients based on a 10-point guideline for decision-making on what to do and not to do.
从历史上看,20 世纪后半叶开发的疫苗接种策略促进了传染病的消除。从 COVID-19 大流行开始到 2021 年 4 月底,全球记录了超过 1.5 亿例病例和 300 万人死亡,经济和社会活动受到干扰,并造成了毁灭性的物质、身体和心理后果。与一些 SARS-CoV-2 疫苗相关的罕见和严重的血栓事件报告,包括脑和内脏静脉血栓形成以及其他自身免疫不良反应,如免疫性血小板减少症或血栓性微血管病,引起了公众和医学界的极大关注。本报告旨在在概述我们对这些极其罕见但后果严重的血栓事件的了解后,提供实际答案。疫苗犹豫有可能使控制疫苗可预防疾病的进展发生逆转。在 SARS-CoV-2 大流行期间,必须客观分析这些不良事件的事实和疫苗接种策略问题。医疗保健专业人员仍然是疫苗接种决策最相关的顾问和影响者;必须支持他们提供有关疫苗的可靠和可信信息。当开出处方时,我们需要向患者提供信息、保证和支持。面对这些挑战和观察结果,一组专家表达了他们的见解,并根据 10 点决策指南为接种疫苗的患者提出了跟踪算法,该指南用于决定做什么和不做什么。