Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Institute of Hematology, Rabin Medical Center, Petah Tikva, Israel.
Platelets. 2022 Jul 4;33(5):781-786. doi: 10.1080/09537104.2022.2071856. Epub 2022 May 10.
As the immune thrombocytopenia exacerbation rate after booster COVID-19 vaccines is unknown, we explore the rates after first, second and booster Pfizer-BioNTech COVID-19 vaccines. A retrospective study of adult ITP patients, receiving 1-3 vaccines was performed. The primary outcome was clinical ITP exacerbation defined as platelet count decrease requiring initiation/escalation of ITP treatment and/or new medical attention due to bleeding, within 3 months. Secondary outcome was any clinically relevant platelet decrease during the 3 months post-vaccination. The study included 93 ITP patients receiving 1 (n = 2), 2 (n = 22) or 3 (n = 69) vaccines. ITP exacerbation occurred in 2/93 (2.2%) patients following initial vaccination and in 3/69 (4.3%) following booster dose. Clinically relevant platelet decreases after initial doses occurred in 8/72 (11.1%) patients and in 8/39 (20.5%) after the booster. Clinical ITP exacerbation after booster doses did not follow clinical exacerbation after initial doses. Half of patients with clinically relevant platelet decreases after booster dose also had clinically relevant decreases following initial vaccination. We concluded that clinical ITP exacerbation is infrequent following Pfizer-BioNTech COVID-19 vaccine. Clinical exacerbation after booster doses was not preceded by clinical exacerbation after initial doses. Clinically relevant platelet decreases after booster doses occur frequently in patients with clinically relevant decreases after initial doses.
由于增强型 COVID-19 疫苗后免疫性血小板减少症恶化的发生率尚不清楚，我们探讨了首次、第二次和增强型辉瑞-生物科技 COVID-19 疫苗后的发生率。对接受 1-3 种疫苗的成年 ITP 患者进行了回顾性研究。主要结局是临床 ITP 恶化，定义为血小板计数下降，需要开始/升级 ITP 治疗和/或因出血而需要新的医疗关注，发生在 3 个月内。次要结局是接种疫苗后 3 个月内任何有临床意义的血小板减少。该研究包括 93 名接受 1 剂（n=2）、2 剂（n=22）或 3 剂（n=69）疫苗的 ITP 患者。初始接种后有 2/93（2.2%）患者发生 ITP 恶化，增强剂量后有 3/69（4.3%）患者发生 ITP 恶化。初始剂量后有 8/72（11.1%）患者和增强剂量后有 8/39（20.5%）患者出现有临床意义的血小板减少。初始剂量后出现临床 ITP 恶化的患者，增强剂量后并未出现临床恶化。增强剂量后有临床意义的血小板减少的患者中，有一半也在初始接种后有临床意义的血小板减少。我们得出结论，辉瑞-生物科技 COVID-19 疫苗接种后发生临床 ITP 恶化的情况较为罕见。增强剂量后临床恶化并不先于初始剂量后临床恶化。增强剂量后有临床意义的血小板减少在初始剂量后有临床意义的血小板减少的患者中很常见。
