Department of Medicine II, Ulm University Medical Center, Ulm, Germany.
Department of Medicine I, Ulm University Medical Center, Ulm, Germany.
Hum Vaccin Immunother. 2023 Aug 1;19(2):2252239. doi: 10.1080/21645515.2023.2252239.
Cases of thromboembolic events in 2021 flared up the discussion about the safety of Astra Zeneca's AZD1222 vaccine. We hereby report three cases of pulmonary embolism (PE), one case of extended portal vein thrombosis, and one case of combined portal vein thrombosis and PE within 2 weeks after vaccination with the Astra Zeneca AZD1222 vaccine in a 60-year-old, a 50-year old, a 33-year-old, a 30-year old, and a 40-year-old male in that year. All patients were healthy before. In three patients, we observed thrombocytopenia and to some extent unusually low antibody levels for the Spike Protein (S-protein), while the other two had normal thrombocyte counts. Only one patient had anti-platelet factor 4 (PF4)-antibodies detectable as it has been described in the "heparin-induced thrombocytopenia (HIT)-like" disease of "vaccine-induced prothrombotic immune thrombocytopenia" (VIPIT) and we therefore assume that heterogeneous mechanisms led to PE. Therefore, we advise to collect and report more cases, in order to determine the age-related risks of vaccination balanced against the benefits of immunity to SARS-COV-2 for the AZD1222 vaccine in order to gain knowledge for the next pandemic.
2021 年血栓栓塞事件的病例引发了关于阿斯利康 AZD1222 疫苗安全性的讨论。我们在此报告三例肺栓塞（PE），一例门静脉血栓延伸，一例门静脉血栓合并 PE，均发生在当年一名 60 岁、一名 50 岁、一名 33 岁、一名 30 岁和一名 40 岁男性接种阿斯利康 AZD1222 疫苗后 2 周内。所有患者之前均健康。在三例患者中，我们观察到血小板减少和一定程度上 Spike 蛋白（S-蛋白）的抗体水平异常低，而另外两例患者血小板计数正常。只有一名患者可检测到抗血小板因子 4（PF4）抗体，正如在“疫苗诱导的促血栓形成免疫性血小板减少症”（VIPIT）中的“肝素诱导的血小板减少症（HIT）样”疾病中所描述的那样，因此我们假设不同的机制导致了 PE。因此，我们建议收集和报告更多病例，以便确定与接种疫苗相关的年龄风险，权衡阿斯利康 AZD1222 疫苗对 SARS-CoV-2 的免疫益处，以便为下一次大流行获得知识。
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