Cases of Cerebral Venous Sinus Thrombosis with Thrombocytopenia After Receipt of the Johnson & Johnson COVID-19 Vaccine [April 13, 2021, 1:00 PM ET]

Details

• Corporate Authors:
  Centers for Disease Control and Prevention (U.S.). Health Alert Network (HAN)
• Description:
  April 13, 2021, 1:00 PM ET
  
  CDCHAN-00442
  
  As of April 12, 2021, approximately 6.85 million doses of the Johnson & Johnson (J&J) COVID-19 vaccine (Janssen) have been administered in the United States. The Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) are reviewing data involving six U.S. cases of a rare type of blood clot in individuals after receiving the J&J COVID-19 vaccine that were reported to the Vaccine Adverse Event Reporting System (VAERS). In these cases, a type of blood clot called cerebral venous sinus thrombosis (CVST) was seen in combination with low levels of blood platelets (thrombocytopenia). All six cases occurred among women aged 18–48 years. The interval from vaccine receipt to symptom onset ranged from 6–13 days. One patient died. Providers should maintain a high index of suspension for symptoms that might represent serious thrombotic events or thrombocytopenia in patients who have recently received the J&J COVID-19 vaccine. When these specific types of blood clots are observed following J&J COVID-19 vaccination, treatment is different from the treatment that might typically be administered for blood clots. Based on studies conducted among the patients diagnosed with immune thrombotic thrombocytopenia after the AstraZeneca COVID-19 vaccine in Europe, the pathogenesis of these rare and unusual adverse events after vaccination may be associated with platelet-activating antibodies against platelet factor-4 (PF4), a type of protein. Usually, the anticoagulant drug called heparin is used to treat blood clots. In this setting, the use of heparin may be harmful, and alternative treatments need to be given.
  
  CDC will convene an emergency meeting of the Advisory Committee on Immunization Practices (ACIP) on Wednesday, April 14, 2021, to further review these cases and assess potential implications on vaccine policy. FDA will review that analysis as it also investigates these cases. Until that process is complete, CDC and FDA are recommending a pause in the use of the J&J COVID-19 vaccine out of an abundance of caution. The purpose of this Health Alert is, in part, to ensure that the healthcare provider community is aware of the potential for these adverse events and can provide proper management due to the unique treatment required with this type of blood clot.
  
  
• Content Notes:
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• Subjects:
  Adverse Drug Reaction Reporting Systems Blood Coagulation/physiology Coronavirus Infections/prevention & Control COVID-19 Vaccines/adverse Effects COVID-19/prevention & Control Sinus Thrombosis, Intracranial Thrombocytopenia Viral Vaccines/adverse Effects
• Keywords:
  HAN Health Alert Network
• Source:
  HAN ; 442
• Series:
  Health Alert Network
• Subseries:
  CDC Health Alert
• Publisher:
  Centers for Disease Control and Prevention (CDC) (U.S.)
• Document Type:
  Text
• Genre:
  Alert
• Place as Subject:
  United States
• Rights:
  Public Domain
• Issue:
  00442
• Collection(s):
  Health Alert Network (HAN)
• Main Document Checksum:
  urn:sha-512:396e3c2d1b470a81cc5ed2b3c7de1abb95890e603236119e06dd5d7ad855ba3f45f5e4f720c38b30ea513886686974ca40cb807353defac7efe984732bc22e4b
• Download URL:
  https://stacks.cdc.gov/view/cdc/105059/cdc_105059_DS1.pdf
• File Type:
  [PDF - 119.17 KB ]