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A Few Covid Vaccine Recipients Developed a Rare Blood Disorder
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One day after receiving her first dose of Moderna’s Covid vaccine, Luz Legaspi, 72, woke up with bruises on her arms and legs, and blisters that bled inside her mouth.
She was hospitalized in New York City that day, Jan. 19, with a severe case of immune thrombocytopenia — a lack of platelets, a blood component essential for clotting.
The same condition led to the death in January of Dr. Gregory Michael, 56, an obstetrician in Miami Beach whose symptoms appeared three days after he received the Pfizer-BioNTech vaccine. Treatments failed to restore his platelets, and after two weeks in the hospital he died from a brain hemorrhage.
It is not known whether this blood disorder is related to the Covid vaccines. More than 31 million people in the United States have received at least one dose, and 36 similar cases had been reported to the government’s Vaccine Adverse Event Reporting System, VAERS, by the end of January. The cases involved either the Pfizer-BioNTech or Moderna vaccine, the only two authorized so far for emergency use in the United States.
But the reporting system shows only problems described by health care providers or patients after vaccination, and does not indicate whether the shots actually caused the problems.
Officials with the Food and Drug Administration and the Centers for Disease Control and Prevention said that they were looking into the reports, but that so far, rates of the condition in vaccinated people did not appear higher than the rates normally found in the U.S. population, so the cases could be coincidental. Overall, the vaccines are considered safe. A small number of severe allergic reactions have been reported, but they are treatable, and the rates are in line with those reported for other vaccines, regulators say.
In a statement, Pfizer said: “We take reports of adverse events very seriously,” and added that it was aware of thrombocytopenia cases in vaccine recipients.
The statement also said: “We are collecting relevant information to share with the F.D.A. However, at this time, we have not been able to establish a causal association with our vaccine.”
Moderna also provided a statement, which did not address the question of the platelet disorder, but said the company “continuously monitors the safety of the Moderna Covid-19 vaccine using all sources of data” and routinely shares safety information with regulators.
Hematologists with expertise in treating immune thrombocytopenia said they suspected that the vaccine did play a role. But they said that cases after vaccination were likely to be exceedingly rare, possibly the result of an unknown predisposition in some people to react to the vaccine by developing an immune response that destroys their platelets. The disorder has occurred, rarely, in people who received other inoculations, particularly the measles-mumps-rubella one.
“I think it is possible that there is an association,” Dr. James Bussel, a hematologist and professor emeritus at Weill Cornell Medicine who has written more than 300 scientific articles on the platelet disorder, said in an interview. “I’m assuming there’s something that made the people who developed thrombocytopenia susceptible, given what a tiny percentage of recipients they are.”
He added: “Having it happen after a vaccine is well-known and has been seen with many other vaccines. Why it happens, we don’t know.”
Dr. Bussel said it was important to share information about the cases, because severe thrombocytopenia can be serious, and physicians need to know how to treat it. Sometimes the condition resists standard therapies, and if very low platelet counts persist, the patient faces an increasing risk of severe bleeding and even brain hemorrhage.
He and a colleague, Dr. Eun-Ju Lee, have submitted an article to a medical journal on 15 cases in Covid vaccine recipients they identified by searching the government’s database or by consulting with other physicians treating patients. The report provides information about treatments and urges doctors to report cases. It also notes that it is too soon to tell whether the affected patients will have lasting recoveries, or recurrences of the platelet problem.
Ms. Legaspi, right, in a photo taken by her daughter that shows bruising and bleeding under the skin caused by the lack of platelets. via Luz Legaspi
A few of the patients had previously had platelet disorders or other autoimmune conditions that might have made them vulnerable, Dr. Bussel (pronounced Bew-SELL) said. People can have low platelets without symptoms, and it is possible that in some, a vaccine reaction could drop the level further, to a point where it becomes apparent by causing bruises or bleeding, Dr. Bussel said.
He has been a paid consultant to Pfizer, not on vaccines but for a drug for the platelet disorder.
Dr. Jerry L. Spivak, an expert on blood disorders at Johns Hopkins University, also said the connection to the vaccine appeared real, but predicted that cases would be exceedingly rare and called them “idiosyncratic,” perhaps related to underlying traits in individual patients.
The cases are not a reason to avoid Covid vaccination, doctors say. The risk of serious illness from the coronavirus is much greater than the risk of developing this rare condition, and the vaccines are crucial for controlling the pandemic.
Ms. Legaspi’s daughter said the last thing that she and her mother wanted to do was create fear of the Covid vaccines. Both women still believe strongly in the need for them, despite Ms. Legaspi’s illness, her daughter said. The daughter asked, at her employer’s request, that her name not be used.
In its most common form, immune thrombocytopenia is an autoimmune disease that affects about 50,000 people in the United States, according to a support group for patients. The condition develops when the immune system attacks platelets or the cells that create them, for unknown reasons. It sometimes follows a viral illness, and can persist for months or become chronic and last for years. It is generally treatable. Professional groups have advised that patients with the disorder be vaccinated for Covid, but after consulting with their hematologists.
More at link
One day after receiving her first dose of Moderna’s Covid vaccine, Luz Legaspi, 72, woke up with bruises on her arms and legs, and blisters that bled inside her mouth.
She was hospitalized in New York City that day, Jan. 19, with a severe case of immune thrombocytopenia — a lack of platelets, a blood component essential for clotting.
The same condition led to the death in January of Dr. Gregory Michael, 56, an obstetrician in Miami Beach whose symptoms appeared three days after he received the Pfizer-BioNTech vaccine. Treatments failed to restore his platelets, and after two weeks in the hospital he died from a brain hemorrhage.
It is not known whether this blood disorder is related to the Covid vaccines. More than 31 million people in the United States have received at least one dose, and 36 similar cases had been reported to the government’s Vaccine Adverse Event Reporting System, VAERS, by the end of January. The cases involved either the Pfizer-BioNTech or Moderna vaccine, the only two authorized so far for emergency use in the United States.
But the reporting system shows only problems described by health care providers or patients after vaccination, and does not indicate whether the shots actually caused the problems.
Officials with the Food and Drug Administration and the Centers for Disease Control and Prevention said that they were looking into the reports, but that so far, rates of the condition in vaccinated people did not appear higher than the rates normally found in the U.S. population, so the cases could be coincidental. Overall, the vaccines are considered safe. A small number of severe allergic reactions have been reported, but they are treatable, and the rates are in line with those reported for other vaccines, regulators say.
In a statement, Pfizer said: “We take reports of adverse events very seriously,” and added that it was aware of thrombocytopenia cases in vaccine recipients.
The statement also said: “We are collecting relevant information to share with the F.D.A. However, at this time, we have not been able to establish a causal association with our vaccine.”
Moderna also provided a statement, which did not address the question of the platelet disorder, but said the company “continuously monitors the safety of the Moderna Covid-19 vaccine using all sources of data” and routinely shares safety information with regulators.
Hematologists with expertise in treating immune thrombocytopenia said they suspected that the vaccine did play a role. But they said that cases after vaccination were likely to be exceedingly rare, possibly the result of an unknown predisposition in some people to react to the vaccine by developing an immune response that destroys their platelets. The disorder has occurred, rarely, in people who received other inoculations, particularly the measles-mumps-rubella one.
“I think it is possible that there is an association,” Dr. James Bussel, a hematologist and professor emeritus at Weill Cornell Medicine who has written more than 300 scientific articles on the platelet disorder, said in an interview. “I’m assuming there’s something that made the people who developed thrombocytopenia susceptible, given what a tiny percentage of recipients they are.”
He added: “Having it happen after a vaccine is well-known and has been seen with many other vaccines. Why it happens, we don’t know.”
Dr. Bussel said it was important to share information about the cases, because severe thrombocytopenia can be serious, and physicians need to know how to treat it. Sometimes the condition resists standard therapies, and if very low platelet counts persist, the patient faces an increasing risk of severe bleeding and even brain hemorrhage.
He and a colleague, Dr. Eun-Ju Lee, have submitted an article to a medical journal on 15 cases in Covid vaccine recipients they identified by searching the government’s database or by consulting with other physicians treating patients. The report provides information about treatments and urges doctors to report cases. It also notes that it is too soon to tell whether the affected patients will have lasting recoveries, or recurrences of the platelet problem.
Ms. Legaspi, right, in a photo taken by her daughter that shows bruising and bleeding under the skin caused by the lack of platelets. via Luz Legaspi
A few of the patients had previously had platelet disorders or other autoimmune conditions that might have made them vulnerable, Dr. Bussel (pronounced Bew-SELL) said. People can have low platelets without symptoms, and it is possible that in some, a vaccine reaction could drop the level further, to a point where it becomes apparent by causing bruises or bleeding, Dr. Bussel said.
He has been a paid consultant to Pfizer, not on vaccines but for a drug for the platelet disorder.
Dr. Jerry L. Spivak, an expert on blood disorders at Johns Hopkins University, also said the connection to the vaccine appeared real, but predicted that cases would be exceedingly rare and called them “idiosyncratic,” perhaps related to underlying traits in individual patients.
The cases are not a reason to avoid Covid vaccination, doctors say. The risk of serious illness from the coronavirus is much greater than the risk of developing this rare condition, and the vaccines are crucial for controlling the pandemic.
Ms. Legaspi’s daughter said the last thing that she and her mother wanted to do was create fear of the Covid vaccines. Both women still believe strongly in the need for them, despite Ms. Legaspi’s illness, her daughter said. The daughter asked, at her employer’s request, that her name not be used.
In its most common form, immune thrombocytopenia is an autoimmune disease that affects about 50,000 people in the United States, according to a support group for patients. The condition develops when the immune system attacks platelets or the cells that create them, for unknown reasons. It sometimes follows a viral illness, and can persist for months or become chronic and last for years. It is generally treatable. Professional groups have advised that patients with the disorder be vaccinated for Covid, but after consulting with their hematologists.
