Thrombosis with Thrombocytopenia Syndrome (TTS)

Context:

Recently, AstraZeneca admitted in U.K. court documents that its COVID-19 vaccine may cause Thrombosis with Thrombocytopenia Syndrome (TTS), a rare side effect linked to blood clotting.

Relevance:
GS-03 (Science and technology)

Key highlights:

  • Doctors in India assert that they were already aware of this risk, as it has been communicated in the vaccine insert available since its introduction to the public.
  • The reported rare adverse events, including TTS, are said to typically occur within 21 days to a month after the first dose of the vaccine.
  • A legal document submitted to the High Court in London mentioned AstraZeneca’s admission regarding the potential of the vaccine to cause TTS in very rare cases.
  • TTS can lead to severe consequences like strokes, brain damage, and heart attacks, which are potentially life-threatening.
  • In India, the product information accompanying the vaccine clearly outlines the risk of TTS in its special warnings and precautions section, highlighting that most events occur within the first 21 days post-vaccination, with some resulting in fatal outcomes.

Thrombosis with Thrombocytopenia Syndrome (TTS):

  • It is an exceptionally rare medical condition characterized by the simultaneous occurrence of blood clot formation (thrombosis) and a decrease in platelet counts (thrombocytopenia).
  • It is also referred to as vaccine-induced immune thrombotic thrombocytopenia (VITT).
  • Thrombosis manifests when a blood clot forms within a blood vessel, potentially obstructing blood flow.
  • Thrombocytopenia, on the other hand, denotes a low platelet count in the blood. Platelets are essential for clotting, aiding in the prevention of excessive bleeding.
  • The CDC classifies TTS into two tiers:
    • Tier 1: Rare occurrence of blood clots, including those in critical areas such as the brain or gut, sometimes alongside more typical clots in the legs or lungs.
      • Platelet count falls below 150,000 per microliter.
      • Tier 1 cases tend to be more severe and pose higher risks, with a higher prevalence observed among younger individuals.
    • Tier 2: More common blood clots, typically found in areas like the legs or lungs.
      • Platelet count drops below 150,000 per microliter, with a positive anti-PF4 ELISA test being essential for diagnosis.
  • Symptoms associated with TTS may include:
    • Severe or persistent headaches
    • Blurred vision
    • Shortness of breath
    • Chest pain
    • Swelling in the legs
    • Persistent abdominal pain
    • Confusion or seizure
    • Easy bruising or small blood spots under the skin beyond the injection site.