The COVID-19 vaccine jointly developed by AstraZeneca and Oxford University has been associated with a spate of blood clot cases in Europe. A number of European nations, including Germany, France, the Netherlands, Italy, Canada, Denmark and Ireland, temporarily suspended administering the shot due to concerns about possible side effects. Responding to the news, a Taiwanese pediatric emergency doctor has recommended seeking immediate medical treatment if anyone experiences the following symptoms between four and 20 days after receiving the vaccine: rapid breathing, chest pain, paleness of the legs and feet, reduced blood circulation, persistent abdominal pain, headaches, blurred vision or bruising.
Wu Chang-teng, a pediatric emergency resident doctor at Linkou Chang Gung Memorial Hospital, in a post on Facebook, addressed recent reports of “rare” cases of severe blood clots in Europe in individuals who had taken the AstraZeneca vaccine, including cases of cerebral venous sinus thrombosis associated with thrombocytopenia. To date, most of the cases identified are women under 55 years of age. However, there are also reports of male cases, and most of them have occured between four to 16 days after vaccination was administered, said Wu.
Wu explained that the condition is being termed as “vaccine-induced prothrombotic immune thrombocytopenia,” or VIPIT for short. Wu added that this is because VIPIT is associated with the production of antibodies that can activate platelets which stimulate the formation of blood clots, leading to thrombocytopenia. Wu said that the process is similar to heparin-induced thrombocytopenia (HIT), but the exact mechanism that triggers VIPIT is still being studied.
Photo: Liao Chen-huei, Liberty Times
照片：自由時報廖振輝
Wu emphasized that medical professionals are still waiting for confirmation of the precise incidence of adverse reactions to the vaccination. According to data provided by the European Medicines Agency on March 18, it was initially estimated that one per million people who took the AstraZeneca vaccine had experienced VIPIT. However, Germany’s Paul-Ehrlich Institut has reported that the incidence is much higher and is in fact one per 100,000 people.
(Liberty Times, translated by Edward Jones)
藥廠阿斯特捷利康（AstraZeneca）與牛津大學合作研製的AZ疫苗在歐洲出現血栓案例不斷，包括德、法、荷、義、加、丹麥、愛爾蘭等多國陸續加入暫停施打行列；對此，兒科急診醫師也呼籲，接種AZ疫苗後的第四天到第二十天，若出現呼吸急促，胸痛，單邊下肢蒼白、血液循環不好，持續性腹痛、頭痛、視力模糊、瘀斑等症狀，應立即就醫。
林口長庚醫院兒科急診主治醫師吳昌騰在臉書粉專發文指出，歐洲最近報導在使用AZ疫苗後，發生罕見的嚴重血液凝塊病例，這包括與血小板減少症有關的腦靜脈竇血栓形成。目前為止，查明的病例中，主要是五十五歲以下的婦女；但也有男性病例的報導，並且大多是發生在接種疫苗後的四至十六天之間。
吳昌騰解釋，這種不良事件被稱為疫苗誘導的血栓性免疫血小板減少症（VIPIT）。這是因為VIPIT與可激活血小板的抗體產生有關，然後經由可激活血小板形成血凝塊並導致血小板減少症。這其中的作用機制與肝素誘導的血小板減少症（HIT）相似。而真正觸發VIPIT的確切機轉仍在研究中。
吳昌騰強調，雖然這種不良事件的發生率仍有待確認。但根據歐洲藥品管理局於今年三月十八日提供的信息說明，最初估計每百萬接種AZ疫苗的人中有一人，但是德國的保羅·埃里希研究所報導的發病率更高，是每十萬人中就有一人。
(自由時報)
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