US: Man, 65, dies from blood clot after Moderna vaccine
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A man who developed an unusual blood clot after the Moderna coronavirus vaccine has died.

Writing in the journal Annals of Internal Medicine, medics from the Allegheny Health Network in Pittsburgh have reported that an unnamed 65-year-old man developed so-called vaccine-induced thrombosis and thrombocytopenia (VITT) after his second Moderna jab dose.

VITT is defined as a blood clot with an unusually low number of platelets, the cells that cause blood to clot, after a vaccine.

This is the first time VITT has been linked to a so-called RNA coronavirus vaccine, like the Moderna or Pfizer-BioNTech jabs, which are based on a different technology to the Oxford-AstraZeneca vaccine.

As well as the Oxford-AstraZeneca vaccine, VITT – also known as thrombocytopenia with thrombosis syndrome (TTS) – has been linked to the single-dose Janssen coronavirus jab, which was recently approved in the UK.

Both the Oxford-AstraZeneca and Janssen vaccines are based on a version of the common cold virus, with a bit of the coronavirus's genetic material added in. Administering the jabs produces the coronavirus's spike protein, which it uses to enter cells. The immune system then launches a response against this protein.

The Pfizer-BioNTech and Moderna vaccines are made up of tiny fragments of the coronavirus's genetic material, known as RNA, surrounded by a bubble of fat. Once injected, the body similarly launches an immune response.

VITT has been likened to heparin-induced thrombocytopenia. In some patients, the blood thinner heparin causes specific antibodies to bind to so-called heparin-platelet factor 4 complexes, activating cells that can cause clots.

Quote:Professor Beverley Hunt, from King's College London, has previously said: "[We] could speculate if [you are] making antibodies to some constituent of the Oxford-AstraZeneca vaccine, something makes them [the vaccines] make a unique antibody that cross-reacts with platelet factor 4."


The man – who had high blood pressure and elevated fat levels in his blood – arrived at hospital 10 days after receiving his second dose of the Moderna vaccine.

Over the previous week, the man endured "discomfort" in both of his legs, as well as a headache that came and went. His breathing had also become labored over the last two days.

A chest scan revealed a "large" clot in his pulmonary artery, which transports blood from the heart to the lungs. The man was also found to have a deep vein thrombosis in both of his legs.

Common TSS causes were excluded, including heparin, the coronavirus itself and other infections.

Despite the medics' best efforts, the man developed cerebral venous sinus thrombosis – when a clot forms in the brain's venous sinuses, preventing blood from draining from the vital organ. The man's DVT also "progressed", spreading to this upper body.

Quote:"He continued to deteriorate, his family elected to pursue comfort measures and he died after compassionate extubation [removal from a ventilator]," wrote the medics.

"In retrospect, this patient met the criteria for VITT or TTS," wrote the medics.



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