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Everyone keeps telling you that the side effects from AstraZeneca and Jansen vaccines are rare and you should get the vaccine. I totally 100% agree with this, but trust is only part of the equation. So here’s what I know about #VITT or vaccine induced thrombotic thrombocytopenia.
Let’s start with the name, because it tells us a bit about the problem. Thrombocytopenia means a low platelet count, which can happen for many reasons, and thrombotic refers to the generation of blood clots. When you understand that platelets are what start most clots ....
You really are a leaky meat bag. No offence. Platelets are constantly plugging tiny holes in blood vessels and maintaining vascular health. They are kind of like clotting grenades. Super effective at what they do, but you don’t want them going off in the wrong place.
For a platelet to go off it needs to be activated. There are plenty of safe guards to “pulling the pin” but it’s a fine balance. Not sensitive enough, and you bleed to death, too much and everything clots and drops off. These mechanisms are highly refined.
Coronavirus targets blood vessels. That’s why COVID infections have such high rates of clots associated with them. These adenovirus derived vaccines deliver the gene for your body to make corona virus spike protein but no corona virus.
Because your immune system is seeing both the adenovirus and also the spike protein that is made after infection more than one antibody is being made, as opposed to mRNA vaccines which only present one thing for the immune system to chew on.
Some where in this immunologic dance, there’s a misstep. Trust me, Tic Toc has proven this to me. It doesn’t happen often but when it does an antibody is made that interacts with a receptor on platelets and activates them. These activated platelets now have a hair trigger.
They can form clots in funny places, like the spleen, or the lungs or even the brain. We have a really good model of this process with heparin, a drug that is supposed to prevent clots, and so we have a highly and effective way to manage #VITT
Why is this process so rare? Like I have said, there are many nature safeguards to prevent clots from happening. Also, everyone’s immune system is a bit different, so getting all the stars to line up before this happens.
Is it lethal? Rarely, but yes, and now that we know about it and are getting the word out, it can be treated, and very effectively. It has tell tale symptoms. Progressive headaches, chest pain, shortness of breath, leg swelling, unexplained abdo pain.
Is it worth the risk. Hey, I’m an ICU doc. I see the worst case scenarios, so of course I think so, but my partner got it, and she’s a Pediatrician. I recommend it to my kids. Life is full of risks, but this one is worthwhile.
We have funny approaches to risk. Really retrospective. I see sins of omission and sins of commission in medicine all the time. They are the same black marks, but we blame actions harder than neglect.
Any way ... gotta get back to work. Hope this helps.
Any way ... gotta get back to work. Hope this helps.
See the above FAQ for the deep dive! 
