VITT and Second Doses of Covid-19 Vaccine

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Abstract
In March 2021, concerns were raised about an increased risk of thrombosis associated with thrombocytopenia among persons who had received their first dose of the ChAdOx1 nCoV-19 (Oxford–AstraZeneca) coronavirus disease 2019 (Covid-19) vaccine. Between 5 and 30 days after vaccination, severe thrombosis developed in these patients, most of whom were previously fit and well. The thrombosis often occurred at unusual or multiple sites, in conjunction with thrombocytopenia, grossly elevated d-dimer levels, reduced fibrinogen levels,1,2 and the presence of anti–platelet factor 4 (PF4) antibodies.