Inside Medicine. What Are You Seeing?

The TL;DR of the linked page is that the B.1.1.7 variant is getting more common, and it appears to be:

  1. more contagious, and
  2. more likely to cause serious cases in younger age groups, and
  3. equally resisted by vaccine-derived immunity.

While 3 above is good news, there still is not enough vaccine for everyone who wants it, and the vaccines are not yet available for those under 16. So people waiting for vaccine need to be extra careful until they get it.

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In case anyone is interested, there is no waiting time to donate blood after Covid vaccination. I just called due to an email I received saying our area is critically short of my type of blood due to two serious trauma accidents in one day requiring 75 units.

I’ll be donating tomorrow. It’ll be interesting to see if any antibodies show up or not. I know the type they test for aren’t guaranteed even when one is fully done with the time. I just had my second Pfizer vax this past Saturday, so I’m a little shy of the official waiting time to be full force.

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Trial for Moderna vaccine for the B.1.351 variant of COVID-19:

Trial for Pfizer / BioNTech vaccine, including version for the B.1.351 variant of COVID-19:

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J&J is currently suspended (recommended anyway) due to blood clots having developed in a few people. Scary stuff. My cousin (in her 40s) had blood clots in her heart shortly after having recovered from Covid (not the vaccine and was never hospitalized with Covid, nor did she have a bad case of it). She was in a major hospital for 2 weeks and is still being monitored now.

My med school lad tells me the clots were likely from Covid because Covid is considered a clotting disease - many “later” issues come from clots including strokes, etc, so he wouldn’t be surprised if it could produce heart clots too. Having read the article, I can’t help but wonder if it’s the same blood clotting or not.

I’m not at all close to this cousin having only learned about her issues from my aunt - and she’s not as keen with her mind as she used to be (age related), so I probably have no way of finding out. I wish I could know more about how it all relates - just to know.

I feel for all those affected, due to Covid or possibly due to the vaccine. Covid really is one nasty bug IMO.

Here’s what’s said about J&J:

“In the United States alone, 300,000 to 600,000 people a year develop blood clots, according to C.D.C. data. But the particular blood clotting disorder that the vaccine recipients developed, known as cerebral venous sinus thrombosis, is extremely rare.”

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I wish the media would explain about risks versus benefits.

There has been ONE death reported due to clotting after 6.8 million people received the J and J vaccination.

Here is the far more sobering statistic: “Out of every 100,000 Americans, 172 have died of the coronavirus.” 172/100,000 x 6,800,000 = 11,696.

So there has been ONE death in the group of 6.8 million people who got J and J. Statistically, you would expect 11,696 DEATHS in that group if they hadn’t been vaccinated. Why isn’t this emphasized in the media?

(And even if the current death rate is much lower than the overall death rate to date, it would still be thousands of times greater than the risk of death due to the J and J vaccine.)

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FWIW, I’m in no way saying the vaccines are dangerous comparatively. I actually suspect those who have a bad time with the vaccines were more likely to have a bad time with Covid itself - esp if the clottings are connected and far, far fewer have drastic effects from the vaccine than Covid.

As I mentioned in my post, my cousin had life threatening blood clots after having had Covid (mild case at that), not the vaccine. I’m merely wondering if the two are the same or similar types.

Article on the cerebral venous sinus thrombosis incidents:

Apparent rates of cerebral venous sinus thrombosis:

Situation Time frame Apparent rate
General population 1 year 5 per million
J&J vaccine weeks after vaccine? 1 per million
AstraZeneca vaccine weeks after vaccine? 5 per million

It has been claimed that the carrier adenovirus may be related to rogue antibodies against platelet factor 4:

Note that the J&J and AstraZeneca vaccines use different carrier adenoviruses.

Background information about cerebral venous sinus thrombosis:

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My husband is also speculating on this. If these women’s immune systems produced antibodies to clotting factor 4 after vaccination, it is likely that they would have also done so after infection with SARS-CoV-2. In fact, immune thrombocytopenia is a known complication of Covid. They are calling this syndrome, “vaccine induced immune thrombotic thrombocytopenia.”

The timing is suspicious for a casual link to the vaccine because all cases (including those in Astra Zeneca) happened 5 to 16 days after vaccination, which is right when the immune response starts to kick in.

I personally think they were right to press pause on administering J&J. They may have enough data on these women to figure out more narrowly who is at risk. (Smoking, birth control pills, overweight, sedentary, race, or just premenopausal women?)

We are very lucky in the US that whomever is at higher risk for this can get Moderna or Pfizer. However, if it were me, and only J&J or Astra Zeneca were available, I would go ahead and get one, and just pay a lot of attention to symptoms at 5-16 days out. Doctors can most likely save these women’s lives and prevent strokes if they come in early enough. That would be preferable to remaining unvaccinated and wondering whether I have asymptomatic Covid and may be approaching a clotting crisis at any time.

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This thread is really helpful - I got the J&J 14 days ago and have been worried ever since. Initially it was the mishandling of the 15 million doses and now this. :roll_eyes: I am in my 50s and healthy, but anxiety can sure get the best of me! My next door neighbor happens to be a vascular surgeon and has also said all of the above… I promised myself I wouldn’t go pester him daily with all of my crazy questions…

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If it helps ease the worry, in our state most teachers got J&J and the state said yesterday there wasn’t a single known blood clot case among the 120,000 or so who received it. It seems to be very, very rare. I’d be wary if I were among them, but not scared. I’d just know if I had symptoms to get to a doctor because it appears to be treatable when they know what they’re dealing with. (All related from our local TV news, so no link to add.)

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@5050100 it sounds like you are almost in the clear for this very rare complication since your vaccine was 14 days ago. It sounds like all these events happened between 5 and 16 days post vaccine, including the events after the Astra Zeneca. So far, all those who have had the clots have been between 22 and 49.

I have been wondering about the difference between clotting as a complication of Covid, and this very rare vaccine-induced clotting (which is accompanied by low platelets which would normally cause bleeding, not clots). The following quote from https://www.medpagetoday.com/special-reports/exclusives/92022 explains the difference. VITT is the brand new name for the post vaccine clots: vaccine induced immune thrombotic thrombocytopenia.

What is striking about VITT is that the brain and abdomen are atypical locations for clots to develop. COVID-19 infection itself can cause autoimmune associated thrombocytopenia and thrombosis, but the majority of those clots are deep venous thromboses (DVTs) and pulmonary embolism (PE). Thrombocytopenia has occurred with other vaccines, but in these cases, low platelets are associated with bleeding, not clots, according to Rajiv Pruthi, MBBS, a hematologist at the Mayo Clinic in Rochester, Minnesota.

Understanding this better will take time, so I hope that the data show some definitive risk factors which connect all those affected so that people can weigh their personal risk. The rest of the world doesn’t have the luxury of pivoting to Moderna or Pfizer like we do.

If the J&J vaccine were my only choice, it would be worth the tiny risk (for me). I could be monitored for symptoms for two weeks, and could seek immediate medical help if needed. (They have learned how to treat this due to its similarity to heparin induced thrombocytopenia.) I would prefer that risk to all the unknowns of getting Covid, especially the risk of long Covid.

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Thank you - that’s interesting…I know my risk is incredibly small, but after listening to the news ALL day (big mistake), my anxiety is through the roof. :neutral_face:

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It seems that they are examining correlation between birth control and blood clots in those women.

https://bjsm.bmj.com/content/bjsports/early/2021/04/07/bjsports-2021-104080.full.pdf

New study paper indicates that consistently active people (>150 minutes exercise per week, 6.4% of the sample) have lower risk of need for hospitalization, need for ICU care, or death when getting COVID-19 than consistently inactive (<10 minutes exercise per week, 14.4% of the sample) or inconsistently active (10-150 minutes exercise per week, 79.1% of the sample) people.

Odds ratios by various characteristics including exercise volume and others commonly mentioned:

Characteristic Odds ratio hospitalization Odds ratio ICU Odds ratio death
Consistently active reference reference reference
Inconsistently active 1.89 1.58 1.87
Consistently inactive 2.26 1.73 2.49
Age <60 reference reference reference
Age 60-69 2.30 2.40 4.01
Age 70-79 3.72 3.44 10.40
Age >=80 6.13 3.52 27.31
Female reference reference reference
Male 1.85 2.38 1.72
White reference reference reference
Asian 2.04 2.29 1.30
Black 1.33 1.25 1.18
Hispanic 1.22 1.31 1.08
BMI <25 reference reference reference
BMI 25-29 0.99 0.98 0.79
BMI 30-39 1.12 1.17 0.89
BMI >=40 1.77 1.95 1.90

Note that overweight/obesity as measured by BMI appears to have relatively little effect, except at the highest BMI range >= 40.

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Vox has a summary regarding current ideas about Long Covid (long haulers):

And my best guess for the pause is because experts are looking for other cases like this one to review. One in a million? Or not? Until they see how many cases come in from various places and if they are somehow related, it makes sense to pause IMO. If there aren’t many, continue on. If there are quite a few lurking, they could have a problem or at least need to restrict who it’s deemed safe for.

I just read that only one of those women (1/6) was on birth control. So doesn’t seem to corelate.

Does anyone know if the low platelets were already present in the 6 patients or if they were caused by the thrombosis CVT?

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Those seem like odd numbers to have picked for activity. I’d say pre-Covid I excercised around 120 minutes a week. I’ve actually upped my exercise since dh has replace 30 on the stepper at the gym with 2 hour walks with me. We usually get at least 2 walks in a week and then do 2 or 3 days of weight workouts that are 1/2 hour to 45 minutes.

For me it’s been the one plus of Covid - I feel like have to do something so staying healthy is an easy one.

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150 minutes per week was presumably picked because it is the most common recommendation (but only 6.4% met that). Less than 10 minutes per week was presumably picked as an approximation of “no exercise”.

Now they tell us? I WAS active more than 150 minutes a week in 2019-2020, up until the time they shut down the gyms. And I am ramping up the activity level again, now that I am vaccinated.

But it was darn hard to stay active when everything was shut down and we were all told to socially distance and avoid socializing with other humans, especially in the fall & winter months. (I actually started biking for the first time in years during the summer months, but that pretty much ended in October. )