Can I Get the AZ Vaccine with a History of Low Platelets?

Can a person with a history of low platelet count receive the AZ vaccine?

Hello Doctor: Two years ago, I had slightly low platelet levels (not to the extent of being classified as low) and have a history of chronic hypotension.
After researching, I found that thrombocytopenia combined with heparin-induced thrombocytopenia prohibits the administration of the AZ vaccine.
Therefore, I would like to ask the doctor if having only slightly low platelet levels still allows me to receive the AZ vaccine.
Thank you, Doctor.

Niming, 20~29 year old female. Ask Date: 2021/09/10

Dr. Yang Zongyan reply Influenza

Thrombosis associated with thrombocytopenia syndrome primarily occurs with adenoviral vector vaccines such as AstraZeneca (AZ) and Johnson & Johnson (J&J).
The mechanism of thrombosis related to these vaccines is similar to that of Heparin-induced thrombocytopenia (HIT).
Currently, there is no evidence indicating that individuals with a history of general thrombocytopenia have a higher likelihood of experiencing this adverse reaction, so vaccination with the AZ vaccine is still recommended.
However, individuals who have previously experienced thrombosis associated with thrombocytopenia syndrome or thrombocytopenia induced by heparin should avoid receiving the AZ vaccine.

Reply Date: 2021/09/10

More Info

When considering vaccination with the AstraZeneca (AZ) vaccine, particularly for individuals with a history of low platelets, it is essential to understand the specific medical context and guidelines surrounding this issue. Based on the information provided, individuals with a history of low platelets that does not reach critically low levels are generally considered eligible for vaccination with the AZ vaccine.
The primary concern with the AZ vaccine arises from its association with a rare condition known as vaccine-induced immune thrombotic thrombocytopenia (VITT), which is characterized by low platelet counts and thrombosis (blood clots). This condition has been observed primarily in individuals who have experienced thrombosis in conjunction with significant thrombocytopenia, particularly following the administration of adenovirus vector vaccines like AZ and Johnson & Johnson. However, the risk of developing VITT is not significantly elevated in individuals who have a history of mild or moderate thrombocytopenia without a history of thrombosis or heparin-induced thrombocytopenia.

In your case, since you mentioned that your platelet count was low but not critically so, and you do not have a history of thrombosis or conditions that would contraindicate vaccination (such as heparin-induced thrombocytopenia), it is generally safe for you to receive the AZ vaccine. It is always advisable to consult with your healthcare provider, who can assess your specific medical history and current health status to provide personalized recommendations.

Additionally, it is important to consider the benefits of vaccination against COVID-19. Vaccination not only helps protect you from severe illness caused by the virus but also contributes to broader public health efforts to control the pandemic. The AZ vaccine has been shown to be effective in reducing the risk of hospitalization and severe disease, even in individuals with underlying health conditions.

If you have concerns about your low blood pressure or any other health issues, it is crucial to discuss these with your healthcare provider before vaccination. They can provide guidance on how to manage these conditions in conjunction with receiving the vaccine.

In summary, individuals with a history of low platelets, provided they do not have a history of severe thrombocytopenia associated with thrombosis, can generally receive the AZ vaccine safely. Always consult with your healthcare provider for personalized advice and to address any specific concerns you may have regarding vaccination.

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