Bruising After AZ Vaccine in Patients with Favism

Bruising at the injection site after receiving the AZ vaccine?

Hello, Doctor: I have G6PD deficiency and received the AstraZeneca COVID-19 vaccine on September 9th.
On the same day, I consulted with the physician at the vaccination site, who indicated that patients with G6PD deficiency can receive the AstraZeneca vaccine.
On the morning of September 11th, I noticed some pain at the injection site, and there is a small area of bruising at the injection site.
I would like to know if this is related to my G6PD deficiency or if there is a possibility of thrombosis (no bruising has occurred elsewhere on my body).
Thank you.

Chen, 30~39 year old female. Ask Date: 2021/09/11

Dr. Liao Yaopan reply Family Medicine

Hello, G6PD deficiency is not a contraindication for receiving the COVID-19 vaccine.
Local redness or bruising is a relatively common reaction that typically subsides after a few days.
You may continue to monitor the situation.
If there is no improvement or if other symptoms arise, please return to a medical facility for evaluation by a physician.
Online consultations are not equivalent to in-person medical visits and cannot provide diagnoses or treatment recommendations.
Changhua Hospital cares about you.

Reply Date: 2021/09/11

More Info

After receiving the AstraZeneca (AZ) COVID-19 vaccine, it is not uncommon for patients to experience localized pain and bruising at the injection site. In your case, as a patient with favism (a condition characterized by a deficiency of the enzyme glucose-6-phosphate dehydrogenase, or G6PD), it is understandable to have concerns about the implications of these symptoms.

Firstly, the presence of bruising at the injection site is generally a normal response to vaccination. The injection itself can cause minor trauma to the tissues, leading to localized bleeding and subsequent bruising. This is especially true if the injection was administered into a blood vessel or if the individual has a tendency to bruise easily. In most cases, this bruising is not a cause for concern and will resolve on its own within a few days to a week.

However, your concern about the potential relationship between your bruising and favism is valid. Favism can lead to hemolytic anemia in response to certain triggers, including certain medications and foods. While the AZ vaccine does not typically pose a risk for hemolysis in G6PD-deficient patients, it is crucial to monitor for any unusual symptoms. If you notice increased bruising, fatigue, jaundice (yellowing of the skin or eyes), or dark urine, these could be signs of hemolysis, and you should seek medical attention promptly.

Regarding the risk of thrombosis, the AZ vaccine has been associated with rare cases of thrombosis with thrombocytopenia syndrome (TTS), particularly in younger individuals. However, the overall risk remains very low. The symptoms of TTS typically include severe headaches, abdominal pain, leg swelling, or persistent shortness of breath occurring several days after vaccination. Since you mentioned that the bruising is localized and there are no other symptoms present, it is unlikely that you are experiencing TTS. Nonetheless, it is essential to remain vigilant and report any concerning symptoms to your healthcare provider.

In summary, localized bruising and pain at the injection site after receiving the AZ vaccine can be a normal reaction, especially in individuals with conditions like favism. However, it is crucial to monitor for any signs of hemolysis or thrombosis. If you have any doubts or if your symptoms worsen, do not hesitate to consult your healthcare provider for further evaluation and guidance. They can provide personalized advice based on your medical history and current condition.

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