Small Bruises on Hands and Feet After COVID Vaccine: Should You Worry?

Small round bruises appearing on the hands and feet?

I received the first dose of the AZ vaccine on September 10th.
In the past three days, I have noticed a small bruise (0.3mm-0.4mm) on each of my hands and feet.
Additionally, my foot has been feeling swollen for a day.
Although it has only been a month since I got vaccinated, I am concerned about the possibility of a blood clot.
I would like to ask the doctor if this could be related, and if I need to seek medical attention, which specialty should I consult? Thank you very much.

AC, 20~29 year old female. Ask Date: 2021/10/16

Dr. Li Han reply Cardiology

Hello, regarding your inquiry about the appearance of small round bruises on your hands and feet, and the recent swelling in your foot after receiving the first dose of the AZ vaccine on September 10, it is understandable to be concerned about a potential connection to thrombosis.
Current research indicates that vaccine-related thrombosis may be associated with anti-platelet antibodies, specifically the syndrome known as vaccine-induced immune thrombotic thrombocytopenia (VITT).
If you are worried, it is advisable to seek medical attention.
You may consider consulting with a dermatologist, hematologist, or a cardiovascular specialist for evaluation.
Thank you for your concern.

Reply Date: 2021/10/16

More Info

After receiving the COVID-19 vaccine, particularly the AstraZeneca (AZ) vaccine, some individuals may experience various side effects, including small bruises or petechiae (tiny red or purple spots on the skin caused by bleeding). In your case, the appearance of small bruises on your hands and feet, along with swelling in your feet, raises valid concerns, especially considering the discussions surrounding vaccine-related thrombosis.

Firstly, it is essential to understand that while the AZ vaccine has been associated with rare cases of thrombosis with thrombocytopenia syndrome (TTS), these occurrences are extremely uncommon. TTS is characterized by the formation of blood clots in conjunction with low platelet counts, which can lead to serious complications. However, the vast majority of individuals who receive the vaccine do not experience these severe side effects.

The small bruises you are observing (0.3mm-0.4mm) could be a result of various factors, including minor trauma, increased fragility of blood vessels, or even a benign reaction to the vaccine. It is also worth noting that some people may experience mild swelling in their extremities post-vaccination, which can be attributed to the body's immune response to the vaccine. This response can cause localized inflammation, leading to temporary swelling.

If you are concerned about the possibility of blood clots or any serious complications, it is advisable to monitor your symptoms closely. Key signs to watch for include:
1. Severe headache: A persistent headache that does not respond to typical pain relief methods.

2. Vision changes: Blurred or double vision.

3. Leg swelling or pain: Particularly if it is unilateral (affecting one leg).

4. Shortness of breath: Difficulty breathing or chest pain.

If you experience any of these symptoms, it is crucial to seek medical attention promptly.
Regarding your specific situation, if the bruises and swelling persist or worsen, it would be prudent to consult a healthcare professional. You may want to schedule an appointment with a primary care physician or a hematologist, who specializes in blood disorders. They can perform a thorough evaluation, including blood tests to assess platelet levels and other relevant parameters, to determine if there is any underlying issue that needs to be addressed.

In summary, while the appearance of small bruises and swelling after vaccination can be concerning, they are not uncommon and often resolve without intervention. However, due to the potential for rare but serious complications, it is essential to remain vigilant and seek medical advice if you have any doubts or if your symptoms change. Your health and peace of mind are paramount, and a healthcare provider can help clarify your concerns and guide you on the next steps.

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