ReviewVaccines2021
Thrombotic Thrombocytopenia after COVID-19 Vaccination: In Search of the Underlying Mechanism.
Review in Vaccines, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
52 citing papers in PubMed, 2 syntheses or guidelines pooled it, 81 citations in OpenAlex.
- Acute ischemic stroke and vaccine-induced immune thrombotic thrombocytopenia post COVID-19 vaccination; a systematic review.Journal of the neurological sciences · 2022Pooled it
- Cardiovascular and haematological events post COVID-19 vaccination: A systematic review.Journal of cellular and molecular medicine · 2022Pooled it
- Xenosialylation as immunological chimerism: a host-centered unifying model for viral and post-vaccination immune complications.European cytokine network · 2026Review
- Unique Features and Collateral Immune Effects of mRNA-LNP COVID-19 Vaccines: Plausible Mechanisms of Adverse Events and Complications.Pharmaceutics · 2025Review
- Assessing the Burden of Thromboembolic Complications in Outpatient COVID-19 Cases: A Focused Study on Patients Followed in Primary Care.The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2025Article
- A lipid nanoparticle-based oligodendrocyte-specific mRNA therapy.Molecular therapy. Nucleic acids · 2024Article
- Immunization of laboratory animal workers: occupational health and safety aspects.Pathogens and global health · 2024Review
- Preliminary Report of Nationwide COVID-19 Vaccine Compensation in Taiwan.Healthcare (Basel, Switzerland) · 2024Article
- Cerebral Venous Thrombosis during Thyrotoxicosis: Case Report and Literature Update.Journal of personalized medicine · 2023Review
- [Research on immunological function of platelet receptor FcγRⅡA].Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi · 2023Article
- Review
- To aspirate or not to aspirate? Considerations for the COVID-19 vaccines.Pharmacological reports : PR · 2022Review
- Oral antiviral treatments for COVID-19: opportunities and challenges.Pharmacological reports : PR · 2022Review
- Autopsy findings of post-COVID-19 vaccination deaths in Tokyo Metropolis, Japan, 2021.Legal medicine (Tokyo, Japan) · 2022Article
- Pulmonary Embolism and Inferior Vena Cava Thrombosis in a Young Male Patient after mRNA-1273 (Moderna) Immunization: A Case Report.Tuberculosis and respiratory diseases · 2022Article
- Article
- Impact of the COVID-19 Pandemic on Global Diseases and Human Well-Being.Journal of clinical medicine · 2022Article
- COVID-19 Vaccine Booster Strategies for Omicron SARS-CoV-2 Variant: Effectiveness and Future Prospects.Vaccines · 2022Review
- Neutrophil extracellular traps promote thrombogenicity in cerebral venous sinus thrombosis.Cell & bioscience · 2022Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The rollout of COVID-19 vaccines brings hope for successful pandemic mitigation and getting the transmission of SARS-CoV-2 under control. The vaccines authorized in Europe displayed a good safety profile in the clinical trials. However, during their post-authorization use, unusual thrombotic events associated with thrombocytopenia have rarely been reported for vector vaccines. This led to the temporary suspension of the AZD1222 vaccine (Oxford/AstraZeneca) in various European countries and the Ad26.COV2 vaccine (Janssen/Johnson&Johnson) in the United States, with regulatory bodies launching investigations into potential causal associations. The thromboembolic reactions were also rarely reported after mRNA vaccines. The exact cause of these adverse effects remains to be elucidated. The present paper outlines the hypotheses on the mechanisms behind the very rare thrombotic thrombocytopenia reported after the COVID-19 vaccination, along with currently existing evidence and future research prospects. The following are discussed: (i) the role of antibodies against platelet factor 4 (PF4), (ii) the direct interaction between adenoviral vector and platelets, (iii) the cross-reactivity of antibodies against SARS-CoV-2 spike protein with PF4, (iv) cross-reactivity of anti-adenovirus antibodies and PF4, (v) interaction between spike protein and platelets, (vi) the platelet expression of spike protein and subsequent immune response, and (vii) the platelet expression of other adenoviral proteins and subsequent reactions. It is also plausible that thrombotic thrombocytopenia after the COVID-19 vaccine is multifactorial. The elucidation of the causes of these adverse events is pivotal in taking precautionary measures and managing vaccine hesitancy. It needs to be stressed, however, that the reported cases are currently sporadic and that the benefits of COVID-19 vaccines vastly outweigh their potential risks.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.