Where could I get some sensible, medical advice regarding the vaccines?

[Springersrock]

I’ve tried my GP - they say speak to 119. 119 say speak to my GP.

My jab is all booked, perfectly happy to have it, but I do have a bit of a medical thing and I would like a bit more information.

I have this thing where when I have a virus or an infection, my blood platelets drop, I end up absolutely covered in small bruises, bloodshot eyes, etc, and complete and utter, bone-crushing fatigue

It doesn’t happen every time I’m ill, but I’ve had it a few times over the last 10 or so years. I’ve had loads of tests and investigations but no one has ever got to the bottom of it, other than around the time it started, blood tests show some sort of infection

With the concerns around Az and blood clots and thrombocytopenia I’d just like a bit of a chat really. I’ve had a bit of a search myself, but I haven’t found anything particularly helpful or reassuring.

Thanks!

Your GP sounds unhelpful. Your GP could book full blood counts before the vaccine and after, so that they can keep an eye on it, or refer you to a haematologist to find out why it happens. There might be an underlying cause e.g. anaemia. Might be wise to follow that approach with any of the vaccines.

I have had low platelets the past and also have asked for a call with the GP to discuss as am due the AZ. I would prefer the Pfizer for this reason but am fully expecting the GP to dismiss it. I think if there is another option then you should be offered it. Good luck.

Personally I'd try and speak to a different GP, yours sounds particularly unhelpful!

I believe that low platelet count itself isn't a risk factor for AZ-associated CVST though, it's a secondary event probably caused by an auto-immune reaction.

Sounds like HSP?

Sorry OP I am not a doctor

Do you have low platelets normally or you experience a drop when you are ill?

From memory, i think they asked "are you on blood thinners or do you have any blood disorder" when I had mine.

Here's the BMJ on the subject, you might have seen it already.

www.bmj.com/content/373/bmj.n954

Your Gp should be the one dealing with it. Threaten a call to the practice manager. Normally works

Thanks all!

I haven’t been able to get through to my GP on the phone - it just rings out. I filled in the e-consult form asking to speak to my GP about it and got a reply to speak to 119. I’ve sent another e-consult since I spoke to 119, but no response.

I don’t normally have low platelets. It’s only when ill, and then it’s not every time. It resolves itself, although last time I did come very close to having to have a platelet transfusion. Last time it happened was August 2019.

I have seen that link, thank you.

I’ve seen a haematologist a couple of times and they’ve never got to the bottom of it. They can see I’ve had some kind of viral infection from blood tests, but that’s about it.

I’m happy to have the vaccine, I’m there with my arm out, but I want a chat with a medical professional first.

Thank you!

I'd try filling in the e consult without the v word. It probably triggers an automatic response. Just say I need to speak to someone urgently about my blood disorder.

I’ve finally heard back from them - I have to have blood tests, then he’ll call me to discuss next week.

Thanks

@Springersrock

I’ve finally heard back from them - I have to have blood tests, then he’ll call me to discuss next week.

Thanks

Hope all is well.

It's a bit of a unknown tbh - so no suprise that nobody has got to the bottom of it yet.

Some useful reading for you here, although it may be nothing new
www.webmd.com/a-to-z-guides/thrombocytopenia-symptoms-causes-treatments#1

www.medpagetoday.com/resource-centers/chronic-immune-thrombocytopenia-meeting-challenge/clinical-challenges-secondary-itp/2412#:~:text=%E2%80%94Same%20characteristics%20as%20primary%20ITP,may%20be%20difficult%20to%20detect.&text=Like%20primary%20immune%20thrombocytopenia%20(ITP,production%2C%20or%20increased%20platelet%20destruction.

In short, you have the same, albeit much milder condition, caused by the vaccine, but from a different source. I would have thought this put you into a category for avoiding the AZ vaccine, because although you're unlikely to be at increased risk of the autoimmune response of concern caused by the vaccine, the fact you get these symptoms from other sources is an unecessary complication when the Moderna vaccine is now available.

Thank you.

I’ll have a proper read of those links later, I don’t think I’ve seen them before.

My GP says I can still have the vaccine, just depending on my blood results it just may have to be a different one. I’m booked in for, we presume, Az at the local vaccine hub, but you don’t get a choice there so I will have to have it at the surgery.

He did say that the haematologist never followed up with my GP, so they were under the impression I hadn’t been for the referral. The haematologist was quite dismissive actually - he asked why I was there, then said they could see I’d had some sort of infection but nothing to worry about and sent me on my way. Bit alarming, but I guess as the last time it happened was 18 months ago, anything serious, I’d know about it by now.

I’ve been and had the blood test, results due Tuesday and GP will ring me Tuesday PM, so we’ll see from there

Thank you!

It's good that the GP is looking after you. There has been thrombocytopenia with all the vaccines, so regardless of which one you have it might be useful to push the GP for an extra full blood count at some stage (a few days?) after the vaccine.

I have contacted a Dr "Lead of Pharmacy" at a UK University who writes about Covid as I caught Dengue Fever 25 years ago which resulted in Thrombocytopenia and my platelet count dropped to less than 10,000 when normal levels are 150,000-450,000.

Some of his reply although specific to my situation may be of interest:

"There have been previous reports of Dengue virus infecting platelets and attracting an immune response that leads to auto-immune destruction of infected platelets. Please refer www.bmj.com/content/372/bmj.n699/rr-20

In majority of patients this is reversible with hospital care particular when immune response was very selective towards infected platelets only and body replenishes the platelets with fresh produce. Often some patients where immune response is non-selective, removal of spleen is often a remedial option. You may wish to check with your medical history if your thrombocytopenia was mediated by any antiplatelets antibodies found in your blood (if tested), if not, there may be a possibility to run a blood test now to assess your current situation (but they may not live that long but may form again if there was a predisposition). In theory, subjects with history of thrombocytopenia or immune thrombocytopenia are at a higher risk of post-covid thrombocytopenia which may increase the risk of internal bleeding (haemorrhage) and spontaneous formation of clots.

The risk of thrombocytopenia with CoViD vaccine has now been recognised by European Medicines Agency and listed as a ‘common’ side effect of the vaccine in the summary of product characteristics in a recent revision. A common side effect is defined as 1 in 10 to 1 in 100. Please refer Table 1 on page 6 here: www.ema.europa.eu/en/documents/product-information/vaxzevria-previously-covid-19-vaccine-astrazeneca-epar-product-information_en.pdf

I would encourage you to discuss this with your GP who may also run some blood tests to check your current blood counts and can do a full thrombotic screen (few additional blood tests) to assess your current risk of clot formation. This may help you understand the risks and making an informed decision about the vaccines."

I am going to ask my GP if I can have a platelet test about 5 days after I have my vaccine (I am 49 so it will be soon I imagine).

I will also take Papaya Leaf extract which is meant to help boost platelet levels.

I should add my last platelet count in 2017 was 217,000 so in normal range. I think knowing a recent baseline level would be sensible for you to make a decision on which vaccine is suitable.