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Platelet blood test before vax appointment

13 replies

Wobbitcatcher · 03/05/2021 20:06

I have a few risk factors for blood clots (so I’m told during pregnancy and contraceptive chats)

I’m also age 30 and recently given birth, so I’ve asked my GP for advice about the vaccine. I’m very pro vax but want to make an informed choice.

GP has suggested a blood test prior to the vax to find out more about my platelets - has anyone else had this? Im looking for more information on the link between have low platelets prior to the vaccine and the chance of clots.
Thanks

OP posts:
MRex · 03/05/2021 20:42

The cause of the specific clots is called thrombocytopenia; that's low platelets. You need platelets to stop bleeding, but with this issue they erroneously clump together and cause clots, known as thrombosis. Details here:
www.hematology.org/covid-19/vaccine-induced-immune-thrombotic-thrombocytopenia.

Your GP is looking to see if you have low platelets already that might put you at rush, and may do a blood test after to look for changes. Sounds like you have a good GP there.

Wobbitcatcher · 03/05/2021 21:02

Thank you @MRex my confusion (and based on very little medical knowledge) comes from the point at which the thrombocytopenia develops. That link reads as though developing it after the vax is the risk not having it before the vax?

Could I have false reassurance if my platelets are fine before it?

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neveradullmoment99 · 03/05/2021 21:07

@Wobbitcatcher

Thank you *@MRex* my confusion (and based on very little medical knowledge) comes from the point at which the thrombocytopenia develops. That link reads as though developing it after the vax is the risk not having it before the vax?

Could I have false reassurance if my platelets are fine before it?

Yes. You could have positive reassurance. They really don't know. The truth is, if you are identified as having low platelets already, I doubt they would give you the vaccine [ At leas the AZ one] To my knowledge, its people who haven't had medical conditions that they know of that have developed this. They think [ although not proven] that there is a causal link between having the vaccine and developing this condition after having the vaccine.
neveradullmoment99 · 03/05/2021 21:08

Sorry false reassurance!

neveradullmoment99 · 03/05/2021 21:10

It really is difficult to tell if these that have developed this condition had it in the first place. Would they have low platelets without knowing it? You would need to ask a doctor!
I think the general thought is that these people did develop it after the vaccine.

ThatIsMyPotato · 03/05/2021 21:13

It is low platlets after the vaccine (possibly caused by) that they are concerned about. If you already have low platlets it is worth getting it looked at generally even if it's just so a note can be put on your file to advise that it's not an issue should you need surgery if this is the case.

MRex · 03/05/2021 21:19

@Wobbitcatcher

Thank you *@MRex* my confusion (and based on very little medical knowledge) comes from the point at which the thrombocytopenia develops. That link reads as though developing it after the vax is the risk not having it before the vax?

Could I have false reassurance if my platelets are fine before it?

Sort of, I don't know what the threshold is for deciding whether to vaccinate. If you already have a possible risk factor then it's good to know that in advance, of course. Getting the blood test after vaccination is also important, but your GP's approach also allows comparison with you 3 days ago rather than general average. So if normal platelets are N and you have N + Y, great have a vaccine. Then retest, if you're now N - X, then even if X is small the GP is alerted to keep checking and it's treatable so that's good.
Wobbitcatcher · 03/05/2021 21:33

Thanks all - so worth doing the blood test because the platelet status of those with issues was unknown so they may have had it prior to the vaccine. Could also provide an accurate and recent base level incase of change after the vax if there’s an issue.

But not to be taken as platelets are fine so not at risk.

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thegcatsmother · 03/05/2021 22:07

The truth is, if you are identified as having low platelets already, I doubt they would give you the vaccine [ At leas the AZ one]

Really? I have had ITP ( and thus a low platelet count) for 26 yars this year, I had my second AZ vaccine yesterday and my count is usually about 32k.

This is helpful. Prof Newland is one of the experts on ITP in the UK.

Covid-19 vaccines and blood clotting. Prof Adrian Newland 02/04/2021

There has been much discussion in the media recently regarding the potential development of thrombosis (clots) post-vaccination and a lot of the debate has centred on the Oxford/Astra Zeneca vaccine, although studies world-wide show that thromboses occur with all 4 currently available vaccines (Pfizer, Moderna and Johnson and Johnson) and the rate is no greater than that expected in the normal population. A published review within the last week from Denmark looking at whole population figures has confirmed this statement. Nevertheless use has been restricted in a number of European countries to certain age groups. Canada has also recently restricted use; although their use of the Oxford/AZ vaccine is restricted and they have reported no cases of thrombosis they are following the European restrictions.

The particular worries have been caused by the recent reports of a specific type of clotting known as cerebral sinus vein thrombosis (CSVT) which is often associated with a lower platelet count. Internationally it has been reported in about 5 cases per million following vaccination, which is equal to the rate described in the normal population. It has attracted attention because it has predominantly occurred in younger women and occurs about 7-14 days post vaccination. In normal populations the use of oral contraceptives enhances the clotting risk and whether there is a hormonal element in these events is not yet clear. Deaths occur in just under half affected, although there is effective treatment if diagnosed early enough. These reports in Europe have been predominantly in those receiving the Oxford/AZ vaccine, although there are rare cases in the other vaccines. A very recent review in the UK has reported 18 cases in the 30 million vaccinated. The populations treated in the different countries are not always comparable and reporting may not be complete but there is no doubt that the use of all the covid-19 vaccines have been subject to closer scrutiny than any other vaccines and adverse events are recognised in all vaccines.

Covid-19 itself causes a very similar syndrome and I am aware of at least one case who was diagnosed with Covid-19 post-mortem, so they had the infection at the time of the vaccination. It is worth noting that Covid-19 itself causes death at the rate of about 200 per million. It has been estimated by Professor Sir David Spiegelhalter, an eminent expert on risk from the University of Cambridge, that there are 2-3 deaths per million in people in their 50s for every week that the vaccine programme is delayed (and of course it is greater in older, more susceptible, age groups). That is of course just one week and for the unvaccinated population that risk is present for every subsequent week that they remain unvaccinated.

It must also be pointed out that thrombotic events occur in 21% of hospitalised patients with Covid-19 and this doubles the mortality (23% against 13%).

It is not clear yet whether the vaccines cause this CSVT syndrome, they may. The evidence is patchy and varies between countries. It may be a batch effect, related to an underlying Covid-19 infection or related to other health factors or medication and this will doubtless become clearer. I can understand the worry but it is a case of balancing risks and benefits. As we can see from the UK and Israel the vaccines prevent infections and rapidly reduce deaths, not to mention the million or so reported today with symptoms of long-Covid-19 problems. The current differences between the UK and the majority of the rest of Europe reflect the impact of the success of our vaccination programme and although we cannot be complacent we can be cautiously optimistic as we slowly come out of lockdown. The various vaccines have now been given to over 250,000,000 people world-wide. With these numbers occasional adverse events may arise but equally with these numbers other, independent health issues will arise as well. What we can say is, that despite many peoples’ worries about the speed of the development of the vaccines, their use has been associated with a major effect on the incidence and impact of Covid-19 infection and spread, were it has been given in sufficient quantities. No major downsides have yet come to light.

We know from previous health scares that public confidence is fragile, as we have seen with MMR, and it is incumbent on the press and the politicians to provide the data and advice in a dispassionate way.

Professor Adrian Newland 02/04/2021
Category: Covid-19 Hub

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neveradullmoment99 · 03/05/2021 23:49

Really? I have had ITP ( and thus a low platelet count) for 26 yars this year, I had my second AZ vaccine yesterday and my count is usually about 32k.

Well I am not a doctor but would have assumed they may have been more wary? Maybe not in your case! Or in other cases!!

Wobbitcatcher · 03/05/2021 23:55

@neveradullmoment99 begs the question why they would test me if the outcome would be the same either way!

@thegcatsmother I’m wondering if my age would make this more of an issue - presuming that if you are older than me then covid is a greater risk to you generally as well as due to clotting?

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PurplePumpkinDream · 04/05/2021 00:11

@thegcatsmother Thanks very informative ad helpful article.

thegcatsmother · 04/05/2021 06:52

Neveradullmoment99 I had my first jab of AZ in February. I am at greater risk of COVID than of having the vaccine, as my immune system is more focused on destroying my platelets than fighting infections/viruses. I wanted AZ as opposed to the others as I had read reports from the U.S. of a issues with Pfizer, and a loss of platelets.

Nothing is risk free. I drive a car; I used to take the pill. You weigh up the risk. On balance, it was less risk to have the jab than not.

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