Australia’s expert advisory group on vaccines has recommended the COVID-19 vaccine be deferred for people who have a history of specific rare blood clotting disorders.

This is the first time a warning has been given for COVID-19 vaccines in Australia, and the recommendation applies to both Pfizer and AstraZeneca vaccines, although the current concerns have been focussed on the latter.

The Australian Technical Advisory Group on Immunisation (ATAGI) said “for the time being, ATAGI recommends that vaccination with any COVID-19 vaccine should be deferred for people who have a history of … rare conditions.”

It listed the rare conditions as people with a confirmed medical history of cerebral venous sinus thrombosis (CVST) and people with a confirmed medical history of heparin-induced thrombocytopenia (HIT).

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CVST is clotting in the veins of the brain that carry blood back to the heart. It’s rare and primarily affects younger people.

HIT is related to the use of the commonly used drug heparin, which reduces the risk of clots.

However, in rare cases, the drug can react to a chemical in the blood, which then induces antibodies and can lead to clotting.

In the case of the AstraZeneca vaccine, German researchers have found that the same antibodies appear to have formed; however, the patients had not been taking the drug heparin.

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ATAGI co-chair Professor Allen Cheng said the clinical advice for both AstraZeneca and Pfizer vaccine was only “precautionary”.

“As of yesterday, there were 18 cases reported in about 20 million vaccinations,” he said.

“It’s early data, but these are unusual thrombosis — different from the usual DVTs (deep vein thrombosis) that people get.”

“We don’t know at this stage if this is a real signal, so as a precaution, people who have had heparin-induced thrombocytopenia in the past probably should hold off on vaccination.

“And people who have cerebral venous sinus thrombosis should also probably hold off.

“It’s just precautionary, but these conditions are incredibly rare.”

Professor Allen Cheng, who has short dark hair and glasses, stands at a Victorian press conference.
Professor Allen Cheng said the clinical advice was “precautionary”.(

ABC News: Scott Jewell

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Professor Cheng said he didn’t know how many people this advice would apply to. but “it wouldn’t be many”.

“I would imagine it could be a couple of hundred people, but I don’t know for sure.”

Australian warning comes as Europeans continue to investigate

Two weeks ago, countries across Europe halted the use of AstraZeneca following reports of blood clots.

However, vaccination programs in most countries resumed again last week after the European medical regulator, the European Medicines Agency, found the benefits of getting the vaccine continued to outweigh the risks.

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But the EMA said while there was no indication the blood clots had been caused by the vaccine, experts would continue to investigate the possibility.

A needle balanced on a vial of the AstraZeneca vaccine
According to AstraZeneca, a review of safety data of people vaccinated with its COVID-19 vaccine has shown no evidence of an increased risk of blood clots.(

Reuters: Dado Ruvic

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The European pause was entirely about the AstraZeneca vaccine, but ATAGI has also recommended a pause for Pfizer.

Professor Cheng said that was also a precautionary move.

“There’s a lot of commonalities — even though they’re different vaccines, there are some common factors about these vaccines and different ways of giving the spike protein,” he said.

“So really, until we know a little bit more about these [clotting reports], we’re advising those specific groups to hold off [on being vaccinated]”.

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Experts are waiting for more data

It’s unknown how long this recommendation will remain in place.

“It’s really an evolving story. There’s a lot of work being done on it at the moment,” Professor Cheng said.

“I expect we’ll know more in the next couple of weeks.”

It appears many experts are awaiting the publication of the German research, which was the first to link the vaccine clotting reports to heparin-induced thrombocytopenia.

The research found that certain antibodies are created after the patient had the AstraZeneca vaccine, which cross-react with platelets in the blood.

For now, authorities around the world are waiting for more information and research before making their next moves.

ATAGI agrees with current European advice that “the benefits of the COVID-19 vaccine far outweigh this potential risk”.

However, it has reminded doctors that they should continue to watch out for unexpected events.

“As for all vaccines, including COVID-19 vaccines, healthcare providers should be alert for persistent, unexpected and/or severe adverse events following immunisation in their patients, particularly those that occur 1–2 weeks after vaccination,” ATAGI’s statement said.



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