{"id":2988,"date":"2021-04-30T10:28:00","date_gmt":"2021-04-30T14:28:00","guid":{"rendered":"https:\/\/news.med.virginia.edu\/kidsmatter\/?p=2988"},"modified":"2021-05-02T08:42:00","modified_gmt":"2021-05-02T12:42:00","slug":"covid-19-corner-april-2021-updates","status":"publish","type":"post","link":"https:\/\/news.med.virginia.edu\/kidsmatter\/covid-19-corner-april-2021-updates\/","title":{"rendered":"COVID-19 Corner: April 2021 Updates"},"content":{"rendered":"<p><em>by Dr. Debbie-Ann Shirley, Division Head of Pediatric Infectious Disease<\/em><\/p>\n<p><strong><em>COVID-19 vaccines and TTS.<\/em><\/strong> Thrombosis with thrombocytopenia syndrome, or TTS, is a rare syndrome characterized by thrombosis (often cerebral or abdominal) with thrombocytopenia that has been observed within 3 weeks of receipt of the Johnson &amp; Johnson (J&amp;J) COVID-19 vaccine. The J&amp;J COVID-19 vaccine was first authorized for use in the US at the end of February 2021. \u00a0Here is a brief recap of the remarkable events that rapidly unfolded shortly after in April:<\/p>\n<ul>\n<li><em>April 13<sup>th<\/sup><\/em>: following initial reports of rare thromboembolic events among J&amp;J vaccine recipients, the CDC recommended a pause in the use of the J&amp;J COVID-19. Similar reports had emerged internationally following receipt of the similar adenovirus-vector Astra-Zeneca vaccine<\/li>\n<li><em>April 21<sup>st<\/sup><\/em>: of 7.98 million J&amp;J vaccine doses administered, there were 15 confirmed cases of TTS reported. All were females, mostly in the third decade of life (age range 18 -59 years), many without known underlying risk factors for thrombosis and all with positive PF4 heparin-induced thrombocytopenia ELISA when tested. In depth review of these cases indicated that risk of death and serious outcome of COVID-19, including thrombosis, overall far outweigh risk of TTS possibly associated with vaccination<\/li>\n<li><em>April 23<sup>rd<\/sup><\/em>: the CDC Advisory Committee on Immunization Practices recommended resumption of the use of the J&amp;J vaccine with a new warning on the patient fact sheet. In addition to providing highly efficacious protection against COVID-19, the single dose J&amp;J COVID-19 vaccine offers advantages of flexibility, choice, improved patient access for vulnerable populations and efficiency for mobile vaccination clinics, Emergency Departments and Student Health centers<\/li>\n<\/ul>\n<p>All healthcare professionals should be alert to the signs and symptoms of TTS in individuals who received the J&amp;J COVID-19 vaccine, which include severe headache, visual changes, abdominal pain, emesis, back pain, difficulty breathing, leg pain\/swelling or petechiae. Evaluation in includes obtaining complete blood count with platelets and imaging for thrombosis based on symptoms, with urgent consultation by a hematologist since the outcome is significantly improved with rapid identification and management<em>.\u00a0<\/em><em>Heparin should be avoided until TTS has been excluded<\/em><em>.<\/em> Education for patients, nursing, and providers at UVA is under development<em>. <\/em>In the meantime, the American Society for Hematology has helpful information <a href=\"https:\/\/www.hematology.org\/covid-19\/vaccine-induced-immune-thrombotic-thrombocytopenia\">here<\/a>.<\/p>\n<p>As a reminder, anyone who is \u2265 16 years living in Virginia is now eligible for COVID-19 vaccination. The Moderna and J&amp;J COVID-19 vaccines are currently authorized for use in those \u2265 18 years of age and the Pfzier\/ BioNTech vaccine for those \u2265 16 years of age. Vaccine makers have expanded age eligibility in vaccine trials down to 6 months of age. Based on interim results, Moderna and Pfizer\/ BioNTech have already submitted to the FDA to expand authorization to \u2265 12 years and planning is underway at UVA to offer vaccination to middle school children in anticipation of a decision soon. Patients eligible for vaccination can call the UVA COVID-19 vaccine call center at 434-2977-4829 (4VAX) to schedule an appointment.<\/p>\n<p>For more information: <a href=\"https:\/\/www.cdc.gov\/mmwr\/volumes\/70\/wr\/mm7017e4.htm\">Updated Recommendations from the Advisory Committee on Immunization Practices for Use of the Janssen (Johnson &amp; Johnson) COVID-19 Vaccine After Reports of Thrombosis with Thrombocytopenia Syndrome Among Vaccine Recipients \u2014 United States, April 2021 | MMWR (cdc.gov)<\/a><\/p>\n<p><strong>In case you missed it, here are links to some other recent COVID-19 updates at UVA:<\/strong><\/p>\n<p><a href=\"https:\/\/emergency.healthsystem.virginia.edu\/human-resources\/team-member-travel\/employee-health-travel-guidelines\/\">Updated Travel Guidelines for UVA Health Team Members<\/a><\/p>\n<p><a href=\"https:\/\/emergency.healthsystem.virginia.edu\/in-patient-plans\/covid-admission-testing-workflows-womens-l-d-and-childrens\/\">Asymptomatic patients with prior COVID+ test excluded from pre-op\/ admission testing to 120 days<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>by Dr. Debbie-Ann Shirley, Division Head of Pediatric Infectious Disease COVID-19 vaccines and TTS. Thrombosis with thrombocytopenia syndrome, or TTS, is a rare syndrome characterized by thrombosis (often cerebral or abdominal) with thrombocytopenia that has been observed within 3 weeks of receipt of the Johnson &amp; Johnson (J&amp;J) COVID-19 vaccine. The J&amp;J COVID-19 vaccine was [&hellip;]<\/p>\n","protected":false},"author":338,"featured_media":2901,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[6],"tags":[270],"class_list":["post-2988","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-features","tag-ds3ru"],"acf":false,"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>COVID-19 Corner: April 2021 Updates - Monthly Matters<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/news.med.virginia.edu\/kidsmatter\/covid-19-corner-april-2021-updates\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"COVID-19 Corner: April 2021 Updates - Monthly Matters\" \/>\n<meta property=\"og:description\" content=\"by Dr. Debbie-Ann Shirley, Division Head of Pediatric Infectious Disease COVID-19 vaccines and TTS. 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