I have not made a post on this thread for some time, as there has been no firm data to report. Now things are changing fast. There does seem to be a definite association between mDNA vaccines and PF4 antibodies. Those are Platelet Factor 4 antibodies. The result if a condition known as thrombotic thrombocytopenic purpura, or TTP.
Now I will do my best to explain all this in as simple terms as possible.
First I have to explain the current state of play in the world.
Our vaccine program is progressing well, but not well enough to prevent serious outbreaks like in Michigan.
Europe is chaotic for multiple reasons.
India and some other countries are in dire straights. India which was to supply a good deal of the world, is understandably using all vaccine produced in india for domestic consumption. The WHO are not happy, but that is the way I think it has to be.
The UK seems to be doing very well. The early decision to space vaccine doses by 90 days, manufacturer's objections notwithstanding, appears to have been a good one. Imperial college feel that most parts, if not all of the UK has reached herd immunity. There are large parts of the country that have not seen a Covid death in weeks.
I mention this now, as it has a bearing on some decisions that are going to have to be made, and are being made going forward. This in the context of the information I am about to attempt to explain to you.
Cases of cavernous sinus thrombosis, and other thrombotic events started to appear in Germany and Scandinavia 6 to 14 days after immunization after receiving the Astrazeneca vaccine. These events were rare at an incidence of 4 in a million doses, with a fatality of one in a million doses.
Since clotting problems are not uncommon, initially it was hard to separate these cases from the noise, and no mechanism of causation was apparent initially. However it was quickly realized that these cases were associated with a precipitous drop in platelet count and bleeding at the same time as clotting in the vessels.
It soon became apparent that these changes had remarkable similarity to a condition known as HITT. That is Heparin Induced Thrombocytopenia. Heparin is a commonly used anticoagulant in hospitals, and this reaction has been known for some time. It is common in many institutions to do platelet counts twice a week in patients receiving heparin.
Since this reaction to the Astrazeneca vaccine, and now the J & J vaccine, is now known as VITT. (Vaccine Induced Thrombotic Thrombocytopenia).
Both conditions generate the PF4 antibody that cause platelet clumping, and therefore clotting and in severe cases catastrophic intravascular clotting.
So the condition can be recognized by ELISA antibody test to the PF4 antigen, in cases of low platelet count in symptomatic patients after vaccination.
In addition the D-Dimer test can be used to assess the degree of intravascular clotting.
The treatment is anticoagulation with an anticoagulant other than Heparin. IVIG, which is gamma globulin should also be administered as soon as possible.
It seems this adverse reaction is commoner in younger patients and females. It also seems to have a somewhat different prevalence in different countries, being more common in Germany, and Scandinavia than the UK. It is possible that this is related to the prevalence of Covid-19 in the community.
The question that is not solved, is what is the component in the vaccine causing this pathological immune reaction? The PF4 antibody levels are higher in VITT than HITT. The former having an antibody optical density of 1.6, whereas VITT cases have an optical density of 2.9 to 3.8.
So the problem becomes what to advise. For most age groups the risk of dying from Covid-19 are considerably higher than dying of VITT. In addition this pandemic is causing economic havoc, and restrictions on populations have to be wound down and soon end. In addition when cases are high then other medical conditions can not be treated in a timely manner. That includes cancer cases and urgent cardiovascular disease. Cancer mortality is on the rise due to this pandemic. So this pandemic is causing excess deaths other than by deaths from infection. So continuing vaccination at pace is an utmost priority.
Sir David Spiegelhalter of Cambridge University has done a detailed risk benefit analysis for the UK. He finds that the risk benefit of vaccination with the Astrazeneca vaccine is positive for all those over 30 years of age, but starts to reverse for those under 30. Accordingly the UK stopped administering the Astrazeneca vaccine to those under 30.
This does remain a significant issue as regards immunizating poorer, less well developed countries. The Astrazeneca vaccine is being produced at cost. The mRNA vaccines are more costly to produce, and have the cold storage problem. Pfizer have just hit the EU with a large price increase.
So it looks as if mDNA vaccines are going to have to do the heavy lifting over most of the world. Lastly countries with poor resources will have a hard time and recognising, and especially treating VITT, as HVIG is scarce, and thousands of dollars a dose.
In many jurisdictions there is the obvious fear of increasing vaccine resistance, delaying exit from the grip of this pandemic. In the UK at least, this has not occurred to a significant degree. Most of the UK public seem to have taken a realistic view of the situation, and a desperate to escape the restrictions of the pandemic.
Lastly the actual element in these mDNA vaccines, which is likely to include Sputnik 5 by the way, is not known. Likely suspects are antibodies to the spike antigen and the adenovirus. The former is not likely, or we would see it with the mRNA vaccine. I should say there is at this time some very low level concern about them also. The most likely suspect is the adenovirus vector. This is because this platelet problem has been seen with adenovirus infections occasionally.
So to end, more understanding as to the causative factors need to be understood. This especially applies to prevention and better treatment. Also it is likely that certain individuals are predisposed to the problem. If that is so, then detecting those individuals would be extremely helpful.
Urgent research into nano shields not requiring high degrees of refrigeration would also be helpful. The Pfizer vaccine no longer requires a two stage compressor freezer. This is vital for third world distribution.
