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Fear of thrombosis Astrazeneca: yes or no? - Doctor answers patient questions

- The most common questions about Astrazeneca -

I have Factor V ailment. Should I get vaccinated with Astrazeneca?

Dr. Ute Scholz: That is a very common question. With factor V disease, blood clotting is impaired and those affected have a higher risk of developing a thrombosis. But the factor V Leiden mutation is a so-called point mutation, which is the mildest inheritable risk of thrombosis in Germany. That has five percent of the European population. And the five percent don't develop those side effects that Astrazeneca has now seen. Incidentally, there were also thromboses with the Biontec vaccine. That is also an opinion of the Saxon Vaccination Commission. Thrombophilia in this sense, i.e. a tendency to thrombosis in the blood that the patient appears to have, is not a contraindication for any vaccine. On the contrary, and I would like to emphasize this very clearly at this point: With a Covid 19 infection, we have a multiple increased risk of getting thrombosis. Also fatal pulmonary embolism. And if we don't vaccinate, we have the problem that these patients suffer extremely serious complications. So the message is clear: vaccinate? Yes! And in this case it doesn't matter which vaccine!

Incidentally, there were also thromboses with the Biontec vaccine.

Dr. Ute Scholz, Leipzig Center for Coagulation Disorders

Wouldn't it be a possibility to give prophylactic blood thinners to women taking the pill to reduce the risk of thrombosis?

Unfortunately, this is being done at the moment that, after vaccination with Astrazeneca, heparin is prescribed to patients. But this is absolutely contraindicated. There is no reason to prophylactically give blood-thinning medication to vaccinated patients. On the contrary. We probably have an immune-mediated reaction that is in the background in the very few - really few - patients. And then you shouldn't give heparin, because complications are more likely to occur.

I already had a deep vein thrombosis / pulmonary embolism. Should I wait for another vaccine?

Clearly: no! It would be good if this patient got vaccinated. Because the risk of developing thrombosis from a Covid 19 infection is significantly higher. And he should definitely get vaccinated and not refuse it. Sometimes I also hear from patients: Then I'll wait for the Russian vaccine! But the Sputnik-V vaccine and that of Johnson & Johnson are also adenovirus vector vaccines. This is practically the same vaccine type that we have at Astrazeneca.

I take a drug that has a higher risk of thrombosis. Should I get vaccinated with Astrazeneca?

There are of course drugs that increase the tendency to thrombosis, for example in oncology. It depends on the overall context why you get this. That is why it has to be discussed with the patient individually.

Can a younger patient who is prone to thrombosis and who has already had the first vaccination with Astrazeneca receive a second vaccination with another vaccine as a precaution?

Here, too, quite clearly: no! There are long approval studies for this and I should get a second vaccination with the same vaccine that I was originally vaccinated with.

How do you recognize a sinus vein thrombosis?

Sinus vein thrombosis is an extremely rare thrombosis. This goes hand in hand with a so-called annihilation headache. So not just a bit of a headache! Many also report after the vaccination that they have a bit of headache and discomfort. And so feel fever and flu. This is not a sinus vein thrombosis. But a real headache without being able to get up. Then you belong in medical treatment. Unfortunately, we have seen that, due to this great uncertainty, many patients went to the hospitals and practices last week with a little headache and a little discomfort and filled the emergency rooms.

I had sinus vein thrombosis years ago. Can I get a vaccination with the Astrazeneca vaccine?

Nobody can really answer this question seriously at the moment. There are currently no data on this very special patient collective. But what we do know is that the normal thrombosis is not caused by the vaccine. Thromboses of the legs and arms and other typical thromboses are not caused by the vaccine.

Dr. Ute Scholz has been working in the field of hemostaseology for over 20 years. She is the director of the Leipzig Center for Coagulation Disorders and answers the seven most frequent questions from viewers about Astrazeneca. (As of March 25, 2021)