Clinical investigation and management of COVID-19 vaccine induced thrombosis and thrombocytopenia
Published 23 April 2021
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This publication is available at https://www.gov.uk/government/publications/clinical-investigation-and-management-of-covid-19-vaccine-induced-thrombosis-and-thrombocytopenia/clinical-investigation-and-management-of-covid-19-vaccine-induced-thrombosis-and-thrombocytopenia
A detailed case review is ongoing jointly by Medicines and Healthcare Products Regulatory Agency (MHRA), UK Health Security Agency (UKHSA) and the Expert Haematology Panel. It is important to ensure all health professionals are alert to relevant symptoms which require urgent further clinical review and investigation.
Clinical investigation and management
An urgent full blood count should be considered in any patient presenting more than 4 days and within 28 days of coronavirus (COVID-19) vaccination with:
- new onset of severe headache, which is getting worse and does not respond to simple painkillers
- an unusual headache which seems worse when lying down or bending over, or may be accompanied by blurred vision, nausea and vomiting, difficulty with speech, weakness, drowsiness or seizures
- new onset of unexplained pinprick bruising or bleeding
- shortness of breath, chest pain, leg swelling or persistent abdominal pain
If you have any clinical concerns, patients should be urgently referred to hospital and to appropriate specialist services for further assessment, particularly if the symptoms are unexplained and present in combination with thrombocytopaenia.
The recommended management of this rare presenting condition is available from the British Society of Haematologists (BSH) with specific guidance produced by the Royal College of Emergency Medicine (RCEM) Emergency Departments and Acute Medical Units.
A brief guidance document on the primary care management of suspected thromboembolism with thrombocytopenia after COVID-19 vaccination has been produced by the Royal College of General Practitioners (RCGP).
Advice on COVID-19 vaccination
For the latest guidance please see The Green Book.
In addition, a range of resources for the public and health professionals have been made available. These resources will continue to be updated as new information becomes available, so we recommend linking to the COVID-19 vaccination and rare side effects collection to ensure that you are providing the most up-to-date guidance.