COVID-19 vaccine-induced thrombosis and adherence of Argentine rheumatologists to current vaccination recommendation guidelines

Autores: Carolina A Isnardi, Rosana Quintana, Alejandro Brigante, Natalia Zamora, Guillermo J. Pons-Estel

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Introduction: thrombotic events associated with thrombocytopenia have been reported following SARS-CoV-2 vaccination.

Objectives: to identify and characterize thrombotic events in patients with immune-mediated rheumatic diseases (IMRD) vaccinated against COVID-19, and to assess vaccine prescription practices and adherence to local guidelines among rheumatologists.

Materials and methods: a cross-sectional, observational study based on surveys conducted among members of the Argentine Society of Rheumatology. Data on thrombotic events and vaccination practices were collected between May and July 2024.

Results: a total of 76 responses were collected. Three cases of thrombosis associated with vaccination were identified, one classified as vaccine-induced immune thrombotic thrombocytopenia (VITT). The events occurred in one woman with rheumatoid arthritis and two men—one with rheumatoid arthritis and the other with lupus—associated with mRNA, adenovirus, and inactivated vaccines, respectively. Among rheumatologists, 80.3% prescribe vaccines, but only 70% are familiar with and follow national guidelines.

Conclusions: this national survey detected three cases of thrombosis related to COVID-19 vaccines, one of which was classified as VITT. The events occurred not only with viral vector vaccines but also with mRNA and inactivated platforms. Although most rheumatologists prescribe vaccines, gaps in knowledge remain, and only 70% adhere to national recommendations, highlighting the need for ongoing education to optimize vaccine safety and efficacy in this population.