The Chief Health Officer has provided an update regarding COVID-19 immunisation and the current understanding of the Thrombosis with Thrombocytopaenia Syndrome (TTS).
Updated guidance – diagnosis and management of TTS
- A broader group of presenting syndromes (including Acute Myocardial Infarction, DVT, PE and CVA) have been described in the four to 42-day period post administration of the AstraZeneca COVID-19 vaccine.
- Where there is a high index of suspicion of TTS in the presence of a normal platelet count, serial platelet counts can be of assistance.
- The Australasian College of Emergency Medicine has provided an updated guideline
- A Multidisciplinary Guideline and other COVID-19 resources are available
- Specialist testing request form is available
Webinar catch-up for GPs
Updated ATAGI advice regarding the risk of TTS following COVID-19 vaccine AstraZeneca – 4 June
ATAGI examined estimates of risk of TTS by age group in Australia and note that there have been 31 confirmed cases reported and a further 10 are considered probable in around 2.2 million doses of COVID-19 Vaccine AstraZeneca given up to 19 May 2021.
Although estimates of risk based on small numbers of cases are imprecise, the risk of TTS is estimated in Australia at around:
- 3.1 per 100,000 in those <50 years; and
- 1.8 per 100,000 in those ≥50 years.
There were no significant differences in estimated risk by sex in those ≥50 years of age.
A breakdown of current rates by decade of age for those aged ≥ 50 years is included here:
|
Age bracket (years) |
Estimated rate (per 100,000 AZ vaccinations) |
|
<50 |
3.1 |
|
50-59 |
1.9 |
|
60-69 |
1.7 |
|
70-79 |
1.9 |
|
≥80 |
1.5 |
ATAGI discussed the case summary and clinical data of TTS cases. It was noted that TTS outcomes occur across a spectrum of severity from more mild cases to cases with long-term morbidity and can result in death, with one fatal case recorded to date in Australia.
ATAGI emphasised the ATAGI/THANZ joint statement on TTS and the use of the COVID-19 Vaccine AstraZeneca is an important resource. The statement provides updated information about TTS and reaffirms ATAGI’s previous advice regarding the safe use of the COVID-19 Vaccine AstraZeneca.
TGA weekly safety report – 3 June
Updated reporting rates of TTS in Australia were published in the statement from ATAGI on 26 May. These reporting rates remain consistent with what is being seen internationally, including in Europe, the UK, the Middle East and Canada.
While TTS is very rare, some people will have concerns that they can discuss with their doctor. This is essential to allow people to make an informed choice. Anyone who has been vaccinated should seek immediate medical attention if they develop any of the following symptoms after vaccination:
- severe or persistent headache or blurred vision
- shortness of breath, chest pain, leg swelling or persistent abdominal pain
- unusual skin bruising and/or pinpoint round spots beyond the site of vaccination
The most common time period for onset of TTS symptoms is four to 30 days after vaccination.
Reminder – reporting Adverse Events Following Immunisation
Serious adverse events in the six weeks following immunisation are notifiable conditions in NSW. You should urgently notify your local Public Health Unit if you are concerned a patient has presented with a serious event in the six weeks following any immunisation.