{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T03:20:30Z","timestamp":1773890430653,"version":"3.50.1"},"reference-count":38,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2024,9,14]],"date-time":"2024-09-14T00:00:00Z","timestamp":1726272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Deutsche Forschungsgemeinschaft","award":["BA5158\/4"],"award-info":[{"award-number":["BA5158\/4"]}]},{"name":"Deutsche Forschungsgemeinschaft","award":["TSG-Study"],"award-info":[{"award-number":["TSG-Study"]}]},{"name":"Herzstiftung","award":["BA5158\/4"],"award-info":[{"award-number":["BA5158\/4"]}]},{"name":"Herzstiftung","award":["TSG-Study"],"award-info":[{"award-number":["TSG-Study"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare but severe complication following vaccination with adenovirus vector-based COVID-19 vaccines. Antibodies directed against platelet factor 4 (PF4) are thought to be responsible for platelet activation and subsequent thromboembolic events in these patients. Since a single vaccination does not lead to sufficient immunization, subsequent vaccinations against COVID-19 have been recommended. However, concerns exist regarding the possible development of a new thromboembolic episode after subsequent vaccinations in VITT patients. Methods: We prospectively analyzed follow-up data from four VITT patients (three women and one man; median age, 44 years [range, 22 to 62 years]) who subsequently received additional COVID-19 vaccines. Platelet counts, anti-PF4\/heparin antibody level measurements, and a functional platelet activation assay were performed at each follow-up visit. Additionally, we conducted a literature review and summarized similar reports on the outcome of subsequent vaccinations in patients with VITT. Results: The patients had developed thrombocytopenia and thrombosis 4 to 17 days after the first vaccination with ChAdOx1 nCoV-19. The optical densities (ODs) of anti-PF4\/heparin antibodies decreased with time, and three out of four patients tested negative within 4 months. One patient remained positive even after 10 months post first vaccination. All four patients received an mRNA-based vaccine as a second vaccination against SARS-CoV-2. No significant drop in platelet count or new thromboembolic complications were observed during follow-up. We identified seven publications reporting subsequent COVID-19 vaccination in VITT patients. None of the patients developed thrombocytopenia or thrombosis after the subsequent vaccination. Conclusion: Subsequent vaccination with an mRNA vaccine appears to be safe in VITT patients.<\/jats:p>","DOI":"10.3390\/jcm13185462","type":"journal-article","created":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T11:36:37Z","timestamp":1726486597000},"page":"5462","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Subsequent Vaccination against SARS-CoV-2 after Vaccine-Induced Immune Thrombotic Thrombocytopenia"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8717-6230","authenticated-orcid":false,"given":"G\u00fcnalp","family":"Uzun","sequence":"first","affiliation":[{"name":"Centre for Clinical Transfusion Medicine Tuebingen, 72076 Tuebingen, Germany"},{"name":"Institute for Clinical and Experimental Transfusion Medicine, Medical Faculty of Tuebingen, University Hospital of Tuebingen, 72076 Tuebingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresa","family":"Ringelmann","sequence":"additional","affiliation":[{"name":"Institute for Clinical and Experimental Transfusion Medicine, Medical Faculty of Tuebingen, University Hospital of Tuebingen, 72076 Tuebingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8005-2916","authenticated-orcid":false,"given":"Stefanie","family":"Hammer","sequence":"additional","affiliation":[{"name":"Centre for Clinical Transfusion Medicine Tuebingen, 72076 Tuebingen, Germany"},{"name":"Institute for Clinical and Experimental Transfusion Medicine, Medical Faculty of Tuebingen, University Hospital of Tuebingen, 72076 Tuebingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Zlamal","sequence":"additional","affiliation":[{"name":"Centre for Clinical Transfusion Medicine Tuebingen, 72076 Tuebingen, Germany"},{"name":"Institute for Clinical and Experimental Transfusion Medicine, Medical Faculty of Tuebingen, University Hospital of Tuebingen, 72076 Tuebingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beate","family":"Luz","sequence":"additional","affiliation":[{"name":"Institute of Transfusion Medicine, Klinikum Stuttgart, 70174 Stuttgart, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7683-6918","authenticated-orcid":false,"given":"Marc E.","family":"Wolf","sequence":"additional","affiliation":[{"name":"Department of Neurology, Klinikum Stuttgart, 70174 Stuttgart, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6534-036X","authenticated-orcid":false,"given":"Hans","family":"Henkes","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Klinikum Stuttgart, 70174 Stuttgart, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6797-6812","authenticated-orcid":false,"given":"Tamam","family":"Bakchoul","sequence":"additional","affiliation":[{"name":"Centre for Clinical Transfusion Medicine Tuebingen, 72076 Tuebingen, Germany"},{"name":"Institute for Clinical and Experimental Transfusion Medicine, Medical Faculty of Tuebingen, University Hospital of Tuebingen, 72076 Tuebingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karina","family":"Althaus","sequence":"additional","affiliation":[{"name":"Centre for Clinical Transfusion Medicine Tuebingen, 72076 Tuebingen, Germany"},{"name":"Institute for Clinical and Experimental Transfusion Medicine, Medical Faculty of Tuebingen, University Hospital of Tuebingen, 72076 Tuebingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,14]]},"reference":[{"key":"ref_1","unstructured":"(2024, August 26). 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