Thrombosis with Thrombocytopenia Syndrome (TTS):
Rare, but serious complication associated with adenovirus vector vaccines (e.g., AstraZeneca, Janssen). – Presents with thrombosis (e.g., cerebral venous sinus thrombosis, splanchnic vein thrombosis) and thrombocytopenia. – Management: Consult hematologist, consider anticoagulation with non-heparin agents (e.g., argatroban, fondaparinux). – Rationale: TTS is immune-mediated, requiring specialized care. – Myocarditis/Pericarditis:
Rare, more common in adolescents/young adults post-mRNA vaccines (e.g., Pfizer, Moderna). – Symptoms: Chest pain, dyspnea, palpitations; elevated troponin, ECG changes. – Management: NSAIDs, colchicine; severe cases may require steroids or IVIG. – Rationale: Likely immune-mediated, often self-limiting. – Anaphylaxis:
Rare (2–5 cases/million doses), typically within 30 minutes of vaccination. – Management: Epinephrine, antihistamines, corticosteroids; observe for 30 minutes post-vaccination. – Rationale: Usually due to polyethylene glycol (PEG) or other excipients. – Local/Systemic Reactions:
Common (e.g., pain, swelling, fever, fatigue); self-limiting. – Management: Supportive care (e.g., acetaminophen, NSAIDs). – Rationale: Expected immune response to vaccination. – Guidelines for Special Populations:
Mild illnesses (e.g., cold): Vaccinate. – Moderate/severe illness (e.g., active COVID-19): Delay until recovery. – Co-administration: Safe with other vaccines. – Rationale: Balances benefits vs. risks; minimizes disruption to care.