Why thrombosis after the AstraZeneca vaccine affects young women the most

Although studies are ongoing and the mechanisms involved still to be fully understood, theAssociation among very rare thromboembolic events e i Covid vaccines a adenoviral vector (the Vaxzevria of AstraZeneca and the Johnson & Johnson) has been confirmed by leading international health authorities, such as the European Medicines Agency (EMA) e la Food and Drug Administration (FDA) American. The emergence of the first suspected cases in recent months followed suspensions e changes to vaccination plans in many countries, however, the debate on the issue is still very heated, even in light of administrations given to age groups for which these drugs are not recommended. Of particular concern among experts are cases of sinus vein thrombosis, a rare form of cerebral thrombosis manifested by platelet deficiency (thrombocytopenia), as well as those of thrombosis of the splanchnic vein (abdominal) and arterial thrombosis. All of these conditions associated with anti Covid sera have been defined by scientists as thrombotic events associated with a low vaccine-induced platelet count (VITT). As indicated, these are very rare events, however epidemiological investigations show that the risk of developing them is not the same for everyone: according to EMA data, in fact, in the age group between 20 and 29 there are about two chances of having a thrombosis every hundred thousand administrations, a significantly higher risk than in the 60-69 range. Young people, and especially women, would therefore be more exposed to the risk of thrombosis: how is it possible?

Given that no conclusive data are yet available to state this with certainty, there are several reasons that may explain why girls would be more exposed to thromboembolic risk after vaccination. As pointed out in an interview with El Pais by Professor Rodrigo Rial, spokesman for the Spanish Society of Vascular Surgery, angiologist and vascular surgeon at the HM Terrelodones University Hospital in Madrid, women are above all more susceptible than men to autoimmune diseases, also in young age the immune system much more ready and reactive, therefore, we are more exposed to complications triggered by autoimmune processes. Experts believe that thrombosis induced by Covid adenoviral vector vaccines are linked to a autoimmune reaction, as explained in the article “Thrombotic Thrombocytopenia after ChAdOx1 nCov-19 Vaccination” published in the authoritative The New England Journal of Medicine by scientists from the Paul-Ehrlich-Institut (the German Federal Institute for Vaccines and Biomedicine). Put simply, the affected patients develop antibodies which bind to a specific protein present on the surface of the platelets call platelet factor 4; this mechanism pushes the platelets to aggregate and give life to blood clots that begin to circulate in the bloodstream. Triggering the thrombosis, according to German experts led by Professor Andreas Greinacher of the University of Greifswald, could be a preservative present in the vaccine called EDTAbut the breakdown of the adenovirus used as a shuttle to carry the genetic information of the protein is also being targeted Spike and the consequent release of the DNA, which in turn would be able to form bonds with platelet factor 4.

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As indicated, the triggering cause of the thrombosis has yet to be ascertained and the simple association with the vaccine indicated by the EMA and the FDA does not show any cause-effect relationshiphowever, as indicated, epidemiological investigations suggest that the risk is greater for young women. In light of these data, numerous experts are asking the Italian Medicines Agency (AIFA), the EMA and policy makers to definitively ban the administration of adenoviral vector vaccines to younger age groups. This request was further intensified after the death of 18-year-old Camilla from Sestri Levante, who was vaccinated on May 25 with AstraZeneca during an “Open Day”. According to Professor Matteo Bassetti, director of the Infectious Diseases Clinic of the San Martino hospital in Genoa, the risk of thrombosis would be particularly high for women who take the birth control pill, to which he would advise against both Johnson & Johnson’s and AstraZeneca’s vaccines. Previously, Professor Rial had stated that “about one in a thousand women who take contraceptive drugs suffers from clots, while the risk among those vaccinated is one case for every 175 thousand vaccinations”. A new ruling by the Technical Scientific Committee (CTS) on adenoviral vector vaccines is expected shortly, which could permanently close the administration in younger groups.

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