Vaccine-induced immune thrombotic thrombocytopenia (VITT): Update on diagnosis and management considering different resources

Andreas Greinacher, Florian Langer, Mike Makris, Menaka Pai, Sue Pavord, Huyen Tran, Theodore E. Warkentin

Research output: Contribution to journalComment / DebateOtherpeer-review

68 Citations (Scopus)


Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare but severe immunological reaction to the non-replicable adenoviral vector-based COVID-19 vaccines. Extreme activation of platelets and the coagulation system leads to a high risk of death from venous or arterial thrombosis or secondary hemorrhage. Public and clinician awareness has reduced mortality of VITT by nearly 90%. The World Health Organization provided a guideline in July 2021 on diagnosis and management of VITT (also called thrombosis with thrombocytopenia syndrome, or TTS). Since July 2021, new, clinically relevant information has become available. This update has been summarized by the authors in an informal process with recommendations for low resource environments. We provide new available evidence on VITT to empower clinicians to recognize VITT early, then effectively diagnose and treat the disorder to reduce morbidity and mortality. We strongly encourage production of clear management pathways for primary care settings and hospital settings.

Original languageEnglish
Pages (from-to)149-156
Number of pages8
JournalJournal of Thrombosis and Haemostasis
Issue number1
Publication statusPublished - Jan 2022


  • adenoviral vector-based vaccine
  • AstraZeneca
  • cerebral vein sinus thrombosis
  • platelets
  • SARS-CoV-2 vaccine
  • vaccine-induced immune thrombotic thrombocytopenia

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