The story of an Iowa teenager whose world turned upside down just a month before her college athletics career was set to start is a story of perseverance.Carly Stevenson was rushed to the hospital with a blood clot a month before her first day of class at Wartburg College. She was all set to throw shot put and discus for the college track team.Doctors thought it was dire. In fact, they told her family to start preparing for the worst. But they kept their faith. She's now in recovery and working with occupational therapists.Every day, they work to improve her balance, head control, hand and arm movements and communication skills. But it’s her team of doctors who have found themselves inspired by her desire to progress. "If you look at her story from start to finish you know. As she's growing up and going through sports and playing at like an elite level, it's kind of easy to look back at her story now and feel sad about it. But I think she really has come over so many things it is really a story about hope," occupational therapist Samantha Williams said.Her mom said she still has a spot on Wartburg's team and that her coaches and teammates still keep in touch with her. A family friend has started a Facebook page and a GoFundMe page — Carly's Fight — for people who want to keep up with her journey through rehabilitation.Carly's mom said friends and family have donated more than $30,000.

Doctors are stressing the chance of getting blood clots from the Johnson & Johnson vaccine appears to be very rare.The U.S. on Tuesday recommended a "pause" in using the single-dose Johnson & Johnson COVID-19 vaccine to investigate reports of rare but potentially dangerous blood clots, a development that could jeopardize the rollout of vaccines around the world."Right now, these adverse events appear to be extremely rare," FDA and CDC doctors said in a joint statement about the pause. The Centers for Disease Control and Prevention and the Food and Drug Administration announced that they were investigating unusual clots that occurred 6 to 13 days after vaccination. The FDA commissioner said she expected the pause to last a matter of days.Dr. Anthony Fauci says Americans who've recently received a Johnson & Johnson COVID-19 vaccine shouldn't be anxious about the "pause."The nation's top infectious disease expert says, "It's less than one in a million." Fauci adds people should "pay attention" to symptoms associated with the blood clots, particularly between one and three weeks after the shot.Mississippi Health Officer Dr. Thomas Dobbs said the condition is extremely rare and those who have already received the J&J shot should not worry.Doctors with the federal health departments said people who have received the J&J vaccine "who develop severe headache, abdominal pain, leg pain, or shortness of breath within three weeks after vaccination should contact their health care provider."More than 6.8 million doses of the vaccine, which is also known as the Janssen vaccine, have been administered as of Monday in the U.S., according to the CDC.The Pfizer and Moderna vaccines are not affected. Dr. Geoffrey Barnes, cardiologist and vascular medicine specialist in Michigan, said there has not been a sign of blood clot risk with those vaccines."It's important to note that we do not yet know if there is a real risk of clotting associated with the J&J/Janssen vaccine," Barnes said on a University of Michigan Health System website. "So far, there are very few reported cases (six) despite millions of doses administered."Barnes said it's wise to be putting the vaccine on pause and that the clots seem to be quite rare.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"The risk of blood clots in patients with COVID is far higher than the very small risk of a blood clot following a COVID-19 vaccine," Barnes said. "Overall, the benefits of COVID-19 vaccination greatly outweigh the very small risks."Barnes said doctors are aware of the condition and have the tools to diagnose and treat patients if it occurs. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said the pause will help give physicians insight for treating people to know if a treatment should be avoided. The Associated Press contributed to this report.

Source link

Doctors say they are homing in on the cause of blood clots that may be linked with certain coronavirus vaccines, and said their findings have important implications for how to treat the condition, regardless of whether vaccines cause it.Even though the link is not firm yet, they're calling the condition vaccine-induced immune thrombotic thrombocytopenia or VITT. It's characterized by unusual blood clotting combined with a low number of blood-clotting cells called platelets. Patients suffer from dangerous clots and, sometimes, hemorrhaging at the same time.It's been linked most firmly with the AstraZeneca coronavirus vaccine, which is in wide use in Europe and the UK.The U.S. Centers for Disease Control and Prevention and the Food and Drug Administration are checking to see if Johnson & Johnson's Janssen vaccine also might cause the blood clots. Both AstraZeneca's vaccine and the J&J vaccine use common cold viruses called adenoviruses as a carrier and some experts suspect the body's response to those viral vectors might underlie the reaction. AstraZeneca's vaccine is not authorized in the U.S.The FDA and CDC have asked for a pause in giving out the J&J vaccine while they investigate.A team led by Dr. Marie Scully, a hematologist at University College London Hospitals, studied 22 patients who developed the syndrome after receiving AstraZeneca's vaccine, and found they had an unusual antibody response. These so-called anti-PF4 antibodies had only been seen before as a rare reaction to the use of the common blood thinner heparin.The findings support a theory that an immune reaction might underlie the rare blood clots, but the findings don't yet explain it, Scully and colleagues reported in the New England Journal of Medicine Friday. What may be going on is a reaction by the immune system with platelets to cause uncontrolled clotting.If vaccines cause it, it's still very rare and unusual, they wrote. It might not even be happening any more often in recently vaccinated people than among the population in general."The risk of thrombocytopenia and the risk of venous thromboembolism after vaccination against SARS-CoV-2 do not appear to be higher than the background risks in the general population, a finding consistent with the rare and sporadic nature of this syndrome," they wrote."The events reported in this study appear to be rare, and until further analysis is performed, it is difficult to predict who may be affected. The symptoms developed more than five days after the first vaccine dose," they added."In all cases reported to date, this syndrome of thrombocytopenia (low platelet count) and venous thrombosis (blood clot) appears to be triggered by receipt of the first dose of the (AstraZeneca) ChAdOx1 nCoV-19 vaccine. Although there have been a few reports of patients with symptoms consistent with this clinical syndrome after the receipt of other vaccines against SARS-CoV-2, none have yet been confirmed to fulfill the diagnostic criteria," they added.But if vaccination can cause the condition, it would be important to recognize that and treat it appropriately — because the usual treatment for blood clots is not recommended for VITT.Patients should be given anti-clotting drugs, but not heparin, and infusions of a blood product called intravenous immunoglobulin may replace the depleted platelets.It's also not clear who's at highest risk, Dr. Douglas Cines of the University of Pennsylvania and Dr. James Bussel of Weill Cornell Medicine wrote in a commentary. "Most of the patients included in these reports were women younger than 50 years of age, some of whom were receiving estrogen-replacement therapy or oral contraceptives. A remarkably high percentage of the patients had thromboses at unusual sites," they wrote.Some European countries have restricted who should get AstraZeneca's vaccine. For example. Belgium limits its use in people under age 55. Other countries have paused its use. CDC's vaccine advisers have been asked to consider whether similar restrictions might be appropriate for Johnson & Johnson's vaccine, although only a handful of cases have been reported in the US.While blood clots in the brain have received the most attention, patients have also had clots in other large veins and arteries.These blood clots in the brain — called cerebral venous sinus thromboses or CVST — are dramatic on their own, but the clots may be forming elsewhere, also.Doctors are being advised to run tests if people develop blood clots after having been vaccinated recently against coronavirus, and to not use heparin to treat the clots until VITT has been ruled out.The condition is very similar to a known development called heparin-induced thrombocytopenia, the American Society of Hematology says new guidance released earlier this week. It's also calling the condition VITT.ASH published guidance saying normal post-vaccination malaise, headache and fever are not of concern."Patients with severe, recurrent, or persistent symptoms, particularly intense headache, abdominal pain, nausea and vomiting, vision changes, shortness of breath, and/or leg pain and swelling, either persisting or beginning four to 20 days following vaccination should be evaluated urgently by a medical provider and consideration given to underlying VITT," ASH says in the new guidance."While current information links VITT to AstraZeneca and Johnson & Johnson vaccines, patients with suggestive timing and symptoms following any COVID-19 vaccine should be evaluated for VITT."CDC's Advisory Committee on Immunization Practices has scheduled a meeting for April 23 to take up the question again after declining to make a decision Wednesday. One committee member told CNN more data is needed."We need to know what the size of the problem is," said Dr. Kevin Ault, professor and division director with the University of Kansas Medical Center. "So we're going to shake the trees in the databases that the CDC has and we also need to know what the denominator is — is it just young women or the whole population that's been vaccinated?"CDC wants to know if there is anything specific that might put people at higher risk of developing blood clots after vaccination."There are still a fair number of people in the United States who have been vaccinated in the last two weeks," Ault said. "We've seen these reactions within two weeks, so it doesn't sound like a very long time, but we'll have a fair amount of data in just those nine or ten days."In a letter to the New England Journal of Medicine, scientists at Janssen, the vaccine arm of Johnson & Johnson, say there isn't enough evidence to show the company's COVID-19 vaccine causes the blood clots and they are "working closely with experts and regulators to assess the data, and we support the open communication of this information to health care professionals and the public." "At this time," they write, "evidence is insufficient to establish a causal relationship between these events and the Ad26.COV2.S vaccine."Vaccines made by Moderna and Pfizer/BioNTech use a different technology that sends genetic material into the body wrapped in lipids, and they have not been linked with blood clots.

Vaccine advisers to the Centers for Disease Control and Prevention are meeting Friday to discuss how to move forward with Johnson & Johnson's Janssen coronavirus vaccine.The Advisory Committee on Immunization Practices is scheduled to meet from 11 a.m. to 5 p.m. Friday and to vote on updated recommendations for use of the vaccine and whether it's likely to be linked to a rare blood clotting syndrome they're calling thrombosis with thrombocytopenia syndrome (TTS).Other groups have called it vaccine-induced immune thrombotic thrombocytopenia or VITT, but the committee is sticking with more neutral language that doesn't presume vaccines are causing the condition.It's characterized by a rare type of blood clot in the brain — and possibly other large blood clots — along with a low number of blood-clotting cells called platelets. Some blood specialists have said they believe it's caused by an unusual immune reaction that targets platelets, causing them to glob together into clots.The committee will hear about any additional cases reported since their last meeting earlier in the month. The cases of six women who suffered TTS, including one who died, prompted CDC and the Food and Drug Administration to recommend a pause in giving the vaccine. Committee members said they needed more time and more information before deciding on whether and how to change recommendations for giving the vaccine.They'll hear about at least one more case. Oregon health officials said Thursday night they were investigating the case of a woman in her 50s who died after having received the vaccine and who had symptoms of TTS."We are very much encouraged by the fact that our safety reporting systems are working," Dr. Shimi Sharief, senior health adviser with Oregon's health authority, told reporters in a briefing. She noted the coronavirus pandemic is ongoing and killing people."This is still extremely rare," she said -- noting that seven cases of blood clots had been reported out of nearly seven million J&J vaccines given, and two of those cases had been fatal.They'll hear from a blood clot expert — Dr. Michael Streiff of Johns Hopkins University, who is likely to brief on what's known how to treat TTS. Reports indicate blood thinners, with the exception of a commonly used blood thinner called heparin — will help dissolve the clots, and use of an immune product called IVIG can help neutralize the mistaken immune response.The committee will also hear from two officials of Johnson & Johnson. Members of committee will consider the potential risks of the vaccine as opposed to the risk of catching coronavirus. Blood clot specialists have told CNN the risk of developing blood clots of all sorts from coronavirus infection are much higher than the risks seen in people who got the vaccine.AstraZeneca's vaccine has been linked to TTS as well. The World Health Organization and European medical regulators have said the benefits of the AstraZeneca vaccine, which is not yet authorized in the U.S., outweigh any potential risks.Earlier this week, Dr. William Schaffner, a non-voting committee member and infectious diseases professor at the Vanderbilt University School of Medicine, told CNN that the committee could recommend that use of the vaccine resume with no changes, or the committee could recommend that the U.S. stop using the J&J vaccine altogether.Schaffner said it's more likely that the committee will recommend that use of the vaccine resume with a warning about possible adverse effects — and potentially, advice to the highest-risk populations to steer clear of this vaccine altogether.