A Covishield Aftershock

Fears of deadly side effects from Covid vaccines, Covishield in particular, has just got real and scary With British pharmaceutical giant, AstraZeneca admitting that the vaccine developed by it and marketed as Covishield in India, can result in a rare side effect known as — Thrombosis with Thrombocytopenia Syndrome (TTS) — anger and panic looms large among the Indian population, who were administered more than 175 crore doses of Covishield. Obviously, the regret now, which is racing across many minds is that they should have chosen Covaxin over Covishield and stayed safe.

But if one were to go by what the union health ministry and the World Health Organisation (WHO) had said back in 2021, it was known that Covishield did have rare side effects. Perhaps, that got lost in the panicky race to get oneself administered with a vaccine.

So what is TTS?

Dr K Subba Reddy of Apollo Hospitals says TTS is a rare condition seen as complication of adenoviral vaccines. “In this condition, blood clots can be found in any organ especially brain, stomach, legs and lungs.

Platelets are generally reduced in this condition. Inspite of low platelets patients can have clots in any vital organs,” he explains.

If this thrombosis (clots) happen in brain, it can lead to dangerous complications. “But is a very rare condition and can be treated by Haematologist and specialty doctor. Treatment is giving Intravenous Immunoglobulins, Blood thinners (anti coagulation) and intensive care management,” says Dr Subba Reddy.

Covishield

The Serum Institute of India developed Covishield using a viral vector platform rather than mRNA technology. The vaccine employs a modified chimpanzee adenovirus, ChAdOx1, to transport the covid-19 spike protein into human cells. It makes the immune system defend against viruses.

Last year, UK-based Jamie Scott, who received the vaccine in April 2021, was left with a permanent brain injury after developing a blood clot. He later lodged a complaint in the High Court. Subsequently, 51 cases were lodged by victims and relatives of those who died, seeking damages estimated to be worth up to 100 million pounds.

Life saver

Vaccination drive has saved a lot of lives and the benefits of Covishield outweighs the risks, says Dr. Aarathi Bellary, Consultant Internal Medicine, KIMS Hospitals, Kondapur Hyderabad. The Covid virus itself is a prothrombotic condition, which means it can cause thrombosis, and lead to clots in our blood and other vaccines, she says.

“That TTS could be a rare side effect was known and was even reported in 2021 as well. For any vaccine or drug for that matter, there will be adverse reactions. But, we look at the risks and benefits. In this case, the benefits far outweighs the risk of this particular complication,” informs Dr Aarathi.

Prior to making the vaccine available in India, the centre had issued a circular in January 2021, in which it was specifically mentioned that Covishield be administered with caution to individuals with thrombocytopenia. By May, the government said 26 cases of potential thromboembolic events were reported. The number rose to 34 in the coming months of which there were 18 deaths.

The issue resurfaced now because a lawsuit was filed, she says. “But, as doctors we have also taken all the doses of Covishield. We have also taken the booster doses too. We all know that there is a risk of particular syndrome, but it is a rare side effect. So, we cannot say that all vaccines are bad, or this particular drug reaction is causing all the cardiac deaths or all the thrombotic deaths,” says Dr Aarathi.

Covishield, she says, saved a lot lives. “It has been administered widely across India which ensured that a lot of hospital admissions and deaths could be avoided,” she says adding that India’s vaccination drive was successful, with a very small percentage of adverse events.

In March 2021, various countries including Germany, Austria, France, Norway, Netherlands, Denmark among others temporarily paused the use of AstraZeneca vaccine after few cases of blood clotting were reported. Later, the World Health Organisation (WHO) announced that TTS was being reported in some cases after Covishield shots was administered. However, it did say that the risk is very low.

A petition seeking the constitution of an expert medical panel to study the risk factors from Covishield has been filed in the Supreme Court of India today, following AstraZeneca’s admission before the UK court.

The petitioner, Vishal Tiwari, an advocate said that with the document filed in UK Court by AstraZeneca, “we are compelled to think on the risk and hazardous consequences of Covishield vaccine.

The Covishield vaccine can produce an adverse reaction called as TTS — Thrombosis with Thrombocytopenia Syndrome. Thrombosis means blood clots within the organs like brain, blood vessels. At the same time, they can cause a reduction in platelets in the body, i.e. upto less than 1.5 lakhs. When the plateles decrease, there can be a risk of bleeding.

TTS is a rare condition seen as complication of adenoviral vaccines. In this condition, blood clots can be found in any organ especially brain, stomach, legs and lungs. But is a very rare condition and can be treated by Haematologist and specialty doctor. Treatment is giving Intravenous Immunoglobulins, Blood thinners (anti coagulation) and intensive care management.” — Dr K Subba Reddy, Apollo Hospitals

That TTS could be a rare side effect was known and was even reported in 2021 as well. For any vaccine or drug for that matter, there will be adverse reactions. But, we look at the risks and benefits. In this case, the benefits far outweighs the risk of this particular complication. As doctors we have also taken all the doses of Covishield. We have also taken the booster doses too. We all know that there is a risk of particular syndrome, but it is a rare side effect.” — Dr Aarathi Bellary, Consultant Internal Medicine, KIMS Hospitals,

The Serum Institute of India developed Covishield using a viral vector platform rather than mRNA technology. Last year, UK-based Jamie Scott, who received the vaccine in April 2021, was left with a permanent brain injury after developing a blood clot. He later lodged a complaint in the High Court.

“It has been administered widely across India which ensured that a lot of hospital admissions and deaths could be avoided.”