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Am J Emerg Med . Severe immune thrombocytopenia following COVID-19 vaccination (Moderna) and immune checkpoint inhibitor: A case report

tetano

Editor, Senior Moderator
Am J Emerg Med


. 2022 Mar 18;S0735-6757(22)00188-7.
doi: 10.1016/j.ajem.2022.03.030. Online ahead of print.
Severe immune thrombocytopenia following COVID-19 vaccination (Moderna) and immune checkpoint inhibitor: A case report


Kah-Meng Chong[SUP] 1 [/SUP], Ching-Yao Yang[SUP] 2 [/SUP], Chien-Chin Lin[SUP] 3 [/SUP], Wan-Ching Lien[SUP] 4 [/SUP]



Affiliations

Abstract

Safe and effective prophylactic vaccines are urgently needed to contain the coronavirus disease 2019 (COVID-19) pandemic. However, several vaccination-related adverse effects have been reported. Here, we report a rare case of severe immune thrombocytopenia occurring 3 days after receiving the mRNA-1273 (Moderna) COVID-19 vaccine in an Asian woman with a history of refractory lung adenocarcinoma treated with durvalumab, an immune checkpoint inhibitor. Treatment with platelet transfusion (12 units) and oral prednisolone (1 mg/kg per day) significantly improved her hemoptysis with thrombocytopenia. To the best of our knowledge, this is the first case of ITP following Moderna inoculation among Asians. This study highlights a potential adverse effect of mRNA-based COVID-19 vaccines in cancer patients receiving immune checkpoint inhibitors.

Keywords: COVID-19; Immune checkpoint inhibitors; Immune thrombocytopenia; Moderna vaccine; mRNA-based vaccine.
 
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