Decline in Pathogenic Antibodies over Time in VITT

This correspondence presents findings from a follow-up study of 35 patients in Germany with vaccine-induced immune thrombotic thrombocytopenia (VITT) following adenoviral vector Covid-19 vaccination. Platelet-activating anti-PF4 antibodies disappeared in 66% of patients within a median of 12 weeks, and optical density values on anti–PF4–heparin IgG ELISA declined by 53%. Only 3 patients achieved full seroreversion. One patient exhibited persistent antibodies and recurrent thrombocytopenia. Five patients later received an mRNA vaccine with no adverse thrombotic events. The study concludes that anti-PF4 antibodies are transient in most cases but may persist, warranting further research into duration of anticoagulation and revaccination timing.

This correspondence presents findings from a follow-up study of 35 patients in Germany with vaccine-induced immune thrombotic thrombocytopenia (VITT) following adenoviral vector Covid-19 vaccination. Platelet-activating anti-PF4 antibodies disappeared in 66% of patients within a median of 12 weeks, and optical density values on anti–PF4–heparin IgG ELISA declined by 53%. Only 3 patients achieved full seroreversion. One patient exhibited persistent antibodies and recurrent thrombocytopenia. Five patients later received an mRNA vaccine with no adverse thrombotic events. The study concludes that anti-PF4 antibodies are transient in most cases but may persist, warranting further research into duration of anticoagulation and revaccination timing.