NHS England (NHSE) has asked the National Institute for Health and Care Excellence (NICE) to develop a guideline on the management and follow up of blood clots and low platelet counts associated with the COVID-19 vaccination.
Vaccine-induced immune thrombocytopenia and thrombosis (VITT) is a syndrome of immune-driven blood clots (thrombosis) and low platelet counts (thrombocytopenia), which has been reported in rare cases after receiving COVID-19 vaccines.
Although extremely rare, with only 14.2 cases occurring per million doses of the COVID-19 vaccine, the condition can be very serious and requires swift diagnosis and sometimes urgent treatment.
Because VITT is a relatively new condition, there is limited evidence available to inform clinicians on how people should be cared for. The NICE guideline will bring together the best knowledge to support clinicians to diagnose and treat individuals with the syndrome. There is currently no national guidance for identifying and managing VITT, although the British Society for Haematology has previously published guidance by the UK Expert Haematology Panel on the condition.
NICE is currently working with an expert panel to review the evidence for identifying and managing VITT. This will be a living guideline, which can be continuously updated to incorporate the latest evidence and keep abreast of new developments.
As with the managing COVID-19 guideline, the VITT guideline will be developed and published in the MAGICapp platform, a global system that promotes evidence sharing from different guideline creators, therefore increasing the speed at which guidance can be developed and the ease with which it can be updated.
NICE aims to publish the guideline towards the end of July.
Dr Paul Chrisp, director of the Centre for Guidelines at NICE, said: “This is an important guideline to help clinicians swiftly identify the small number of people who develop VITT after having a COVID-19 vaccine, and to support them in treating these patients effectively. To be clear, this guideline is not looking at the safety of COVID-19 vaccines; that is not NICE’s remit and the data from MHRA overwhelmingly shows the vaccines are safe. NICE’s role here is to provide the best advice to help clinicians treat patients in the rare instances where they do develop VITT.”