What Is Thrombotic Thrombocytopenia? J&J COVID Vaccine Blood Clot Linked to Woman's Death

A Seattle woman has died from a rare blood-clotting syndrome after receiving the Johnson & Johnson single dose COVID vaccine, health officials confirmed Tuesday.

The 37-year-old woman was the first in King County to die from a rare form of thrombosis called thrombocytopenia syndrome (TTS). Jessica Berg Wilson, whose name was revealed in an obituary published in The Oregonian, received her vaccination on August 26 and died on September 7.

According to the Centres for Disease Control and Prevention (CDC), Wilson is just the fourth person in the U.S. to die from the rare vaccine complication. Of the nearly 9 million doses of the J&J vaccine administered by May, the CDC said there have been just 28 cases of TTS.

Assessing the risk presented by this form of thrombosis, which is also known as vaccine-induced thrombotic thrombocytopenia, and its potential association with the J&J vaccine, the CDC concluded that the risks of COVID vastly outweigh those of TTS, even for the most at-risk group: women aged 18 to 49.

The assessment was performed after the CDC and the U.S. Food and Drug Administration (FDA) paused the use of the J&J vaccine on April 13, 2021, after six reports of cerebral venous sinus thrombosis (CVST) and three cases of TTS.

The single-dose vaccine was reauthorized on April 23, following the publication of the report.

"For every 1 million doses of the J&J vaccine administered to women aged 18–49 years, 297 hospitalizations, 56 ICU admissions, and six deaths related to COVID-19 could be prevented, compared with seven expected TTS cases," Seattle & King County officials said in the press release referring to data from the Vaccine Adverse Event Reporting System (VAERS). "The risk of any complication is extremely low."

According to the CDC, thrombosis occurs when blood clots block blood vessels, with symptoms including a severe headache, abdominal pain, leg swelling and shortness of breath. While the condition is rare, it can lead to death. One of the key signs doctors use to identify TTS is a low blood platelet count.

The American Society of Hematology says TTS is a syndrome characterized by thrombosis at unusual sites, including in the brain's venous sinuses, which prevents blood from draining from the brain. Known as cerebral venous sinus thrombosis, this was found in 19 of the 28 cases reported by the CDC prior to May 7.

It adds that initial symptoms of TTS develop within 6 to 14 days of the vaccine being administered and should not be confused with standard symptoms of the COVID vaccination, such as fever, fatigue, headache or muscle aches.

The American Society of Hematology recommends that those with severe, recurrent, or persistent symptoms from four to 42 days following COVID-19 vaccination, including intense headache, abdominal pain, back pain, nausea and vomiting, vision changes, change in mental status, shortness of breath, leg pain and swelling, or bleeding, should contact a medical practitioner.

The CDC offered additional advice on the J&J vaccine following its reauthorization: "Women younger than 50 years old should especially be aware of the rare risk of blood clots with low platelets after vaccination. There are other COVID-19 vaccines available for which this risk has not been seen."

As of April 24, the CDC said it had been unable to confirm any TTC cases associated with mRNA vaccines such as the Pfizer-BioNTechd double-dose vaccine.

Seattle & King County officials offered condolences to the family of Jessica Berg Wilson.

"Seattle & King County and state and federal health agencies take vaccine safety very seriously. Public Health medical staff conduct a daily review of medical records to identify patients who may have had adverse health outcomes related to vaccination," a press release read. "We at Public Health are saddened by this loss and offer condolences to the woman's family and loved ones."