Hematologic Abnormalities 90 Days after COVID-19 Vaccination
Controlled Study Demonstrates Multiple Findings Emerge Over Time
PETER A. MCCULLOUGH, MD, MPH APR 04, 2024
I have notice that vaccinated patients have many more laboratory abnormalities than their unvaccinated counterparts. mRNA in lipid nanoparticles distributes to the bone marrow where blood cells are made, but is there any clinical relevance? Are there any large scale sources of evidence to justify concern?
Choi and colleagues performed a retrospective cohort study using automated data and compared vaccinated (58% mRNA, 35% viral vector, 7% mixed) to unvaccinated in the 90 days after injection:
“Retrospective cohort analyses of data from the Korean National Health Insurance Service (KNHIS) database were conducted from July 2022 to August 2023. We randomly selected data of half of those living in Seoul City as of January 1, 2021 with their diagnostic records up to December 31, 2021. The included participants were vaccinated and nonvaccinated persons aged 20 years or older (n= 4,203,887). Hematologic abnormalities after COVID-19 vaccination were identified as nutritional anemia, hemolytic anemia, aplastic anemia, coagulation defects, and neutropenia using International Classification of Diseases, Tenth Revision codes after index date. Incidence rates of hematologic abnormalities in the vaccination group 3 months after vaccination were significantly higher than those in the nonvaccinated group: 14.79 vs. 9.59 (P<.001) for nutritional anemia, 7.83 vs. 5.00 (P<.001) for aplastic anemia, and 4.85 vs. 1.85 (P<.001) for coagulation defects. COVID-19 mRNA vaccine was associated with higher development of nutritional anemia (odds ratio [OR], 1.230 [95% CI, 1.129-1.339], P<.001) and aplastic anemia (OR, 1.242 [95% CI, 1.110-1.390], P<.001) than the viral vector vaccine. The risk of coagulation defects was increased (OR, 1.986 [95% CI, 1.523-2.589], P<.001) after vaccination, and there was no risk difference between mRNA vaccine and viral vector vaccine (OR, 1.075 [95% CI, 0.936-1.233], P=.306). In conclusions, COVID-19 vaccination increased the risk of hematologic abnormalities. When administering the COVID-19 vaccine, careful observation will be necessary after vaccination.”
In many circumstances abnormalities observed in the complete blood count (CBC), prothrombin time (PT), partial thromboplastin (PTT), and d-dimer tests will need follow-up by a family physician or internist. In some cases hematology consultation will be necessary. Vaccinated patients should take a look at their laboratories in the months after taking the shot and be sure abnormal findings have cleared up.
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Peter A. McCullough, MD, MPH
President, McCullough Foundation
