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. 2022 Nov 9;7:141. doi: 10.1038/s41541-022-00569-8

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© The Author(s) 2022

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 1 — VITT is a newly identified disease, which occurs very rarely post adenovirus vector COVID-19 vaccines. Crucial clinical and laboratory signs of the disease are: thrombosis with thrombocytopenia, elevated D-dimers, high levels of anti-PF4 antibodies as measured by ELISA. Secreted anti-PF4 immunoglobulins (IgG) can form aggregates with PF4 in the blood circulation. These aggregates can activate platelets and trigger the downstream prothrombotic cascade. Worldwide, the exact number of VITT among all TTS cases after adenovirus vector COVID-19 vaccination remains currently unresolved due to the limited availability of anti-PF4 antibody testing.