he occurrence of blood clots in the context of AstraZeneca's COVID-19 vaccine has led to a concern about the risks for people with varicose veins and to the question if treatment is still possible for those who have been vaccinated.
How likely is it to get thrombosis after COVID-19 vaccination?
Dr. Salama: Although a link has been established between the Astra-Zeneca vaccine and a very rare but serious side effect called thrombocytopenia syndrome (TTS), the likelihood that COVID-19 vaccine will lead to blood clots has not been established. But the likelihood of COVID-19 vaccine stoﬀe leading to blood clots is extremely low. Incidence only 4 in one million people! This rare disease has been found to occur more frequently in people aged 50 to 59 years, and the Pﬁzer vaccine has been recommended as the preferred vaccine for people under 60 years of age.It was also recommended that people of all ages who received the first dose of the Astra-Zeneca vaccine and had no serious adverse events receive a second dose, while people over 60 can be safely vaccinated with either option (i.e., AstraZeneca or Pﬁzer).
Is there an increased risk of blood clots after COVID-19 vaccination for varicose veins?
Dr. Salama: Varicose veins increase the risk of blood clots in the leg veins, which are caused by blood slumping back into the in-competent veins or by the vein wall expanding due to reverse bloodﬂux. Although an association between the Astra-Zeneca vaccine against COVID-19 and blood clots has been demonstrated, the number of patients who develop superficial venous thrombosis in varicose veins has not increased signiﬁcantly. Thrombocytopenia syndrome (TTS) differs from other blood clotting disorders such as deep vein thrombosis (DVT) because it is triggered by the immune system's response to the Astra-Zeneca vaccine against COVID-19 , it results not only in thrombosis but also in low platelet levels as well. Thrombocytopenia syndrome (TTS) typically occurs approximately 4 to 28 days after vaccination with the AstraZeneca vaccine against COVID-19.
Consequently, this means that there is no increased risk of thrombosis in people with varicose veins after receiving the Astra-Zeneca or Pﬁzer vaccines.
Can I still undergo varicose vein treatment after vaccination?
Dr. Salama: While there is a low risk of deep vein thrombosis when veins are treated by stripping or under general anesthesia, the risk of superficial vein thrombosis is much lower with endovenous laser treatment with local anesthesia.There is no evidence of risk of thrombotic disease following COVID-19 vaccination in persons with a history of coagulation disorders, including persons with deep vein thrombosis and/or pulmonary embolism.
The fear of risks due to COVID-19 vaccination in connection with varicose vein treatments is consequently unfounded, postponing the treatment should not be done! On the contrary, untreated varicose veins (especially larger ones) can lead to serious complications such as skin rashes, infections, bleeding, wounds and blood clots. LBCL Surgery & Vein Practice recommends waiting at least ten days between vaccination and treatment.
Do the benefits of Astra- Zeneca's or Pﬁzer's COVID 19 vaccine outweigh the risks?
Dr. Salama: With the Astra-Zeneca vaccine, the risk of blood clots is 1 in 1,000,000, whereas with COVID-19 disease, blood clots occur in 165,000 out of 1,000,000 cases. This means that patients who inﬁce with coronavirus have a much higher risk of blood clots than those who are vaccinated.
If you have had other types of blood clots in the past, or if you have risk factors for blood clots, you can still get vaccinated with AstraZeneca's vaccinestoﬀ - there is no evidence of an increased risk of developing thrombocytopenia syndrome (TTS) in people in this category.