VPB0114 - BNT162b2 mRNA SARS-CoV-2 vaccination does not cause upregulation of endothelial activation markers or hypercoagulability: A Prospective, Single-Arm, Longitudinal Study.

Sunday, July 10, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: Virtual

Co-Author(s)

XL

Xin Rong Lim

Consultant
Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore
Singapore, Singapore
BL

Bernard PuiLam Leung

Associate Professor
Health and Social Sciences, Singapore Institute of Technology, Singapore
Singapore, Singapore
CS

Christina Lai Lin SUM

Principal Medical Technologist
Department of Laboratory Medicine, Tan Tock Seng Hospital, Singapore
Singapore, Singapore
GL

Gek Hsiang Lim

Principal Biostatistician
Clinical Research and Innovation Office, Tan Tock Seng Hospital, Singapore
Singapore, Singapore
CC

Choon Guan CHUA

Associate Consultant
Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore
Singapore, Singapore
TT

Tian Ming TU

Senior Consultant
Department of Neurology, National Neuroscience Institute, Singapore
Singapore, Singapore
KR

Kollengode RAMANATHAN

Senior Consultant
Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre, Singapore
Singapore, Singapore
MH

Mei Yan HUANG

Post doctoral student
Health and Social Sciences, Singapore Institute of Technology, Singapore
Singapore, Singapore
HH

Hwee Siew HOWE

Senior Consultant
Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore
Singapore, Singapore

Presenting Author(s)

Bingwen Eugene Fan, MBBS, MRCP, MMED

Consultant
Department of Haematology, Tan Tock Seng Hospital, Singapore
Singapore, Singapore

Background: Reports of thrombosis post COVID-19 mRNA vaccination have sparked concerns about safety.

Aims: We prospectively evaluated blood samples of 18 participants who had received 2 doses of the BNT162b2 mRNA vaccine to determine if vaccination results in endothelial activation or hypercoagulability.

Methods: 18 participants who received the BNT162b2 vaccine were enrolled. Participants completed a questionnaire on their cardiovascular and thrombotic risk factors. Blood samples were collected at three time points: pre-vaccination (day of vaccination), a median of 17 (IQR 16-18) days after the first dose and a median of 9 (IQR 7.5–14.5) days after the second dose of BNT162b2 vaccine. Endothelial markers included ICAM-1, VCAM-1 and P-selectin. Coagulation tests included PT and aPTT with clot waveform analysis, von Willebrand factor levels, Factor VIII and D-dimer levels. Statistical tests of association between endothelial and coagulation parameters were performed with repeated measures ANOVA and Mauchly’s test of sphericity.

Results: The median age of the participants was 35 years (IQR 31 – 44), and 14 (78%) were female. 15 did not have any cardiovascular risk factors. There was a statistically significant increase in median ICAM levels post first (66.1ng/ml) and second dose of vaccination (69.5ng/ml)(p=0.04), although this remained within the normal limit of ICAM levels. A statistically significant decrease in median PT (p=0.005) and aPTT (p=0.03) was observed post vaccination, with a corresponding statistically significant increase in aPTT clot waveform analysis (CWA) for maximum acceleration (max2)(p=0.03) and maximum deceleration (max2)(p=0.04) post first and second dose of vaccination. However, all evaluated endothelial and coagulation parameters remain within the reference ranges (Table 1).

Conclusion(s): Our findings provide reassuring preliminary data that BNT162b2 vaccination does not result in endothelial activation or hypercoagulability. Mild variations in endothelial markers and coagulation parameters, though statistically significant, remain within the reference ranges and may be related to an inflammatory immune response to vaccination.