A hematologist’s challenges during COVID

April 14, 2022 – Shifting advice about the safety of the AstraZeneca-Oxford COVID vaccine in 2021 put hematologists in Australia “into a dizzying spin,” according to an article by Edward Cliff, MPH ’22.

In an April 1, 2022 article in The Lancet Haematology, Cliff described the dilemma he and his colleagues faced when concerns were raised about a rare but potentially severe complication of the AstraZeneca-Oxford vaccine—blood clots called vaccine-induced immune thrombotic thrombocytopenia (VITT).

Cliff noted that Australia faced a unique quandary. Community transmission of SARS-CoV-2 was low, as was people’s risk of severe disease. But older people faced greater risk of VITT. “We hoped to avoid severe vaccine complications, but an avoidable death from COVID-19 despite the availability of an effective vaccine is no less tragic,” he wrote.

As the dilemma unfolded, an Australian advisory group on immunization offered shifting advice. Hematologists struggled to keep up with new data and changing guidelines and to adequately convey the risks of either getting vaccinated or opting not to. “Being caught in the crossfires of government policy and the scientific, medical, and human storm of VITT was a unique introduction to hematology, but it hasn’t put me off,” Cliff wrote. “I still love hematology for its scientific and human complexity, but I prefer it without the controversy of 2021.”

Cliff also wrote an April 7, 2022 article in Cancer Care Chronicles about his experience with patients who had to make a difficult decision: whether to receive treatment for serious conditions in the hospital during a pandemic lockdown—and be unable to see their families—or forego treatment and risk earlier deaths.

Read the Lancet Haematology article: The rollercoaster of vaccine-induced immune thrombotic thrombocytopenia

Read the Cancer Care Chronicles article: A Decision Shared Is a Decision Halved (subscription required)