hey guys welcome to another video yesterday i was seeing one of my patients in the pulmonary
clinic and she was asking me about my thoughts about getting the covid vaccine
she also asked me if i heard about the doctor in florida who died after getting the first
pfizer vaccination so this is something i want to talk about so there was an obstetrician
gynecologist in miami who received the first dose of the pfizer vaccine on december 18th
and shortly after receiving the vaccine he reportedly developed acute immune thrombocytopenia
he died 16 days after getting the vaccine his cause of death being a result of brain hemorrhage
or bleeding into the brain obviously this is horrible it's tragic and you
have to feel for his family but it makes you wonder was his death a result of the vaccine
and if it was a result of the vaccine should that change your perspective on getting the vaccine
so i'm going to tell you my thoughts on this but first let's learn a little bit more about what
happened pfizer is actively investigating the case but they don't seem to think that the vaccine is
the cause of this so far over 10 million people in the united states have received at least one shot
of either the pfizer or the moderna covid vaccine these are the two authorized in the
united states as of right now me personally i received both doses of the pfizer vaccine
which overall went very smoothly now so far there have been about 40 cases of anaphylaxis
as a result of these vaccines meaning a severe allergic reaction none of which were reported
as being fatal now many people have had other side effects that are very common after the
vaccine like having a sore arm having some fatigue headache or fever and this typically lasts a day
or two the miami-dade county medical examiner's office is investigating this death as well
and as of right now there is no official autopsy report but based off the reports let's see what
we can make of this case so this man was healthy he did not smoke he did not take any medications
never had any reaction to any medication or vaccines supposedly three days after he gets
the first dose of the pfizer covid vaccination he gets tiny reddish spots or petechiae caused
by bleeding under the skin of his hands and feet this prompted him to go to the er he gets blood
work done and his platelet levels are low and this is something called thrombocytopenia platelets are
one of the components of blood clotting if platelets are too low it makes people more
prone to bleeding normal platelet counts range from anywhere from 150 000 to 400 000 or so
people can have spontaneous bleeding including internal bleeding but that doesn't typically
happen unless the platelet levels are less than ten thousand his levels were reportedly zero
and because they're so low or absent really he gets admitted to the intensive care unit
for two weeks doctors tried to get his platelet count higher as he had experts from all over the
country involved in his care now presumably they tried a number of different treatments
typically we give platelet transfusions which is really a blood product that we're transfusing but
also we give steroids specifically glucocorticoids such as salimetrol or methylprednisolone if that
doesn't work we try other drugs like ramiplostim or eltrombopag to try to stimulate the bone
marrow to make more platelets sometimes we give immunoglobulins sometimes we give a drug called
rituximab which is a monoclonal antibody if all else fails the last resort is to take out
the spleen because sometimes a spleen plays a role in sequestering and destroying platelets
so they were actually planning on doing a splenectomy meaning removing his spleen
but shortly before that he ends up developing a hemorrhagic stroke that took his life in a matter
of minutes in other words he bled into his brain now just because someone bleeds into their brain
it doesn't necessarily mean that they die but what happens is if the bleeding is severe enough
the pressure starts building up inside the skull and this is known as raised intracranial pressure
and this compresses the brain and eventually the pressure forces the brain down through the base
of the skull that big hole at the bottom of the skull known as the foramen magnum
when this happens the only life-saving option is emergent brain surgery where a neurosurgeon does a
craniotomy to relieve the intracranial pressure but his bleeding was so severe and happened so
quickly it took his life and his thrombocytopenia was not only severe but it wasn't getting better
despite all the treatments that they tried and this leads to the question why does a healthy
guy all of a sudden get severe thrombocytopenia to the point of bleeding to death because no
matter what the cause is this kind of thing is incredibly rare i've never had a similar case
like this in the intensive care unit now there are some cases like this reported with certain drugs
medications can lead to thrombocytopenia as a result of drug-induced antibodies
being made by the immune system that end up attacking the body's platelets
so drug-induced thrombocytopenia refers to acute immune-mediated thrombocytopenia and
it should be suspected when someone has a sudden severe thrombocytopenia so ditp or drug-induced
thrombocytopenia is even more strongly suspected when a patient has repeated episodes of a sudden
severe drop in the platelet count by far the most common drugs that cause this are things like
quinidine the blood thinner heparin and then also sulfonylureas like trimethoprim saltomethoxazole
aka bactrim and also there's other antibiotics that are fairly common that cause this as well
so it's not just drugs that can cause this but also certain foods herbal remedies and one
vaccine the mmr vaccine the risk of itp occurring within six weeks after getting the mmr vaccination
is increased however the attributable risk of thrombocytopenia within six weeks after mmr
vaccination remains overall low at one in 25 000 vaccinated children now complications or long-term
consequences of itp in this age group are rare for the majority of children less than six years
of age the illness is self-limiting vaccines stimulate the immune system and in theory could
in rare cases cause it to mistakenly identify some of a patient's own cells as enemy invaders that
should be destroyed but with that said millions of various vaccinations are given every year
and clusters of thrombocytopenia don't occur and regarding the covid vaccine millions of doses
have been given and so far there are no other reports or associations with low platelet counts
so did the pfizer vaccine cause this based on the timing of things it seems like it but it's too
early to come to a conclusion one way or another we have to know all the facts and understand the
autopsy report but even then it's still not a guarantee that we come to a solid conclusion
although this is an incredibly sad story and even if it does prove that the vaccine did cause this
i hope people aren't dissuaded from getting the vaccine because this type of thing is still
very incredibly rare every decision we make in medicine is based on risk versus benefit
and when you compare the risks of covid and the risks and benefits of the vaccine
the benefits outweigh the risks for the vast majority of people in fact there are lots of
covet patients in the intensive care unit that have thrombocytopenia so that is something
else to put in perspective knowing more details about this case might help us to better devise
treatment plans in case this happens again and other people after they get the vaccine but
i doubt we're going to hear many more cases like this anyway that's all i have for this video
thanks for watching and i'll see you in the next one you