Follow-up form ITP

Please read the Inclusion Criteria 1-4 below.   These tell you both which patients to complete the form for, but also when to complete it.  You will only be asked to complete the follow-up form once, but we ask for your email address in case we need to clarify something.
1) Adults age 18 or more
2) Diagnosis of ITP made by a clinical haematologist, based on history, examination, full blood count and blood film examination consistent with international consensus definition (Provan 2019).  Cases can be primary or secondary.
3) Patients who developed a significant new* episode of ITP within 30 days of COVID-19 vaccination, or developed a significant relapse** of existing ITP
* significant new episode defined as platelets <30
** significant relapse defined as platelets <30 and a fall from baseline pre-vaccine platelet count of 50% or more

4) Minimum follow-up time of 12 weeks from first vaccine, but also, if ITP is after first dose, give adequate duration of follow-up to determine impact of ITP on 2nd vaccine: either decision to defer, or if received 2nd dose, at least 4 weeks FU post 2nd Vaccine with FBC checks.
 
 
 
 
 
 Sex
 
 
 
 Patient status
 
 

Previous History

 Did the patient have a known history of ITP
 
 Was it primary or secondary?
 
 
 
 Had the patient received prior splenectomy
 
 Was the patient on active ITP treatment at time of vaccine
 
 

Vaccine History

 
 First vaccine type
 
 Second vaccine type
 
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