For the treatment of vaccine-induced immune thrombotic thrombocytopenia (VITT), an uncommon adverse effect of adenoviral vector vaccinations against coronavirus illness, high-dose intravenous immune globulin (IVIG) plus anticoagulation is advised (Covid-19). The response to IVIG therapy in three of the first patients with VITT in Canada after receiving the ChAdOx1 nCoV-19 vaccination is described. The patients ranged in age from 63 to 72 years old, with one being a woman. Canada had restricted the use of the ChAdOx1 nCoV-19 vaccine to people 55 and older at the time of this publication, based on concerns that VITT had occurred largely in younger people. Two of the patients in our study had limb-artery thrombosis, while the third had venous and arterial thrombosis in the brain. In response to heparin and platelet factor 4 (PF4), different patterns of serum-induced platelet activation were detected, showing the variety of VITT manifestations in serum. All three individuals had lower antibody-induced platelet activation in serum after starting IVIG.
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