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Letter to 2024 NEJM Links Adenoviral Anti-PF4 to VITT

First paragraph: To the Editor:
Disorders caused by antibodies against platelet factor 4 (PF4) gained major attention during the pandemic, when platelet-activating anti-PF4 antibodies were found to explain vaccine-induced immune thrombocytopenia and thrombosis (VITT) after coronavirus disease 2019 (Covid-19) vaccination with two adenoviral vector–based vaccines, ChAdOx1 nCoV-19 (Oxford–AstraZeneca) and Ad26.COV2.S (Johnson & Johnson–Janssen). Affected patients often have multiple or unusual sites of thromboses, such as the cerebral venous sinus and splanchnic veins, with high levels of d-dimer.
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