There have been reports of vaccine-induced immune thrombotic thrombocytopenia (VITT) associated with COVID-19 vaccines produced by both AstraZeneca/Oxford University (ChAdOx1 CoV-19) and Johnson & Johnson (Ad26.COV2.S). This serious adverse event is very rare (reported in less than 1 in 100,000 vaccinated people), but guidance for management of VITT has been recommended by the COVID-19 Guidelines Committee and National Essential Medicines List COVID-19 Therapeutics Subcommittee – see attached Appendix I.  The recommended medicines for the management of VITT, fondaparinux and/or direct-acting oral anticoagulants1, can be procured by Provinces, through a buy-out process for use by specialists (or in consultation with specialists) at Tertiary and Quaternary hospital level facilities.