Yes, the clinical definition of thrombocytopenia is low platelets. Like many clinical definitions, it says nothing about the cause of the condition, and I'm sure that's what the FDA and J&J want to investigate.

I wouldn't pretend to want to give advice on how to deal with patients, but I will says this: adenovirus vectors are very common in the world. They cause colds, and they've been used to develop other vaccines. So I doubt that it's the AAV causing this problem. It is probably more likely that the spike protein antigen is stimulating the immune system in a similar way that the covid virus does, as clotting is an all too common complication of covid--it's one of the main drivers of the cardiovascular issues that have affected so many people. So for me, I wouldn't want to scare anyone off of AAVs generally.

All that said, I'm also not going to pretend to understand something I inherently don't. Just reading up on the other AAV vaccines that have been studies over the years, it looks like they don't generally see the side effect profile that the J&J vaccine evokes. So there's clearly something weird here. Our bodies, as you know first hand, really hate this spike protein.

I think the prudent thing here is to remember we're talking about 6 serious adverse events and 1 death out of about 7 million total doses given. I don't know the proportion of women from 20-50 in that cohort, but let's say it's 20% for argument's sake, which would mean we're talking about 6 out of 1.5 million, or about 1/250,000. If you're a betting man you take those odds. If you're a pregnant patient, maybe you just wait for the RNA vaccines to become available to you.