While there remains controversy over the clinical significance of a low-titer anti-PF4, due the limited access to functional assays, we propose that patients with a positive anti-PF4, markedly elevated D-dimer, thrombocytopenia and thrombosis within the time frame of VITT, regardless of the type of vaccine, be treated with the same urgency and consideration as cases of confirmed VITT. Here, PF4 is linked to Venous thrombosis.