Cerebral Venous Sinus Thrombosis after a Third Dose of mRNA COVID-19 Vaccine in an Adolescent

Several effective vaccines against Coronavirus disease 2019 (COVID-19) have been developed to control the spread of the disease. A few cases of thrombosis have been reported post-vaccination, especially among young adult women immunized with viral vector-based vaccines; although no pediatric cases of cerebral venous sinus thrombosis (CVST) have been reported after messenger ribonucleic acid (mRNA) vaccine administration. Here, we report a case of CVST in a 14-year-old girl immunized with the BNT16B2b2 vaccine. Other than this recent COVID-19 vaccination, there were no precipitant risk factors in her medical history. Laboratory work-up showed low levels of protein S activity. Further research revealed no pathological gene mutation. She was treated with anticoagulant therapy and discharged with mildly impaired coordination/movement of the fingers. CVST may occur following a COVID-19 vaccination, even among children. Health care providers should be informed about this rare, but severe and potentially fatal, complication following a mRNA COVID-19 vaccination.

Note:

Funding Information: None.

Declaration of Interests: The authors have no conflicts of interest relevant to this article to disclose.

Ethics Approval Statement: This study was approved by our institutional review board (no. R4-64). Informed consent was obtained from patient and patient’s parents using the opt-out method.

Keywords: COVID-19, mRNA vaccine, cerebral venous sinus thrombosis, acquired protein S deficiency

Suggested Citation: Suggested Citation

Mizuno, Shinsuke and Koyama, Junji and Horikawa, Shogo and Kishimoto, Kenji and Hasegawa, Daiichiro and Kosaka, Yoshiyuki and Kasai, Masashi, Cerebral Venous Sinus Thrombosis after a Third Dose of mRNA COVID-19 Vaccine in an Adolescent. Available at SSRN: https://ssrn.com/abstract=4309849 or http://dx.doi.org/10.2139/ssrn.4309849