COVID-19 vaccine (mRNA BNT162b2) and COVID-19 infection-induced thrombotic thrombocytopenic purpura in adolescents

The mRNA COVID-19 vaccine and COVID-19 infection caused by the SARS-CoV-2 virus may be immunologic triggers for the development of thrombotic thrombocytopenic purpura (TTP). There is not yet literature that discusses TTP induced by COVID-19 vaccination or infection in pediatric or adolescent patients. We describe three adolescents presenting with TTP (both de novo and relapsed disease) following administration of the Pfizer COVID-19 vaccine or after COVID-19 infection. Our observations demonstrate that the Pfizer-BioNTech mRNA vaccine and COVID-19 infection can act as triggers for the development/relapse of both congenital and acquired TTP.

Automated summary

The mRNA COVID-19 vaccine and COVID-19 infection may trigger the development of thrombotic thrombocytopenic purpura (TTP), but there is limited literature on the subject in pediatric or adolescent patients. This study describes three adolescents who developed TTP, either as newly diagnosed or relapsed cases, after receiving the Pfizer COVID-19 vaccine or contracting COVID-19. The findings suggest that both the Pfizer-BioNTech mRNA vaccine and COVID-19 infection can act as triggers for the development or relapse of both congenital and acquired TTP.