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The COVID-19-pandemic has had a huge impact on health and economics all over the world resulting in widespread vaccine development. Vaccine-induced immune thrombotic thrombocytropenia has been described, suggesting a link between the two adeno-vector vaccines ChAdOx1 nCoV-19 (Vaxzevria from AstraZeneca) and Ad26.COV2-S (Janssen from Johnson and Johnson). This rare clinical condition should be suspected in patients with headache, abdominal pain, suspected thrombosis or hemorrhage and thrombocytopenia within 3-30-day post vaccine. In this case report a previously healthy man had thrombocytopenia with fatal intracerebral haemorrhage which was suspected to be related to vaccine.

Vaccine-induced immune thrombosis and thrombocytopenia (VITT) is a new syndrome, which has emerged after introduction of the adenovirus vector-based COVID-19 vaccines ChAdOx1 nCoV-19 og Ad26.COV2-SVITT is characterised by venous thrombosis at unusual, and often multiple localisations, especially including cerebral venous sinus thrombosis. Besides, bleeding manifestations often occur. Biochemically, VITT is characterised by thrombocytopaenia and elevated fibrin d-dimer. VITT is a rapidly progressing and potentially life-threatening syndrome where rapid diagnosis and treatment are essential as argued in this review.