What is the relationship between COVID-19 (Coronavirus Disease 2019) vaccine and internal carotid artery aneurysm?

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Last updated: May 23, 2025View editorial policy

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From the Research

Individuals with pre-existing internal carotid artery aneurysms can generally receive COVID-19 vaccination safely, as the benefits of vaccination in preventing severe disease, hospitalization, and death from COVID-19 typically outweigh theoretical risks for people with aneurysms. The relationship between COVID-19 vaccines and internal carotid artery aneurysms has been explored in several studies, including a 2022 study published in Surgical Neurology International 1, which reported three cases of intracranial aneurysm rupture shortly after receiving mRNA COVID-19 vaccines. However, this study did not establish a causal relationship between the vaccine and aneurysm rupture. Another study published in 2022 in the NMC Case Report Journal 2 reported two cases of ruptured vertebral artery dissecting aneurysm after mRNA anti-COVID-19 vaccination, but again, the study did not establish a causal relationship.

Key Considerations

  • The benefits of COVID-19 vaccination in preventing severe disease, hospitalization, and death from COVID-19 typically outweigh theoretical risks for people with aneurysms.
  • COVID-19 infection itself poses greater cardiovascular risks than vaccination, as the virus can cause inflammation and coagulation abnormalities that might potentially impact existing vascular conditions.
  • If you have a diagnosed internal carotid artery aneurysm and are concerned about vaccination, it's advisable to consult with your neurosurgeon or vascular specialist for personalized guidance based on your specific medical situation.
  • They may consider factors such as the size, location, and stability of your aneurysm when making recommendations.
  • Standard post-vaccination precautions apply, including monitoring for common side effects like injection site pain, fatigue, headache, and mild fever, which typically resolve within a few days.

Additional Evidence

A 2021 study published in Neurology 3 reported a case of adenovirus-vectored COVID-19 vaccine-induced immune thrombosis of the carotid artery, but this study did not specifically address internal carotid artery aneurysms. A 2020 study published in Colombia Medica 4 reported a case of internal carotid artery thrombosis in a patient with COVID-19, but this study did not address vaccination. A 2013 study published in Acta Neurochirurgica 5 discussed the management and outcome of patients with intracranial aneurysms and internal carotid artery occlusion, but this study did not address COVID-19 vaccination.

Recommendation

Based on the available evidence, individuals with pre-existing internal carotid artery aneurysms can generally receive COVID-19 vaccination safely. However, it's essential to consult with a neurosurgeon or vascular specialist for personalized guidance based on your specific medical situation. They can assess the size, location, and stability of your aneurysm and provide recommendations on vaccination and post-vaccination precautions.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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