Immunogenicity and safety of BNT162b2 mRNA COVID-19 vaccine in a subject affected by Shapiro’s syndrome: A case report

Shapiro’s syndrome (SS) is a rare neurological disorder characterized by spontaneous periodic hypothermia and hyperhidrosis without identifiable systemic causes or brain injuries. We present the case of F. a young patient, without agenesis of the corpus callosum and with episodes of recurrent hypothermia, who was successfully immunized against SARS-CoV-2 via vaccination. F. was born on 2012 and started suffering from episodes of hypothermia at the age of three, with body temperature reaching as low as 32.8°C Hypothermia episodes were initially associated with ibuprofen intake, but were later defined as symptoms of SS. No SARS-CoV-2 infections had been reported before vaccination. The subject received the first dose of pediatric formulation anti-SARS-CoV-2 Comirnaty vaccine on 11 January 2022 and the second dose on 5 February 2022. A one-week follow-up for adverse events was performed via telephone contact after both administrations. Further contact occurred one month after immunization. Anti-SARS-CoV-2 IgG titers were evaluated fifteen days after administration of the second dose. Following vaccination, slight fluctuations in body temperature and local adverse events were noted. These adverse events were not worrying; the vaccine’s safety profile is therefore confirmed. The child also developed an excellent antibody titer (>28x10(3) AU/ml), thus suggesting a good immune response.