I answered my own question (I think).
Modulo redefinition of the phases of operators, projective representations are in correspondence with central extensions (as both are built out of nontrivial algebraic 2-cocycles). For n>2, Spin(n) is a universal cover, so the phase of any of its projective representations is a coboundary, which is to say that operators can be redefined to make the representation linear.
tl;dr: There are no nontrivial projective representations of Spin.
What happens in n=1,2? I haven't thought about it.