American doctors described the occurrence of multisystem inflammation syndrome in a man who had a coronavirus infection and in the following weeks was vaccinated against the coronavirus with Pfizer / BioNTech. 22 days after the second dose, he was admitted to the hospital with low blood pressure, fever and elevated markers of inflammation in the blood. Doctors believe that vaccination may have influenced the onset of the syndrome, but more research is needed to confirm this with certainty. The case is described in Emerging Infectious Deseases.

After coronavirus infection, multisystem inflammation syndrome can develop. This is a fairly rare condition: it occurs in 1-10 people per million per month around the world. Despite the fact that this syndrome is more typical for children, its cases have been described in adults. Usually, 3-4 weeks after recovery, the patient’s body temperature rises, blood pressure decreases, abdominal pains, vomiting, and headaches occur. In laboratory tests, markers of inflammation (C-reactive protein, interleukins) are increased. Scientists cannot yet say exactly why some people develop a hyper-inflammatory reaction after being infected with a coronavirus, while others do not. It also remains unknown whether multisystem inflammation syndrome can occur following covid vaccination.

American doctors led by John Dunn of the Tennessee Department of Health described the syndrome of multisystem inflammation that developed after vaccination against coronavirus in a man who had recently had covid. A 30-year-old man suffered a mild infection with fatigue and loss of smell. At this point, he was not tested for coronavirus. Six days after the onset of symptoms, he had already fully recovered and decided to vaccinate against covid with the Pfizer / BioNTech vaccine. After 20 days, he received a second dose, and for two days afterwards, he felt tired and unwell, which then resolved.

22 days after the second dose of the vaccine, the man went to the hospital with complaints of fever, headache and pain when swallowing. The coronavirus test came back negative. The man’s condition worsened in the following days, so he was hospitalized. The patient had low blood pressure, enlarged cervical lymph nodes, and blood tests showed increased markers of inflammation, and IgG antibodies to coronavirus were also present, but early IgM antibodies were absent. Despite the treatment, the man’s condition continued to deteriorate – he developed confusion, and an echocardiogram revealed heart dysfunction. The man died four days after being admitted to the hospital.

Microscopic examination of lung and heart tissues showed infiltration with inflammatory cells, microthrombosis and necrosis of certain tissue areas. Taking into account the tests performed and the clinical picture, the doctors diagnosed the man with multisystem inflammation syndrome. It cannot be said with certainty that it was vaccination that influenced its occurrence, since the patient had had a coronavirus infection shortly before that. It is worth noting that usually the syndrome of multisystem inflammation occurs a month after the transferred covid, and in this case, almost two months have passed, so the vaccine could have contributed to its development. Doctors talk about the need for further research in this area.

Denmark, Sweden and Finland recently suspended Moderna vaccinations for young people. The country made this decision because of the rare side effect of mRNA immunization with vaccines in young men – myocarditis and pericarditis.

Anastasia Kuznetsova-Fantoni

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