Severe rhabdomyolysis temporally associated with SARS-CoV-2 vaccine in an adolescent: a case report

Abstract

Background: Rhabdomyolysis has been reported following common vaccines such as influenza vaccines. It has now more recently been temporally associated with SARS-CoV-2 vaccine administration in adults. To our knowledge, there are no published reports of severe rhabdomyolysis temporally associated with SARS-CoV-2 vaccine administration in children. Case Description: We report a case of severe rhabdomyolysis occurring in a 16-year-old previously healthy female, following receipt of the second dose of the Pfizer/BioNTech SARS-CoV-2 vaccine without any other identifiable triggers on history, physical examination, and laboratory investigations. This patient’s creatinine kinase (CK) peaked at 246,900 U/L, at about 90 hours post-vaccination. The patient was hospitalized and treated successfully with intravenous hyperhydration over a 3-day hospital admission with subsequent complete recovery. Conclusions: This is the first pediatric report of rhabdomyolysis temporally associated with administration of the SARS-CoV-2 vaccine. This patient’s full recovery followed a brief hospitalization for hyperhydration. While causality cannot be assigned to this single event, reporting of such adverse events following SARS-CoV-2 vaccination in the pediatric populations is important to create awareness, and to ensure continued post-licensure surveillance of COVID-19 vaccines. The benefits of these vaccines in reducing hospitalizations and deaths, however, continue to outweigh any potential risk of rare adverse events.