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Since late April 2022, reports of children with hepatitis have suddenly begun to increase. Over 109 cases of hepatitis in children were reported from 24 states in the U.S. with five deaths. In the U.K, 176 cases were confirmed and cases were also reported in other European countries including Spain, Scotland, Denmark, and Ireland, among others. Most cases affect children under five years of age. The Center for Disease Control and Prevention (CDC) is advising parents on the signs and symptoms to look out for in their children while they investigate the possible reasons for the outbreak. Jaundice and vomiting are the most common symptoms experienced by the children affected. Soon after the proliferation of cases, claims started circulating that the outbreak was linked to the COVID-19 vaccine.
Ongoing Investigations
Thus far, one study has linked the COVID-19 vaccine to possible hepatitis. The case report, which was conducted on one male adult, recognized autoimmune-hepatitis-like (AIH) disease following vaccination as a “rare adverse event not identified in early trials.” Given the global widespread vaccine administration there is also the question of “causality vs. coincidence,” especially since AIH-like disease after vaccination was reported in patients with higher risk factors for spontaneous AIH, such as age and gender. The study adds that “while some of these cases thus may represent coincidence, a causal relationship to the vaccine is also possible, such as bystander hepatitis driven by elevation of systemic cytokines or chemokines after vaccination, similar to cases occurring in association with natural SARS-CoV-2 infection.”
According to the World Health Organisation (WHO), they are studying a number of factors that may have been the cause. Such as a reduced level of circulation of adenovirus, which raises susceptibility amongst young children during the COVID-19 pandemic, the potential emergence of a novel adenovirus, as well as SARS-CoV-2 co-infection, need to be further investigated. Hypotheses related to side effects from the COVID-19 vaccines are currently not supported as most affected children did not receive COVID-19 vaccination. Other infectious and non-infectious explanations need to be excluded to fully assess and manage the risk. The possibility of a new adenovirus emerging, as well as COVID-19 co-infection must be examined further. This was also backed by the UK Health Security Agency (UKHSA).
The WHO, as well as the UKHSA, and Scottish government have all said that a link between COVID-19 and the hepatitis outbreak in children is unsupported given the great majority of afflicted children did not receive the vaccine, this was also reported by the BBC. Scotland had at least 13 cases, their Public Health Minister Maree Todd told the Scottish Parliament that the COVID-19 was not causing the hepatitis as none of the children had received the vaccine. Dr Meera Chand, director of clinical and emerging infections at the UK Health Security Agency (UKHSA), said that their “investigations ‘increasingly’ suggested the rise was linked to adenovirus infection.” However, they are also investigating COVID-19 infections and other potential causes including environmental.
Lack of Studies
Further research must still be conducted, as a one-person study may not necessarily be applied to the general adult population but will provide insight on how to possibly improve the vaccine and closely monitor those with higher risk factors.
As for hepatitis in children who have not taken the vaccine at all, there is still a lack of studies. Further investigations are required.
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