Vaccination against COVID-19 did not cause acute metabolic decompensation in a group of 18 children with inborn errors of metabolism including fatty acid metabolism disorders, reported a new study published in the Journal of Paediatrics and Child Health. It, therefore, seems to be safe in this group of patients. 

However, the authors said that the small sample size and unequal distribution of subgroups of inborn errors of metabolism are limitations of this study and that patients should be “monitored closely after vaccine administration to prevent vaccine-related metabolic exacerbation.”

It is of great importance to vaccinate children with inborn errors of metabolism against COVID-19 to prevent the spread of the disease and provide metabolic control. However, there are no clinical studies or recommended guidelines on the safety of COVID-19 vaccines in these patients. There are concerns that the vaccines may trigger a catabolic state by increasing energy expenditure leading to acute metabolic decompensation, which can be life-threatening.

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In the present study, a team of researchers from Turkiye led by Cigdem Aktuglu-Zeybek, MD investigated the relationship between COVID-19 vaccination and metabolic outcome in children with inborn errors of metabolism.

The researchers analyzed 18 patients, 12 to 18 years of age, who had a total of 36 vaccines. Of these patients, 13 had organic acidemia, urea cycle disorders, maple syrup urine disease, or phenylketonuria, 4 had fatty acid metabolism disorders or LIPIN 1 deficiency, and 1 had glycogen storage disorder type 5. Almost all patients received the BNT162b2 vaccine apart from 1 who received CoronaVac. 

The results showed that the levels of phenylalanine in the plasma increased significantly within 24 hours of the second dose of vaccine in 2 of the 5 patients with phenylketonuria.

None of the patients with any other type of disease experienced acute metabolic attacks. They also did not need emergency department admission due to metabolic decompensation within 1 month of vaccination.

“According to our results, COVID-19 vaccination appears to have a safe and acceptable profile in [inborn errors of metabolism] patients in terms of acute metabolic decompensation,” the authors concluded.


Zubarioglu T, Oral-Cebeci S, Hopurcuoglu D, et al. Safety of COVID-19 vaccines in children with inborn errors of metabolism in terms of developing metabolic decompensation. J Paediatr Child Health. 2022;29:10.1111/jpc.16231. doi:10.1111/jpc.16231