Michigan teen’s death fueled anti-vaccine rhetoric. We got CDC’s investigative report.
A 13-year-old Saginaw County boy who died in his sleep three days after getting a second dose of a COVID-19 vaccine had a systemic bacterial infection that caused his death, according to an investigation by the U.S. Centers for Disease Control and Prevention.
Jacob Clynick's family discovered the boy on June 16, 2021, in the bedroom of his Zilwaukee home. He'd gone to sleep the night before complaining of flu-like symptoms and a slight stomachache, and never woke up.
Preliminary autopsy findings revealed that Jacob had myocarditis, which is inflammation of the heart muscle that can affect heart rhythm and its ability to pump.
Three days before Jacob's funeral, a CDC advisory committee acknowledged "a likely association" between the Pfizer and Moderna coronavirus vaccines and a slight risk of heart problems in adolescents and young adults.
Jacob's sudden death sparked speculation that the Pfizer BioNTech coronavirus vaccine he'd gotten at a Walgreens store earlier that week may have played a role.
Father still suspects vaccine link
A CDC spokesperson told the Free Press on Friday that "the primary cause of the patient’s death was sepsis (bloodstream infection) due to the bacteria Clostridium septicum, a type of bacteria that produces a toxin that can cause inflammation and damage to the heart and other organs."
That news was a surprise to Jacob's father, Joseph Clynick.
"I think it had to have something to do with the vaccine," he said. "It doesn't make any sense that it wouldn't."
Clynick, told the Free Press that he didn't get any notification from federal, state or local health authorities about the outcome of the CDC investigation. His child's autopsy report lists the cause of death as "myocarditis of unknown etiology."
"I haven't heard anything," Clynick said. "They have never given me any information ever. ... It's a nightmare."
In addition, documents the Free Press obtained from the CDC under the Freedom of Information Act show tension over the official cause of death between federal health investigators and the medical examiner who signed the autopsy report in Jacob's case.
Boy had an infection that's 'rapidly progressive and often fatal'
The CDC conducted extensive testing of autopsy tissue samples and found that the Clostridium septicum infection likely originated in Jacob's abdomen and quickly spread. The bacteria were "extremely abundant" in Jacob's spleen, kidneys and liver, but some also were identified in his heart and lungs.
"Clostridium septicum infections are rapidly progressive and often fatal," Dr. Sarah Reagan-Steiner, medical officer, epidemiology and operations team lead for the Infectious Diseases Pathology Branch of the CDC, wrote in an October 2021 email message with Dr. Randy Tashjian, then-deputy chief medical examiner for the Michigan Institute of Forensic Science and Medicine, a private company that was contracted at the time to provide medical examiner services to Saginaw County.
Yet Tashjian, who conducted Jacob's autopsy, rebutted those findings in email messages with CDC physicians, in the final autopsy report and in a medical journal article he co-authored about two teens — Jacob and another boy from Connecticut — who died within days of taking the second dose of a COVID-19 vaccine.
"Based on the circumstances known at this time, reported clinical history, and collective postmortem,histological, and toxicological findings, it is my opinion that the cause of death in this individual resultedfrom myocarditis of uncertain etiology," Tashjian wrote in Jacob's final autopsy report.
"Whether the second vaccine dose this adolescent received contributed to his death is unknown at this time. If additional information becomes available in the future, the case can be reviewed and the cause of death amended, as necessary. The manner of death is classified as natural."
Medical examiner 'open to discussion with CDC and MDHHS'
Local, federal and state health leaders were aware in early October 2021 of the differences of opinion about what caused Jacob's death. Email messages show they might have tried to sway Tashjian's point of view.
"The medical examiner associated with this case is ready to sign off on the death certificate and final autopsy report," Sally Bidol, who works within the Bureau of Infectious Disease Prevention at the Michigan Department of Health and Human Services, wrote in an Oct. 1, 2021, email to Reagan-Steiner.
"He reached out to give us an opportunity to discuss where he stands on the findings and how he will phrase the cause of death on the DC (death certificate). ... He has reached some conclusions around cardiomyopathy (stress-induced) and he noted vaccine delivery.
"He is open to discussion with CDC and MDHHS and is willing to wait to talk with the family and temporarily hold off on releasing the reports until he has discussions with public health."
More: Michigan boy dies 3 days after getting Pfizer COVID-19 vaccine, CDC is investigating
Email correspondence shows the CDC's pathology branch provided the final report of its investigation to Tashjian and took part in a conference call with him and state health officials to discuss the findings.
The state health department didn't respond to a request from the Free Press for comment on whether any Michigan health leaders tried to influence Tashjian about the official cause of death he listed on Jacob's death certificate.
The CDC said its staff "focused on sharing and explaining our key findings — evidence that C. septicum contributed to the patient’s death. We also acknowledged that the determination on a cause of death on the autopsy report is always the purview of the medical examiner.
"While CDC lends its expertise with testing and analysis, we defer to our state and local partners in terms of running the investigation and communicating with their residents."
Examiner's former employer said vaccine was not linked
Four months passed after the October 2021 call with state and CDC leaders to discuss the pathology findings, and Tashjian still hadn't finalized Jacob's autopsy report.
He told Reagan-Steiner and others at the CDC in February that he had left his position at the Michigan Institute of Forensic Science and Medicine and had begun working with the Wayne County Medical Examiner's Office and the University of Michigan.
His former employer, MIFSM, had been embroiled in a dispute with Saginaw County government leaders that resulted in a termination of its contract handling medical examiner services.
Though Tashjian was no longer employed by MIFSM, the company issued a news release Feb. 3, 2022, saying it had completed Jacob's forensic and medical autopsy.
"Included in this investigation were toxicological, histological, microbiological, and an extensive physical assessment," the news release said. "CDC experts were supplied with access to all data and information made available and/or collected by MIFSM investigators and staff.
"Conclusions by the CDC and local investigators were that no definitive evidence of a causal relationship between vaccine administration and this young man’s natural death existed."
Journal article hypothesizes vaccine link
On Valentine's Day 2022 — three days before Tashjian signed Jacob's autopsy report — a medical journal article he co-authored published online in the Archives of Pathology and Laboratory Medicine. It reviewed the two deaths of teenage boys who died in the days after they each got a second dose of a COVID-19 vaccine.
Tashjian and the article's co-authors hypothesized that the first dose of the vaccine could have caused some inflammation and damage to their hearts, and when the teens got a second dose, their bodies reacted with "an excessive and uncontrolled inflammatory response."
The damage in the teen boys' hearts, the article says, appeared to be different than what is typically seen with myocarditis caused by a bacterial infection or a virus.
Tashjian didn't notify the CDC in advance of the journal article's publication.
Rather, Reagan-Steiner sent Tashjian an email message two days after it published to confirm that Jacob was among the boys referenced in the article. She noted that CDC investigators "have received some questions from CDC leadership regarding this report."
Tashjian replied: "I ended up calling the cause of death as myocarditis of unknown etiology and raised possible scenarios in my report summary, including CDC's findings. But without an obvious GI (gastrointestinal) source of infection, I backed off on attributing it to Clostridial sepsis. ... I hope the reactions to the article are not blown out of proportion."
That began a tense back-and-forth exchange that played out on the pages of the Archives of Pathology and Laboratory Medicine as Reagan-Steiner and others from the Infectious Diseases Pathology Branch of the CDC published a letter to the editor, writing "with concern" about Tashjian's findings on Jacob's cause of death.
"The conclusion of IDPB ... was death attributable directly to C. septicum sepsis," the letter to the editor said. "Clostridium septicum sepsis is characteristically a fatal and fulminating infection that often presents with nonspecific signs and symptoms. The infection is lethal in approximately 60% to 70% of cases, and death typically occurs within 12 to 48 hours of symptom onset. ...
"The report ... unfortunately omitted many important findings provided by pathologic evaluations at the CDC that ... identified a specific infectious cause of death for patient B. These omissions could lead incorrectly to the assumption that COVID-19 vaccines were directly responsible for the deaths of these two patients."
That drew a rebuttal from Tashjian and his co-authors, who wrote in the journal that the CDC "unfortunately overstepped its role ... by diagnosing the death as 'attributable directly' to clostridial sepsis. ... It misinterpreted common postmortem findings, including bacterial overgrowth.
"The clinical history and cardiac findings simply do not support a diagnosis of clostridial sepsis. The clostridial 'diagnosis' was not included in the report because it was a postmortem artifact; it was not an 'important finding' or an 'alternate cause of death.' "
The CDC did not answer questions from the Free Press about whether Jacob's case ultimately was included in data about the risk of myocarditis after taking a COVID-19 vaccine.
Tashjian did not return email messages or phone calls from the Free Press.
'The vaccine has more benefit than harm'
Dr. B. Keith English, professor and chair of the Department of Pediatrics and Human Development at the Michigan State University College of Human Medicine, said it's far more likely that a person will develop myocarditis or pericarditis from having a coronavirus infection than from taking the vaccine.
"Everything we do in medicine has some side effects," he said. "So if you take aspirin or you take ibuprofen or you take amoxicillin, there's a lot of benefit, but there are occasional side effects that can cause problems. That's true of everything, including vaccines."
The CDC's Advisory Committee on Immunization Practices found an association with rare cases of myocarditis and pericarditis, inflammation of the sac or pericardium around the heart, among adolescents and young adults who got the Pfizer or Moderna vaccines.
The complications have been reported at a rate of 12.6 per million among people ages 12-39 within 21 days after a second dose of the vaccine. The problems were most likely to appear within the first five days after vaccination, according to a Vaccine Safety Datalink analysis. Some cases have been reported after the first vaccine dose as well.
"We discovered that some of the vaccines ... did have some relatively rare side effects including myocarditis, or inflammation of the heart, that could occur, particularly in young men, teenagers," English said. "... We still don't know for sure why that is. It was definitely associated with these mRNA vaccines, but at the same time, it was much less likely than inflammation of your heart if you got COVID.
"Of course, if you got COVID, there are a lot of other problems that could happen besides inflammation of your heart. And so clearly, without question, in everybody, including teenage boys, the vaccine has more benefit than harm. There's no question about it. It's been proven over and over again."
However, misinformation campaigns on social media, along with public distrust of public health that grew out of the pandemic, have affected the public's willingness to take vaccines.
More: A distrust, based on history, keeping many Black Detroiters from getting COVID-19 vaccine
"The solution of vaccine hesitancy is to be totally transparent and honest about everything we know," English said. "It's not to cover up anything or hide anything."
In cases like Jacob's, when people die or get sick within days of taking a vaccine, it's human nature to believe that the cause of that illness or death must be the vaccine, he said.
"And it's completely understandable ... if somebody succumbed from that and it was a few days after getting the vaccine that they would think: 'Well gee, I wonder if that was really the vaccine or not,' " English said. "As human beings, we focus on cause and effect. If something happened just yesterday, and we don't feel well today, we wonder: 'Gee, is that what caused it?' Sometimes it is, but often it isn't.
"You have to do a big study, and big studies were done showing that was not any more common in people who got the vaccine than people who didn't get the vaccine. ... I can say that these vaccines have been studied more and more carefully than any vaccines in the history of vaccines. It's pretty amazing, really. ... I don't know how many total millions of people have been saved because we have these COVID vaccines."
Though he didn't play any role in investigating Jacob's death, English said he has seen some patients with bacterial infections like Jacob's.
"Clostridium septicum, for reasons we don't understand, can get in your bloodstream and spread all around," English said. "Even the name, septicum, comes from the word sepsis. It is a severe bloodstream Infection ... and the body's immune response is so bad, that there is sort of a circulatory collapse.
"This is a terrible bacteria. If you get that in your system causing a systemic illness, there's a high degree of fatality. ... That's the kind of thing that is usually fatal. ... They have terrible inflammation throughout their body, it's not just in the heart."
'Then he was gone on the third day'
Jacob, his father said, had been given a "clean bill of health" by his primary care physician a few months before he died.
"Then he got his first vaccination shot, and he was fine," Clynick said. "He got his second one, and he had flu-like symptoms for two days. Then he was gone on the third day.
"The coroner's office, when they gave me the initial medical report ... they said they found traces of that (bacteria), but his heart was enlarged and there was fluid around it, and that was what caused his death.
"They never even gave me the medical report, the final ruling."
Contact Kristen Shamus: [email protected]. Subscribe to the Free Press.
This article originally appeared on Detroit Free Press: CDC reports why Michigan boy died 3 days after getting COVID vaccine
