Abstract
The World Health Organization declared the Coronavirus disease of 2019 (COVID-19) a public health emergency of international concern on 30 January 2020, and a pandemic on 11 March 2020. Vaccines have proven to be vital in the effort to control and possibly eventually eradicate this viral infection. There have been reports of thromboembolic events associated with the use of vaccine but from available information, no reported case of atypical Hemolytic Uremic syndrome (HUS) in a black male has been described. We report a case of a 43-year-old black male Sub-Saharan African c5dwho presented with chills, fever, and generalized body aches of 3 days duration after receiving the second booster dose of the COVID-19 vaccine. He developed thrombocytopenia, hemolytic anaemia, and acute kidney injury on admission, and an initial diagnosis of malaria was made. He was managed with parenteral artesunate and then oral artemether/lumefantrine. His hemolytic anaemia was thought to be from malaria-associated hemolysis. This diagnosis was however later re-evaluated to hemolytic uremic syndrome and managed with 50mg daily oral prednisolone which resolved, and he resumed work a week later. Although mass vaccination is a key strategy to control the spread of COVID-19, critical observations should be made to confirm the risk of trigger for abnormal complement activation. Further observations should be made especially if it is a chimpanzee adenovirus-vectored vaccine.