Fifteen-year-old Nik sits next to his mom at a table in the family’s home, a camera and microphone recording his latest YouTube video.

But this video isn’t like any he has made in the past. Normally, they’re filled with funny pranks, adventures with friends or acrobatic flips and spins associated with his favorite sport, known as freerunning.

In this video, Nik is simply grateful to be upright and breathing well. Still fragile and emotional, he talks about his continuing recovery after 12 days in the pediatric intensive care unit at Johns Hopkins All Children’s Hospital — about his respiratory failure, his close call with death.

“I was really scared,” Nik says. “I thought, ‘Am I even going to be here another day?’”

Nik had been vaping for years. And while he tested negative for COVID-19, he was presenting in a similar fashion — and showing all the signs of multisystem inflammatory syndrome (MIS-C), which impacts not only the respiratory system, but many other organs and systems in the body.

It is a pattern that doctors are seeing more and more in pediatric patients who vape.

“Patients who vape and who come to us with some other problem tend to be sicker,” says pediatric hospitalist John Morrison, M.D., Ph.D. “Their symptoms are worse; they may present with multiple issues — gastrointestinal symptomatology, for example, or even heart failure.”

It begs the question, what exactly is going on here?

It’s a question to which Morrison and critical care physician Anthony Sochet, M.D., are determined to find answers. They are co-principal investigators in a year-long study, the Vaping Associated Systemic Toxicity (VAST) trial, which launched this month. 

The study seeks to understand the toxicities on the entire body and mind as it relates to youth who vape compared to those who do not. These physicians and researchers want to acquire more data — from the psychology behind the choices kids make to vape — to the actual systemic injury that the practice may have on their bodies, beyond just harm to the lungs, known as vaping-associated lung injury.

The study is being funded by Johns Hopkins All Children’s Foundation through a new grant mechanism — this one awarded to the Department of Pediatric Medicine — for studies just like this, where investigators have questions early in the stage of research, which need initial financial support to get off the ground. The resulting data can inform even better questions, which can, in turn, be parlayed into more possibilities for external funding for further research.

Because the implications are so far-reaching, the VAST study has captured the interest of a cross-disciplinary team — strong collaborators, all — at Johns Hopkins All Children’s Hospital.

Colleagues from General Pediatrics and Adolescent Medicine will assist in identifying patients for the study.

The Center for Behavioral Health is lending expertise on gathering information about children’s perceptions about vaping, including its safety.

Additionally, there is participation or interest from Pulmonology, Cardiology, Nephrology, Gastroenterology and Radiology, among other divisions.

The hospital’s pediatric biorepository will be employed as well, storing samples for this study and for related ones in the future.

The results may not only assist pediatric physicians in offering the very best care for these children, it could ultimately inform and impact policy. 

With one in four high school kids in this country reporting vaping, with growing evidence that shows vaping is toxic, at a minimum, to the respiratory system, and with few laws currently governing the availability and use of these products for kids — the need for research is more relevant and more pressing than ever.

“We don’t fully know yet just how toxic these substances are to children,” Sochet says. “But we need to start looking.”