Covid 19 pandemic has shocked the world but with the use of covid appropriate behavior and mass vaccination life is returning back to normal. Vaccination although relatively safe can cause some serious side effects. Here we describe a case of suspected inflammatory and thrombotic response to vaccination (kuonis syndrome) with the AstraZeneca vaccine, COVISHIELD (ChAdOx1 nCoV- 19 Corona Virus Vaccine) within 2 hours of vaccination leading to development of acute LAD artery thrombus which presented as acute ST elevation anterior wall myocardial infarction. This is the possibly the shortest time period for vaccine induced MI in the world. A 28-year-old male presented in the Emergency Department with severe, retrosternal chest pain of 2 hours duration. Within 15 minutes after the dose of the Covishield vaccine patient started having feeling of uneasiness and chest pain. Traditional risk factors of cardiovascular diseases or comorbidities were absent. His vitals were stable. ECG showed ST-segment elevation in precordial leads suggestive of acute ST-elevated anterior wall myocardial infarction (Figure 1). An echocardiogram showed hypokinesia of anterior, anteroseptal and anterolateral wall with left-ventricle ejection-fraction of 40%. His coronary-angiography showed 70% stenosis of ostio-proximal left anterior descending coronary artery (LAD) with thrombus (Figure 2A), which was fixed with one drug-eluting stent. Some residual thrombus was there in post procedure angiogram so patient was put on heparin infusion for 24 hours. The patient improved gradually and was subsequently discharged on dual antiplatelet therapy.