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Can the Covid Vaccines Cause Psychosis, Delirium & Other Psychiatric Conditions? 29 Case Report Studies Suggest the Answer is YES!!
A veritable rainbow of psychiatric deficits
Below are 29 case report studies documenting a variety of psychiatric conditions following covid vaccination.
For each study, I included the title, lead author and selected excerpts that convey the basic story of the vaccine injury.
I bolded the descriptions of the psychiatric or mental conditions in the quotes lifted from the studies.
Case Report Study #1: Focal onset non-motor seizure following COVID-19 vaccination: A mere coincidence?
A 68-year-old man from rural India without comorbidities except well-controlled arterial hypertension (on regular anti-hypertensives, i.e. losartan 50 mg/day and amlodipine 5 md/day) presented with history of sudden onset impaired consciousness for a period of about 2–3 minutes as stated by his wife and son. Family history and history of illicit drug use was non-contributory. This event occurred four days after he received the first dose of Covishield vaccine. On detailed enquiry, his family members said that after receiving it, he had transient muscle aches and feverish sensation that subsided within one day without medications. That morning (day of event), the patient went to bathroom and forgot to lock the door and after some time he came out of toilet completely naked and soiled with feces. Then the person sat on sofa without cleaning himself. His wife was astonished with this bizarre behaviour, but he seemed to be in a “trance state” and without responding to any questions. Soon after, his wife noticed that he became unresponsive lying on the sofa and a “peculiar vocalization” was heard. This state persisted for near about 2–3 minutes after which he regained consciousness but was still disoriented to time, place and person. He went to sleep and slept for long 6–8 hours before waking up normal. For the next two days, he did normal activities, but his family members pointed out that he was inattentive and making frequent trivial mistakes. These problems abated within a week and he was living normal life for the next two weeks. Then he went to a local physician (R.G.) and a consultant neurologist (S.D.) regarding advice whether to take the next dose of vaccination when it is scheduled.
Case Report Study #2: First episode psychosis following receipt of first dose of COVID-19 vaccine: A case report, Grover et al
An 18 years old female student, without any past psychiatric (including the substance use disorders) or medical history, with no family history of mental illness, was brought to the emergency by family members for irrelevant talk and bizarre behavior. There was no past history of physical illness or substance use. Exploration of history revealed that the patient was apparently maintaining well before vaccination and there was no apparent psychosocial stressor prior to vaccination, nor did the patient have any vaccine hesitancy.
As per family members fever subsided the next day, but patient reportedly started to remain anxious. She was not able sleep at night, frequently woke-up, appeared fearful and would appear to be staring in between. She would keep on pacing around and would appear distressed. Over the next 3 to 4 days, she started to remain irritable, talk irrelevantly, try to run away from home, voiced delusions of persecution and reference, and reported visual hallucinations of seeing Gods and demons. As it became difficult to control her at home, she was brought to emergency for further management. There was no history of seizures, altered level of consciousness, use of any other medications, depressive features, and neurological deficits.
Case Report Study #3: Can new onset psychosis occur after mRNA based COVID-19 vaccine administration? A case report, Reinfeld et al
A 31-year-old, single Hispanic male without past medical or psychiatric history, was brought to the emergency room by police because of erratic and bizarre behavior. He was found to be anxious, guarded, superficial and grandiose. He reported becoming ‘clairvoyant’, being able to talk with dead people, hearing ‘people drumming outside his house’ and the constant voice of a co-worker whom he believed to be a paramour- it was later confirmed that there was no romantic relationship. All these symptoms began one month ago, after receiving the first dose of an mRNA-based COVID-19 vaccine, and markedly worsened three weeks later after receiving the second dose. Previously, he was asymptomatic, working full-time as an office manager. Although functional in adolescence and adulthood, he described himself as a loner, with an inclination to overly spiritual ideas, and able to communicate directly with God. He had a few close friends and romantic relationships.
We need to be mindful that this patient had some schizotypal personality traits, strongly associated with the development of schizophrenia, and we could be observing the onset of schizophrenia, with the vaccine being only an epiphenomenon. However, first psychotic breaks occur infrequently at this age and our patient did not exhibit thought disorganization. His-predominant symptoms were auditory hallucinations, grandiose delusions of becoming clairvoyant, and erotomaniac delusions to which he demonstrated poor insight on initial evaluation. His-psychotic symptoms persisted and worsened until one week after the second vaccine dose he required hospitalization and initiation of antipsychotic medication. Hence, the most parsimonious explanation is that the vaccine, innocuous to the millions of people who have already received it, may have triggered psychotic symptoms in an individual with an intrinsic vulnerability, likely via a hyperinflammatory state.
Case Report Study #4: Sequential provocation of Ekbom's syndrome and acute mania following AstraZeneca COVID-19 vaccination, Chang FY et al
A 39-year-old married woman had no history of major mental disorders and revealed good role function previously. During COVID-19 pandemic, she received the first dose of AZ vaccine on July 30, 2021. Two days later, she perceived extreme itching all over the body and became irritable. She was very sure to feel 5–7 cm worms crawling under her skin and used a blade to cut through the dermis layer to find worms. She went to the dermatology department but didn’t find any dermatological abnormality. She was transferred to the psychiatry department for treatment, but poor compliance. She took many kinds of insecticide to get rid of the body worms she perceived. The distressful feeling was diminished 3 months later.
By getting second dose of AZ COVID-19 vaccine on October 23, 2021, she perceived full drive and energy to run her business and became self-inflated. Until February 2022, the patient shown full blown mania including irritable mood, overactivity, spending spree, decrease need of sleep and presented agitated behaviors, and frequent conflicts with her husband. She was brought to our emergency room due to conscious change and low blood pressure after swallowed approximately 40 pills of sleeping pills and beta blockers on March 7, 2022. By acute intervention, she was transferred to acute psychiatric ward. A series of examinations were performed, no neurological deficit or abnormal blood testing. The brain MRI showed gliosis over bilateral frontal lobes. Psychological assessment revealed significant deficit in executive cognitive function. Banda Gestalt test also showed impaired planning ability and delayed memory. She was prescribed aripiprazole 30 mg and valproic acid 1000 mg to control the manic features. She regularly followed up at psychiatric outpatient department after discharge form 3 weeks of hospitalization. Her mood lability and cognitive deficit were gradually subsided after 12- week of treatment.
Case Report Study #5: Psychosis Associated With COVID-19 Vaccination, Aljeshi et al
The patient was a 20-year-old single woman in her final year of technical college, with no significant medical or psychiatric history and no family psychiatric history. She was brought to the emergency department by her family after having a single seizure-like episode at home preceded by a 4-week history of anxiety, sleep disturbance, and behavioral changes that started a few days after receiving the second dose of COVID-19 vaccine.
The patient reported feeling anxious and restless, having a reduced appetite, and hearing terrifying voices and seeing random people staring at her. She also complained of interrupted sleep with frequent nightmares and sleep terror.
While she was in the inpatient unit, she was noted to be aggressive against male hospital staff, which was clearly driven by her paranoid delusional beliefs. The olanzapine dose was gradually titrated to 25 mg/d. She became fully oriented to time, place, and person after a few days, but she continued to complain of auditory and visual hallucinations. Fourteen days later, her paranoia and suspiciousness, aggressiveness, and auditory and visual hallucinations started to improve. She remained in the hospital for a total of 28 days and was discharged home after complete remission of acute psychotic symptoms with some residual symptoms, mainly reduced concentration and motivation.
Case Report Study #6: First Episode Psychosis Following COVID-19 Vaccination: a Case Report, Renemane et al
A 45-year-old single Caucasian male without past medical and psychiatric history visited the outpatient psychiatric clinic accompanied by his parents because of bizarre behaviour and an attempted suicide by hanging in the early morning of the visit day.
A month before the hospitalisation, he received the second dose of the mRNA-based COVID-19 vaccine and immediately developed total insomnia, unreasonable anxiety, and tremor. As a result, he contacted his family doctor who prescribed metoprolol 50 mg a day, phenibut 250 mg a day, zolpidem tartrate 10 mg a day, but this therapy did not help, insomnia and fear remained.
After 2 weeks, he realized that he has been jinxed as he found some white powder under the carpet in his apartment. From that moment, he became cautious, did not leave the apartment, and reported persecution. On the last day before his visit to the psychiatric clinic, the patient saw a man walking past the windows of his apartment and watching him. The patient described the thoughts in his head as not his own, giving him commands to observe the person on the street. He did not sleep that night and had a strong belief that he should commit suicide. He attached a rope, tried to hang himself, but his father stopped him. In the psychiatric department, he was found to be emotionally withdrawn, immersed in his experiences, hypomimic (he sat in one position, spoke very quietly, did not actively participate in the conversation, answered questions in monosyllables or in short sentences after a long pause). Correctly said his name, age, location but was disoriented to time. He reported that he was scared and full of fear. The patient had a decrease in concentration ability, his memory was not altered. The patient demonstrated poor insight but after an explanation agreed to proceed with the investigation and treatment.
Case Report Study #7: Neuroleptic malignant syndrome following COVID-19 vaccination, Alfishawy et al
A 74-year-old female with medical history significant only for dementia and bipolar disorder on maintenance therapy with memantine, Donepezil and quetiapine presented to Emergency Room (ER) after she sustained a fall and facial injury.
Her family members noticed that she had abnormal posture three days prior to admission and was confused so family members increased quetiapine dose and when she remained confused for two more days which ended by a ground level fall and head injury, they brough her to hospital ER, they reported she got COVID-19 vaccine 16 days prior to this event.
In the ER she was vitally stable but febrile at 38.5C with delirium and on and off agitation, she had bilateral periorbital swelling and ecchymosis, she had generalized muscular rigidity including neck rigidity and hyperreflexia.
Case Report Study #8: Post-COVID-19 vaccine acute hyperactive encephalopathy with dramatic response to methylprednisolone: A case report, Al-Mashdali et al
In this report, we describe a 32-year-old previously healthy man who developed acute confusion, memory disturbances, and auditory hallucination within 24 hours from getting his first dose of the COVID-19 Moderna vaccine.
A 32-year-old Asian male was brought to the emergency department by his neighbors on May 28th, 2021, because he was seen roaming around his apartment with confusion and agitation. Proper history could not be taken as he was disoriented and amnesic. However, he had no significant past medical history based on his electronic medical record and family information. Also, there was no history of psychiatric illnesses, alcohol use disorder, or other substances abuse. Interestingly, he received the first dose of SARS-Cov-2 vaccination (Moderna vaccine) on May 26th, 2021 (two days before the presentation), and that was the last time seen fine. Upon presentation, he was afebrile and vitally stable. The neurological examination was unremarkable, apart from agitation, disorientation to time, place, person, and memory disturbances.
During his hospital stay, he received a five-day course of ceftriaxone and acyclovir for suspected meningoencephalitis, but his disorientation and aggressiveness got worse. Additionally, he developed auditory hallucinations and abnormal behaviours. He received multiple doses of haloperidol and lorazepam and finally required bed restraints. Based on his clinical manifestations, autoimmune encephalitis was suspected, and empirical intravenous methylprednisolone (1 g/day) was started on day six of the hospital stay. After two doses of methylprednisolone, he showed a dramatic improvement and became able to understand and answer our questions. He confirmed that he started to develop forgetfulness and mood disturbance within 24 hours of receiving the covid-19 vaccine dose, but he did not remember what happened after that. CSF extensive workup for autoimmune encephalitis (including anti-aquaporin-4, anti-myelin basic protein, anti-myelin oligodendrocyte glycoprotein, anti-glial fibrillary acidic protein, anti-NMDAR, anti-GAD, and other autoimmune encephalitis antibodies) was negative. He was discharged from the hospital after receiving three days of methylprednisolone. At follow-up in our outpatient clinic (one month after the discharge), he was asymptomatic and fully oriented.
Patient perspective: “Actually, this was the first time during my life I felt like I could not remember anything. It was a very terrifying period and I hope that it will not happen again. Obviously, I think that the vaccine is the only possible explanation for my disease. Honestly, I am not sure if I will be able to take the second dose of the vaccine”.
Case Report Study #9: A Single-Health System Case Series of New-Onset CNS Inflammatory Disorders Temporally Associated With mRNA-Based SARS-CoV-2 Vaccines, Ballout et al
An 81-year-old man with no relevant neurological history presented to the emergency department (ED) with rapid-onset acute change in mental status with severe encephalopathy noted about 13 days following the administration of the first dose of the Moderna SARS-CoV-2 vaccine.
A 27-year-old woman presented to the ED with a 2-day history of acute-onset confusion and anxiety of unclear etiology. It started 6 days following the first dose administration of Pfizer-BioNTech SARS-CoV-2 vaccine that resulted in transient headache and fatigue.
Case Report Study #10: Case Report: Acute Necrotizing Encephalopathy Following COVID-19 Vaccine, Bensaidane et al
We case report of a 56-year-old male who was found to have altered mental status upon awakening. The patient had no specific complaints the day prior aside from mild fatigue. He had received his first dose of the ChAdOx1 nCoV-19 vaccine 2 days prior.
Case Report Study #11: Cognitive deficits and memory impairments after COVID-19 (Covishield) vaccination, Chaurasia et al
We report a 65-year-old man who developed cognitive deficits and memory impairments following his first dose of Oxford AstraZeneca vaccine (Covishield) against 2019 Coronavirus disease (COVID-19). Patient was admitted to Bhawani Hospital and Research Centre after sudden memory loss lasted for a day. He was not oriented to time, place and person. He was unable to describe both short and long-term memory previously acquired. He received Oxford AstraZeneca vaccine 6 days back with no clinical neurological sign for first 5 days after vaccination. On examination his speech was of a non-fluent type characterized by isolated words. He was completely unaware of his presence in the hospital.
Case Report Study #12: Severe Dyskinesia After Administration of SARS‐CoV2 mRNA Vaccine in Parkinson's Disease, Erro et al
In June 2021, the day after her second vaccine dose, she developed fever (38°C), confusion, delusions, and continuous severe dyskinesia for 3 days. Laboratory tests revealed an increased D‐dimer level (3228 ng/mL). She was treated with paracetamol, and her levodopa was reduced to 350 mg daily. After 2 weeks, she was afebrile, but mild confusion and dyskinesia that are more severe than her baseline persist.
Case Report Study #13: Acute Psychosis Due to Anti-N-Methyl D-Aspartate Receptor Encephalitis Following COVID-19 Vaccination: A Case Report, Flannery et al
We report the first known case of anti-NMDAR encephalitis after SARS-CoV-2 immunization in a young female presenting with acute psychosis, highlighting a rare potential immunological complication of vaccination against SARS-CoV-2 that is currently being distributed worldwide.
A female in her 20's presented to the Emergency Department (ED) with a chief complaint of urinary frequency 1 week after receiving her first dose of the Pfizer-BioNTech COVID-19 vaccine (Figure 1). The patient's family stated she had increasingly frequent bouts of anxiety, decreased mentally acuity, insomnia, and a fixation that she suffered from irritable bowels and kidney disease. She displayed waxing and waning hypochondriacal delusions that she had contracted COVID-19 and that “her body was shutting down.”
Case Report Study #14: ‘Wine Glass’ sign following COVID-19 vaccination in a previously healthy adult, Ghosh et al (1)
A 47-year-old previously healthy man from rural West Bengal (India) was brought to the emergency department with abrupt onset rapidly progressive stiffness of bilateral lower limbs and clumsiness of both upper limbs for the last five days. It was associated with slurring of speech, gait unsteadiness, and behavioral changes in the form of inappropriate laughter, crying spells and inappropriate intermittent anger outbursts. According to his family members, these symptoms started within five days of the second dose of COVID-19 vaccination (COVISHIELD). There was no cognitive impairment, dysphagia, nasal regurgitation, sensory, visual, or sphincter disturbance.
Case Report Study #15: Altered mental status and pronounced febrile response after second mRNA-1273 (Moderna) COVID-19 vaccine administration in a patient with previously documented COVID-19 infection, Hilaire et al
A 54-year-old man who was previously found to be COVID-19 positive received two doses of mRNA-1273 (Moderna) vaccine 4 weeks apart, as recommended by the manufacturer. He was brought to the emergency department 1 day after second dose of the vaccine with altered mental status, headache and high fever. The patient was hospitalised for 2 days and managed with supportive care. He completely recovered with return of mental status to baseline and resolution of fever.
Case Report Study #16: Psychiatric pathology potentially induced by COVID-19 vaccine, Roberts et al
The patient had his first dose of AstraZeneca COVID-19 vaccine in mid March 2021. No other precipitating factors were identified, such as illicit substance use or significant stressors. In the days after administration of this initial dose, he developed flu-like symptoms that included a severe ‘splitting’ headache. Ten days later, his wife observed that he was becoming confused, with a significant change in his behaviour. He was taken to the accident and emergency department of the local general hospital by ambulance after he stopped eating, drinking and communicating. Physical assessment, including a CT head scan and routine blood tests, found no abnormalities. Therefore, two days later he was referred to psychiatric services and was subsequently admitted to the adult mental health inpatient unit under Section 2 of the Mental Health Act 1983.
A number of clinical features were reported by the patient's wife and subsequently observed by the nursing staff during his psychiatric inpatient admission. He was confused and disoriented in time and place. His communication ranged from speaking in short sentences, sometimes whispering or mumbling to being completely mute. He was thought disordered. When he was given some paper to write down his thoughts, he was unable to write anything meaningful and was drawing lines only. He stated that he was hearing voices, both male and female, saying the word ‘Covid’ to him, but he could not elaborate any further. His mood was labile and informed his behaviour, which was bizarre and at times very disinhibited. On one occasion he was incontinent of urine. Physical examination was unremarkable; aside from the aforementioned confusion and disorientation, there were no abnormalities that suggested neurological symptomatology. Physical investigations, including routine bloods, were all normal.
Case Report Study #17: A case report of ChAdOx1 nCoV-19 vaccine-associated encephalitis, Takata et al
A 22-year-old woman of Middle Eastern origin, born in Iran and recently living in Western Europe, presented to a UK hospital with a three-week history of intermittent frontal headache and fatigue a few days after she received her second dose of AstraZeneca ChAdOx1 nCoV-19 vaccine. These symptoms did not respond to paracetamol and progressed on to an acute two-day history of confusion and hallucinations (visual and tactile). She reported seeing “disco balls” and experiencing someone touching her skin. She had non-syndromic retinitis pigmentosa but no other medical co-morbidities, and there was no personal or family history of psychiatric illness. She was a non-smoker and non-drinker, and enjoying undergraduate studies at university.
On admission, she had one recorded fever of 38ºC, but otherwise-normal observations (HR 91, BP 123/81, RR 18, O2 saturations 100% on air). She was alert but disorientated to time, person and place, and agitated with a labile affect; she complained of auditory and visual hallucinations – for example, that the room was on fire – and delusions that were often hyper-religious in nature. She was also seen to be gesturing to the air as if responding to unseen stimuli.
Case Report Study #18: New-Onset Panic Disorder Following Pfizer-BioNTech COVID-19 Vaccination, Uvais
A 48-year-old married Indian man working in the Middle East for 13 years received a second dose of Pfizer-BioNTech COVID-19 vaccine on July 7, 2021. There were no immediate adverse events after taking the vaccine, and he continued his heavy manual work on that day. The following morning, he developed palpitation, tightness of chest, and restlessness, which lasted for around 10–20 minutes. It was also associated with dryness of mouth, body trembling, sweating, and feeling of impending doom. He had similar episodes in the following days. Gradually, he developed fear of death, fear of being alone, fear of going crazy, and significant loss of sleep. There were no symptoms of fever, body pain, or pain at the injection site or any allergic reactions. There was no history of psychiatric illness. There was family history of generalized anxiety disorder in his mother, who was on regular psychotropic medications. He also denied any vaccine-related fear before taking the second dose.
He was diagnosed with panic disorder, and oral sertraline 50 mg/d was started along with antihypertensive medications, and he was asked to consult a psychiatrist for proper evaluation and optimization of the medication.
He presented to the outpatient department of our hospital within 1 week of reaching India with complaints of palpitation, worries, fear of going crazy, and significant impairment in sleep.
This patient experienced new-onset panic disorder within a day after receiving the second dose of the Pfizer-BioNTech COVID-19 vaccine. In the absence of other life stressors or fear of vaccination, we could assume that panic disorder in this patient was caused directly by the vaccine itself.
Case Report Study #19: A novel adverse effect of the BNT162b2 mRNA vaccine: First episode of acute mania with psychotic features, Yesilkaya et al
A 42-year-old male was admitted to the psychiatric emergency department five days after being vaccinated with the first dose of the BNT162b2 mRNA vaccine with complaints of irritability and sleeplessness. Although the patient did not have any symptoms outside of weakness on the day of vaccination, the complaints started one day after receiving the vaccine. The patient had delusions that his family was being followed by the deep state and that they were in danger. This was the patients first psychiatric admission. The medical history of the patient showed absence of any illnesses or regular use of medication. In addition, the patient was vaccinated voluntarily and did not have extreme anxiety about vaccination. At the clinical examination, the patient's cooperation and orientation were intact; however, his speech output, speed as well as psychomotor activity were increased. The patients affect was anxious and the mood was dysphoric. He exhibited a loosening of associations, described persecutory and reference delusions and displayed a lack of insight.
At the routine psychiatric evaluation 15 days after discharge, the patient declared that he was unable to remember the initiation of psychiatric symptoms.
A 57-year-old male was admitted to the psychiatric emergency department with complaints of irritability, sleeplessness, talking to himself and suicidal attempt with thoughts of extinction three days after receiving the second dose of the BNT162b2 mRNA vaccine. While firstly the patient only had local myalgia on the arm on the day of vaccination, psychiatric symptoms started at night on the day he was vaccinated. The patient did not have a history of any diseases that required the use of medication, was vaccinated voluntarily and did have any anxiety about vaccination. Clinical evaluation suggested intact cooperation and orientation while speech output, speed as well as psychomotor activity were increased. The patient was anxious, and his mood was dysphoric. Nihilistic delusions with no insight were recorded.
Case Report Study #20: First Episode of Psychosis Following the COVID-19 Vaccination - A Case Series, Borovina et al
The patient's unusual behaviour began within five days of being vaccinated with Ad26.COV2.S adenoviral vector vaccine. He became anxious, suspicious, paranoid, disorganised and complained of headaches.
Finally, two weeks after the COVID-19 vaccination, persecutory delusions and delusions of reference led the patient to suicide attempt by stabbing himself in the abdomen. After abdominal surgery, the patient was admitted to the Clinic of Psychiatry. In addition to paranoid delusions, the psychiatric evaluation revealed intrapsychic tension and low affect modulation.
After two weeks of treatment, the patient's condition improved enough to allow a psychological evaluation. It revealed mild depressive symptoms with suspected paranoid experiences. After 23 days of treatment in our Clinic, he was discharged without psychotic symptoms.
Five days after the second dose of the BNT162b2 mRNA vaccine, he began to experience frontal headaches, pain in the left intercostal space, paresthesias on the left side of his body, as well as paranoid delusions and severe anxiety. The patient was examined several times by a neurologist. No neurological deficits were found on examination and diagnostic tests (including magnetic resonance imaging (MRI) of the brain). Finally, he was admitted to the Clinic of Psychiatry due to psychotic symptoms and psychomotor agitation. In addition to the above symptoms, the psychiatric examination revealed a depressed, irritable mood and olfactory hallucinations.
Three days after receiving the first dose of the BNT162b2 mRNA vaccine, the patient began to complain of headaches and paraesthesia in his legs. He also had syncope and was examined by a neurologist, who found no deficit. Two weeks later, he visited the psychiatric emergency room twice because of persecutory delusions and delusions of reference.
Due to the ongoing worsening of his psychotic symptoms, the patient was hospitalised in our Clinic a few days later. During the psychiatric evaluation, he was agitated, dysphoric, and paranoid.
After one month of hospitalisation, the patient was discharged with partial remission of his psychotic symptoms.
Case Report Study #21: Delirium triggered by COVID-19 vaccine in an elderly patient, Zavala-Jonguitud & Pérez-García
Herein, we describe the case of an 89‐year‐old patient, who developed delirium after the administration of the aforementioned vaccine.
An 89‐year‐old patient presented to the office the second day after the first dose of BNT162b2 COVID‐19 vaccine was given, with a 24‐h history of confusion, fluctuating attention, anxiety and inversion of the sleep–wake cycle.
Case Report Study #22: Delirium after COVID-19 vaccination in nursing home residents: A case series, Mak et al
In the current study, delirium or subsyndromal delirium of mild to moderate severity was identified in 10% of Nursing Home residents the day after vaccination, with no potential competing explanation. Strengths of this study are the inclusion of older adults with physical and cognitive impairment, underrepresented minorities, baseline assessments to facilitate determination of a change in cognition, and rigorous cognitive testing.
In this study, delirium after COVID‐19 vaccination resolved without complications, which contrasts with complications of COVID‐19 infection itself. Thus, the risk–benefit ratio strongly supports vaccination in this population. Nevertheless, because of the heightened risk of delirium and its potential complications in NH residents, clinicians and staff should monitor for delirium after COVID‐19 vaccination.
Case Report Study #23: Induced Depressive Disorder Following the First Dose of COVID-19 Vaccine, Rammouz et al
The case was a 26-year-old man with a history of Down syndrome with moderately good autonomy for daily routine tasks. The patient, who presented hypothyroidism at 10 years old and schizophrenia at 15 years old, was doing well before the vaccination and received his first dose of the BNT162b2mRNA vaccine. Twenty-four hours later, he presented depressive symptoms that resolved spontaneously after one week. Then, fifteen days later, the symptoms reappeared, and the episode lasted for 5 weeks.
Case Report Study #24: Acute dizziness and mental alteration associated with Moderna COVID-19 vaccine: a case report, Pinzon et al
We describe a 39-year-old female with uncontrolled hypertension who showed behavioral change, communication difficulty, social withdrawal, and a confused state within 7 days from getting her first dose of the Moderna vaccine.
Behavioral changes, communication difficulties, social disengagement, and confusion were reported by the patient’s family 1 day before admission.
The patient had 2 doses of Sinovac vaccine on January 2021 and February 2021 and had 1 dose of Moderna COVID-19 vaccine on August 20th, 2021. On the following day, the patient experienced tenderness and swelling on the Moderna COVID-19 vaccine administration site and subsided after the paracetamol consumption.
Case Report Study #25: Transient Global Amnesia [TGA] Related to the Third Coronavirus Disease-19 (COVID-19) Vaccination, Katsuki M et al
A 65-year-old Japanese woman with no previous medical history presented with confusion and anterograde amnesia 3 hours after her third COVID-19 vaccination [COVID-19 Vaccine Moderna Intramuscular Injection (Lot 000011A, Moderna, Takeda, and Moderna)]. She lived alone and was an elementary school teacher. She had not experienced any side effects of the vaccinations, but she felt undefinable anxiety during the third vaccination.
Her amnestic symptoms improved after 12 hours. She remembered that she had the third vaccination, but other memories during TGA were lost.
Case Report Study #26: First episode psychosis following the anti- COVID vaccination: a case reports, Giné Servén et al
We reported two patients with first- episode psychosis after anti-COVID vaccination admitted in the psychiatric ward of our hospital.
In relation with clinical presentation, in both cases, the apparition of psychotic symptomatology was acute (12 hours and 7 days) and with an atypical profile (cycloid psychosis-like phenotype and marked cognitive impairment with oro-mandibular movements, respectively).
Case Report Study #27: Severe Panic Disorder After Vaccination With the Pfizer-BioNTech Vaccine: A Case Report, de Souza Melo et al
A 26-year-old woman was admitted to the hospital psychiatric unit with suicidal ideation after episodes of severe and recurrent panic attacks.
Twenty-six days after her full recovery, she received the second dose of the Pfizer vaccine. Approximately 4 hours after getting the second dose, she reported paroxysmal onset of chest pain, palpitations, dyspnea, throbbing holocranial headache, fainting, and an impending sense of doom.
Case Report Study #28: Bipolar I Disorder Exacerbation Following COVID-19 Vaccination, Guina et al
A 60-year-old African American female patient with previously stable BD1 presented to the office after three weeks of depressed mood, anxiety, and decreased need for sleep. She was observed to have increased energy, impulsivity, labile affect, verbose speech with repetitive phrases, tangential thinking and flight of ideas, paranoia, and ideas of reference, consistent with a mixed episode with psychotic features. She reported that her symptoms began within a week of receiving the second dose of the Pfizer-BioNTech COVID-19 vaccine. She denied suicidal and homicidal ideations. Her symptoms were distressing and led her to call off work repeatedly, despite satisfaction with her job.
A 40-year-old White male patient with previously stable BD1 and attention deficit hyperactivity disorder (ADHD) was voluntarily hospitalized due to a mixed episode with psychotic features. He reported depressed mood, suicidal ideation, and auditory hallucinations encouraging him to kill himself, but denied homicidal ideation. Upon admission, he was observed to have hyperactivity, impulsivity, irritability, flight of ideas, labile affect, pressured and hyperverbal speech, tangential thought processes, limited attention, and poor short- and long-term memory, with limited recall of three objects after five minutes and major historical events. He reported that his symptoms began after receiving the second dose of the Moderna COVID-19 vaccine and subsequently worsened after he discontinued his medications five days prior to admission. He lost his job after a verbal altercation with his boss, prompting him to seek inpatient treatment.
Case Report Study #29: Depression following ChAdOx1-S/nCoV-19 vaccine, Uvais
A 73-year-old male who had no past or family history of psychiatric illness, was seen in outpatient psychiatry clinic of our hospital with son in law with psychiatric symptoms of 2 week duration. The symptoms started 2 days after he received first dose of COVID-19 vaccine (ChAdOx1-S/nCoV-19 vaccine) from a primary health centre near his home on 26th April 2021. During the first day after receiving vaccination he complained of pain at the site of injection. From the second day onwards, he started complaining of tiredness, exacerbation in pain in both knee joints, low mood, dryness of mouth, lack of interest in activities which he usually enjoyed like reading news papers or watching TV, marked reduction in appetite, and difficulty in initiating sleep. There was no history of fever, neurological deficits, or seizure following vaccination. According to family, he had no ongoing life stressors and he was very active in family as well as in his job. His mental status examination revealed reduced speech productivity, depressed affect, hopelessness and helplessness. There was no delusions or hallucinations.