One week after receiving a first dose of Pfizer/BioNTech’s COVID-19 vaccine, a previously healthy young woman in her 20s presented to the emergency department at Sharp Memorial Hospital in San Diego, complaining she was urinating frequently. Her family was more concerned that she was increasingly anxious, not sleeping well, not mentally acute, and was fixated on the belief that she was suffering from kidney disease and irritable bowels. She had no history of mental illness but was convinced that she had contracted COVID-19 and that her body was “shutting down.” Her family also noticed that she had trouble communicating and seemed to have difficulty with motor control at times. Blood and urine tests taken on this visit were normal, although her heartbeat was fast and her blood pressure was elevated, according to the case report published earlier this month in Frontiers in Neurology. She was sent home.

The following day, the young woman returned to the hospital, this time complaining that she was hearing accusatory voices. A COVID PCR test was negative, but further testing revealed two elevated liver enzymes. Her blood pressure was still up, and her heart was racing, so she was hospitalized. The following morning, she took off all her clothes in her hospital room and defecated on the floor.

Doctors began treating the young woman with psychiatric drugs, but she only became “increasingly psychotic,” according to the case report. A prescription of lithium was tried, and then abandoned, when she became catatonic. She was put on another drug, Risperidone, and then suffered a grand mal seizure.

Her memory was intact, and the young woman responded to doctors’ questions, but only in short sentences, in a monotone flat voice. She was lethargic with lingering symptoms of catatonia. She could walk, but slowly, and had to be prompted to move.

A lumbar puncture (spinal tap) and analysis of the young woman’s cerebrospinal fluid (CSF) revealed elevated white blood cells which was evidence of inflammation within her nervous system. Spinal fluid and blood tests for a list of viruses from herpes simplex and Epstein-Barr virus to HIV were negative.

“The constellation of symptoms (spontaneous defecation, catatonia, sudden encephalopathy without metabolic or infectious findings) coupled with the preliminary CSF results and the history of deterioration after SARS-CoV-2 vaccination led to a strong clinical suspicion of an autoimmune-mediated encephalitis driven by the vaccine,” states the paper written by doctors at the Salk Institute of Biological Studies, Sharp Memorial Hospital, in San Diego, and the Center for Immunity, Infection and Inflammation at the University of California-San Diego School of Medicine in La Jolla, CA.

Vaccine encephalitis

Eventually, CSF tests confirmed the diagnosis of Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis – an autoimmune condition characterized by neuropsychiatric syndromes and the presence of antibodies against glutamate (GluN1) receptors detectable in the spinal fluid.

Anti-NMDAR encephalitis has been associated with viral illnesses such as Japanese encephalitis, Epstein-Barr virus, and COVID infection. It has also been associated with vaccinations against H1N1, yellow fever, TdaP-IPV booster, and Japanese Encephalitis. New onset psychosis has been associated with other vaccines as well, including for rabies and smallpox.

The 2018 documentary Malcolm is a Little Unwell depicts the ordeal of British veteran foreign affairs correspondent Malcolm Brabant’s descent into psychosis after he got a yellow fever vaccine to travel.

After ruling out all other potential causes, the young woman was treated with immunoglobulins and rituximab – a drug used for autoimmune conditions – and steroid therapy. She gradually improved and, 61 days after her first dose of the COVID shot and 45 days in the hospital, she was discharged with “minor neurological deficits.” She remained on anticonvulsant drugs for seizures three months later but was able to return to work.

Other case reports

Though the researchers describe this as the “first instance of anti-NMDAR encephalitis after receiving the Pfizer-BioNTech COVID-19 vaccine,” other case reports of sudden onset psychosis following COVID vaccination are already in the medical literature.

One case report published in Psychiatry Research in October describes a previously healthy 31-year-old, single Hispanic office manager who police brought to the emergency room because of his “erratic and bizarre behavior.” He was anxious, guarded, and claimed to be “clairvoyant,” and 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, but it turned out, with whom he had no romantic relationship.

The symptoms began a month earlier after he had received a first dose of mRNA based COVID-19 vaccine, according to the case report from doctors at Stony Brook University and Northport Veteran Administration Medical Center in New York. They had gradually worsened until he was admitted to the hospital’s neurology unit. The following day he was wandering the unit talking to himself, stating that the EEG machine was communicating with him. He was launched onto anti-psychotic medications and his hallucinations and delusions resolved after two days. He was discharged on the medication five days later, and a week later was asymptomatic and back to work.

Another case series describes a 42-year-old man with paranoid delusions that began the day of his Pfizer mRNA vaccine and a previously healthy 57-year-old man who was admitted to a psychiatric emergency unit after attempting suicide three days after receiving Pfizer’s shot. His psychiatric symptoms began on the evening he received the vaccine, when he became irritable, sleepless, and began talking to himself and developed “nihilistic delusions.”

Autoimmune encephalitis, suicides, psychotic episodes after Pfizer shots

The phenomenon has been reported in children as well. One report to the U.S. Government’s Vaccine Adverse Event Reporting System (VAERS) describes a 13-year-old from Virginia who developed “extremely elevated anxiety, nonstop worries and fears, irrational thoughts, OCD thoughts and behaviors” that began the day of a Pfizer injection in June. The boy, who experienced tingling in his limbs and sharp electric-like jolts of pain in his brain, would lie under a blanket for hours afraid of the world, had severe sleep disruption, tics, angry outbursts, and would often stare blankly. He was diagnosed with “autoimmune encephalitis” and has lost the ability to care for himself and now requires a full-time carer.

Other VAERS reports describe young lives ruined. One woman reported that her 28-year-old son, forced to get vaccinated by his employer, was hospitalized two days after receiving his first Pfizer dose after he went into “such a severe state of psychosis that he tried to jump out of my vehicle going 40 miles an hour.” She reported that we have been going through “pure hell” since his reception of the vaccine.

Some reports describe psychosis that ends in suicide.

A 48-year-old Tennessee woman who had a Pfizer shot reported that she had a psychotic episode the same day. “I literally thought I was going to drive myself and my nephew to Heaven… I left the house without a phone and drove all the way to where my vehicle ran out of gas. I was apprehended by the highway patrol and taken to the local hospital.” The woman said that she refused to eat, drink, or sleep because of paranoid thoughts that people were trying to poison her and was hospitalized for two days. She was medicated to sleep and awoke recovered.

“Why didn’t you all have psychosis as a possible side effect?” she asked.

121,559 psychiatric disorders

VigiBase, the World Health Organization’s global database of adverse drug events lists 121,559 reports of psychiatric disorders following administration of any COVID vaccine. These include:

• 29,661 individuals reporting insomnia
• 18,377 reports of anxiety
• 13,904 reports of a “confusional state”
• 11,447 reports of sleep disorders
• 6,234 reports of “nervousness”
• 5,202 people reporting “disorientation”
• 4,463 reports of “acute stress disorder”
• 3,682 people who experienced “restlessness”
• 3,430 people reporting hallucinations
• 3,405 reports of depression
• 3,301 reports of “depressed mood”
• 2,814 “panic attacks”
• 2,444 people who experienced “poor quality sleep”
• 1,883 experiences of “delirium”
• 1,864 people reporting “agitation”
• 1,752 reports of nightmares
• 1,507 people who reported having “abnormal dreams”
• 606 eating disorders
• 365 cases of “psychotic disorder” or “acute psychosis” or “psychotic behavior”
• 226 instances of tic disorder

Some of the less common reports on VigiBase include 213 reports of Near Death Experience after vaccination, 57 completed suicides, and 25 cases of “exploding head syndrome” – a condition in which people hear a very loud noise like an explosion, gunshot or cymbals clanging as though it is right next to them, usually just as they are falling asleep or waking, but it is not real.

British Yellow Card adverse event reporting data alone includes 26,916 psychiatric disorders following COVID vaccination.

Mechanisms

“The virus that causes COVID –SARS-CoV- 2 is known to trigger a powerful immune response, which includes the release of large amounts of proinflammatory cytokines,” note the New York researchers in their case report described above. “It has been hypothesized that a COVID-19 triggered cytokine storm may increase the risk of psychosis.” They cited 42 reported cases of psychosis following COVID infection. Coincidentally, schizophrenia has been linked to inflammation in recent research. Vaccination, which is designed to provoke an inflammatory response, can go awry as well.

A 2018 study of 41 college-aged people looked at some inflammatory markers before and after receiving the influenza vaccine and found that those with higher levels of serum interleukin-6 (IL-6) after vaccination also showed more severe depressive symptoms.

In a 2017 pilot study, researchers from Yale University School of Medicine and Pennsylvania State University College of Medicine looked at vaccine records and found that children diagnosed with neuropsychiatric conditions anorexia nervosa, obsessive compulsive disorder (OCD) and tic disorder, were more likely to have been recently vaccinated than control children.

**By Celeste McGovern

**Source