Six-Month Follow-up after New onset psychosis potentially induced by COVID-19 vaccine: Case Report

Objectives. Vaccines are crucial to ending the COVID-19 pandemic. An mRNA-based COVID-19
vaccine can cause mild to moderate side effects. A number of cases of cardiac, gastrointestinal, and psychiatric
side effects have been reported as rare side effects associated with the COVID-19 vaccine.
We present a patient’s case, who after the second injection of the mRNA-based COVID-19 vaccine,
immediately developed anxiety, nonspecific fear, and insomnia as the prodromal phase of psychosis. Starting
from the second week, the patient manifested delusions of persecution, delusions of influence, thoughts
insertion, and delusional behaviour, culminating in the suicide attempt. The duration of psychosis was
eight weeks, and symptom reduction was observed only after the gradual administration of antipsychotics
over four weeks. Patient is continuing to use an antipsychotic (olanzapine 10 mg per night) in maintenance
phase of treatment.
The investigations of the patient did not support any structural changes of the brain, any severe medical
conditions, a neurological abnormality, a confusion or a state of unconsciousness or alterations in laboratory
tests. Psychosis due to the use of alcohol or psychoactive substances was excluded. The psychological
assessment of the patient demonstrated the endogenous type of thinking, and the patient had schizoid and
paranoid personality traits strongly associated with schizophrenia.
This case indicates a strong causal relationship between the mRNA-based COVID-19 vaccine injection
and the onset of psychosis. Six months follow up did not reveal any psychotic symptoms. The COVID-19
vaccine could possible play a trigger role in the development of primary psychosis. Longer-term supporting
evidence is needed to estimate the prevalence of psychosis following vaccination with the COVID-19
vacci ne.