Dec. 2023 (Darren Cheng Han Teo et al) – The first reported case of new-onset mania and psychosis post heterologous bivalent mRNA COVID-19 booster vaccination (4th dose).

• there are case reports describing associated neuropsychiatric manifestations following COVID-19 vaccination, but none reported post heterologous bivalent boosting yet
• 47 year old man with no history of psychiatric illness presented with 4 day history of manic and psychotic symptoms after 1st Moderna bivalent COVID-19 vaccine a week prior to admission.
• Before this, he received 3 doses of Pfizer COVID-19 Vaccine without significant side effects.
• 3 days after Moderna mRNA bivalent, he reported developing an elevated mood, increased irritability, psychomotor agitation, increased energy, decreased need for sleep, increased distractibility, grandiosity and paranoid delusions relating to work and family.
• his ability to function at work was affected.
• he had no family history of psychiatric disorders.
• no history of substance or significant alcohol use, and he had been functioning well in his profession in the science, technology, engineering, and mathematics (STEM) discipline.
• A contrast-enhanced MRI brain was unremarkable
• His presentation was suggestive of an Other Specified Bipolar And Related Disorder With Manic And Mood-congruent Psychotic Features (DSM-V). Differential diagnosis (DSM-V) included Bipolar I Disorder and a Brief Psychotic Disorder
• He was started on oral Olanzapine, titrated up to 7.5 mg once daily in view of his manic and psychotic symptoms. He was discharged after 8 days of inpatient treatment, where he demonstrated full resolution of his manic and psychotic symptoms. Subsequently, he opted to stop the oral Olanzapine approximately 12 days after his discharge. He remained well one-month post discharge with a full reported recovery of his functioning when he was reviewed in the outpatient setting with no recurrence of the manic and psychotic symptoms.

Psychosis and Mania with COVID-19 Vaccines

Let’s look at some other published cases.

3rd mRNA dose

2022 Sep (Kita et al): 37 yo Japanese man had psychosis & suicide attempt after Moderna mRNA booster jab

• 37 year old Japanese man with no psychiatric history had Moderna booster
• He presented 4 days after Moderna jab with talkativeness and grandiose delusions, saying that he had won 2 billion yen in horse racing. Had emotional instability (crying), sleeplessness, excitement, hyperactivity and sexual deviance.
• He was discharged. Nine days after Moderna booster he jumped from the 2nd floor of his house, and was brought back to hospital by ambulance.
• He exhibited flight of ideas, hyperactivity, distraction, hyperthymia and religious delusions, such as saying “my child is God”. He displayed lack of insight and became enraged when his actions were restricted.
• Diagnosis: acute mania with psychotic features, stayed 66 days in the hospital.

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2nd mRNA dose

2023 June (Fekih-Romdhane et al) – 26 yo woman has acute psychosis & lupus after 2nd Pfizer mRNA

• 26 yo woman had 2nd Pfizer dose
• 4 days later presented to ER with acute psychomotor agitation, incoherent speech and total insomnia evolving for 5 days
• she was diagnosed with a brief psychotic disorder
• was also found to have an acute SLE (lupus) cerebritis

2023 May (Yen-Li Lien et al.): 15 yo boy had psychosis after 2nd Pfizer mRNA (Taiwan)

• 15 yo Taiwanese boy presented to ER with agitation, involuntary limb stretching and screaming 2 days after 2nd dose of Pfizer
• After admission, he had bizarre behaviors, including sitting up and lying down frequently and taking up the mannerism of praying in bed.
• had auditory hallucinations and delusions, persisted > 1 month after discharge
• He was healthy without any specific medical history before the vaccination

2022 Nov (Alphonso et al) – 45 yo Asian-American married woman, had psychosis after 2nd Moderna mRNA

• 45 yo woman with no psychiatric history, presented to psychiatry after having psychosis for 3 months.
• Her new-onset paranoia and auditory hallucinations began 1 month after receiving her second Moderna COVID-19 vaccine. She abruptly quit her job of 18 years and stopped eating—losing 56 lb in 4 months.
• The patient would only get dressed in the dark, believing people could see her in her closet or bathroom behind a closed door. She would pace all day and stopped doing the household chores she had done for years.
• She would wake her husband in the middle of the night trying to convince him that the neighbors were going to hurt her and were breaking into their home.
• Due to this irrational fear, she would sleep only 2 to 3 hours per night and no longer slept in the bedroom, preferring to lock herself in the bathroom to sleep.
• She heard whispers of people talking about her and would carry on full conversations with them. She would only do this in a room alone with the door closed.

2022 Sep (Guina et al) – 40 yo caucasian man had Bipolar I Disorder Exacerbation Following 2nd Moderna mRNA

• 40 year old white man had 2nd Moderna dose and his symptoms began immediately after
• He reported depressed mood, suicidal ideation, and auditory hallucinations encouraging him to kill himself
• he lost his job after a verbal altercation with his boss, prompting him to seek hospitalization
• on admission he was hyperactive, impulsive, irritable, flight of ideas, pressured and hyperverbal speech, poor memory
• His only previous hospitalization was five years prior to vaccination for mania and impulsivity

2022 Sep (Guina et al) – 60 yo African American woman post 2nd Pfizer mRNA dose had Bipolar Disorder exacerbation (psychosis)

• A 60-year-old African American female patient with previously stable BD1 presented 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.

2022 May (Deng et al) – 45 yo man had psychosis & suicide attempt after 2 Pfizer doses

• 45 year old man had 2 Pfizer mRNA doses in May 2021.
• In June 2021 he presented to ER with depression, paranoia, intermittent agitationand had preliminary diagnoses of bipolar disorder and delirium
• reported to the psychiatrist that he was hearing voices and felt depressed, also had episodes of uncontrollable crying
• he was discharged after 2 weeks
• 2 months after his 2 Pfizer doses he attempted to commit suicide by drowning himself in a toilet. He was feeling depressed and suicidal
• also experienced auditory hallucinations, paranoia and persecutory delusions.
• His speech was noticed to be repetitive, meaningless, and unintelligible. He was frequently hitting his head with his fists. Soft mitts were placed on his hands.
• during admission to adult psychiatric unit, he was kicking both of his legs up in the air and banging his head and upper body onto the stretcher in a rhythmic fashion. His speech was largely unintelligible except stating, “God bless you” repeatedly, as well as repeating phrases that were said by staff. Upon being released from the restraints, Mr. A continued to be restless, screaming, hitting himself on the face, slamming his upper body, and kicking. He required a physical hold to apply 4-point restraints to prevent self-harm.

2022 May (Borovina et al) – 41 yo man develops psychosis after 2nd Pfizer mRNA

• 41 yo male had 2nd dose of Pfizer mRNA
• 5 days later, had headaches, paranoid delusions and severe anxiety
• in ER he had a depressed, irritable mood and olfactory hallucinations
• he was discharged with ongoing psychotic symptoms and had to be re-admitted with changes to his anti-psychotic medications

2022 Feb (Aljeshi et al) – 20 year old woman in Saudi Arabia had psychosis after 2nd COVID-19 mRNA vaccine

• 20 year old College student had 2nd mRNA vaccine (Saudi Arabia gives Pfizer & Moderna mRNA vaccines).
• she presented to ER with 4 weeks of anxiety, sleep disturbance, restlessness, reduced appetite that started 4 days after her 2nd mRNA jab.
• in ER, she complained of “hearing terrifying voices and seeing random people stare at her”
• in hospital she became agitated, aggressive, disoriented and complained of auditory and visual hallucinations. She had disjointed speech and grossly disorganized and disruptive behavior and was disoriented
• she was diagnosed with acute psychosis and stayed in hospital 28 days

2022 (Renemane et al) – 45 yo Latvian man had psychosis & suicide attempt after 2nd mRNA

• 45 yo Latvian man had 2nd dose of mRNA vaccine
• immediately developed insomnia, anxiety, tremors
• 2 weeks after jab “discovered white powder under the carpet in his apartment”
• 1 month after jab he was “receiving commands” including to commit suicide
• he attached a rope, tried to hang himself but his father stopped him.

2021 Oct (Reinfeld et al.) – 31 yo man had psychosis after 2nd Moderna mRNA

• A 31-year-old, single Hispanic man had two doses Moderna
• symptoms began 1 month ago, after receiving 1st dose of mRNA vaccine, and markedly worsened 3 weeks after receiving 2nd dose.
• brought to ER by police
• was 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 he believed was his lover

2021 Oct (Yesilkaya et al) – 57 yo Turkish man had suicide attempt after 2nd Pfizer dose

• 57 year old man presented to ER with irritability, sleeplessness, talking to himself and suicidal attempt with thoughts of extinction 3 days after receiving 2nd dose of Pfizer.
• had increased speech output, speed and psychomotor activity
• had no history of psychiatric illness

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1st mRNA dose

2023 Feb (Neves et al) – 38 yo Brazilian woman had refractory psychosis after 1st Pfizer mRNA

• had 1st Pfizer dose, presented to ER within 24hr
• She became delusional, aggressive, disheveled with poor hygiene, unfriendly face, lacking self-orientation and uncooperative with doctors & staff.
• She believed staff were persecuting her, that several city mayors were her parents. Her mood was dysphoric and enraged.
• She was put on psychiatric medications but didn’t improve.
• After 6 months of hospitalization, she remained hostile, persecutory and refusing to talk to staff and her psychosis was defined as refractory. She never recovered.

2021 Nov (Flannery et al) – 20 yo woman had psychosis after 1st Pfizer mRNA

• 20 yo presented to ER 1 week after 1st Pfizer dose
• had auditory hallucinations
• one morning she removed her clothes and had a bowel movement on the floor, then became increasingly psychotic

2021 Oct (Yesilkaya et al) – 42 yo Turkish man had psychosis after 1st Pfizer mRNA dose

• 42 yo man with no psychiatric history was admitted to psychiatric ER 5 days after 1st dose of Pfizer with complaints of irritability and sleeplessness.
• The patient had delusions that his family was being followed by the deep state and that they were in danger.
• Physical exam: anxious, dysphoric mood, persecutory and reference delusions
• Diagnosed with acute mania / psychotic episode

2021 Sep (Al-Mashdali et al) – 32 yo man had psychosis after 1st Moderna mRNA

• 32 yo man had 1st dose of COVID-19 Moderna mRNA
• within 24hr he developed acute confusion, memory disturbances and auditory hallucinations

My Take…

There are now case reports of psychosis and mania after 4th, 3rd, 2nd and 1st doses of Pfizer or Moderna COVID-19 Vaccines. Some of these cases result in suicide attempts.

This most recent case shows that the newer COVID-19 mRNA boosters, bivalent flavor, can also cause psychosis and mania, as did the original boosters and the original mRNA jabs.

I note several observations:

1. The published cases only involve psychosis or mania that occurred within days or at most 2-3 weeks after the last mRNA dose. My guess is that the longer the time period after mRNA vaccination, the less likely a doctor is to link the psychosis to the jabs.
2. Most cases are being published outside of the US, as foreign doctors are less likely to be threatened by their medical boards, and are less likely to be stripped of their licenses for reporting these cases and getting them published.
3. Not all cases resolve with psychiatric drugs. Some result in permanent disability.
4. Teenagers can develop psychosis after mRNA jabs as well – mandating kids, whether to be able to play sports or go to University/College was medical malpractice – the risks clearly outweighed any possible benefit.
5. NO ONE is studying the long term effect of mRNA jabs on mental health.
6. Pfizer & Moderna COVID-19 mRNA Vaccines cause an increased risk of suicidal ideation, leading to suicide attempts. This is not controversial or a conspiracy theory. That risk alone should get these mRNA jabs pulled off the market.

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Dr. William Makis is a Canadian physician with expertise in Radiology, Oncology and Immunology. Governor General’s Medal, University of Toronto Scholar. Author of 100+ peer-reviewed medical publications.