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Do COVID-19 vaccines cause catatonia?

This article was published on
June 8, 2021

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COVID-19 vaccines do not cause catatonia. Recent studies have noted that a small number of people infected with COVID-19 developed catatonia after their infections. These people were not vaccinated.

COVID-19 vaccines do not cause catatonia. Recent studies have noted that a small number of people infected with COVID-19 developed catatonia after their infections. These people were not vaccinated.

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What our experts say

Catatonia is a group of symptoms that make moving and communicating challenging. People experiencing catatonia usually appear stiff, unable to move and are frequently mute, but that is not always the case.

There are a number of symptoms that can be part of catatonia, including:

  • Stupor (when a person can’t move, speak, or appear to respond)
  • Mutism (little or no verbal responses)
  • Agitation
  • Grimacing (keeping a facial expression in a fixed position)
  • Echolalia (imitating the speech of others)
  • Echopraxia (imitating the movements of others)
  • Catalepsy (the body is in a rigid posture and it looks like the person is in a trance as they often appear numb and have a decreased sensitivity to pain, sometimes they are unconscious while the limbs and body are rigid)
  • Waxy flexibility (the person will keep their body and limbs in the position someone puts them in and not move)
  • Negativism (no response to stimuli)
  • Sterotypy (frequently repeated movements for no obvious reasons)
  • And a variety of others

None of the COVID-19 vaccines approved for emergency use authorization by the World Health Organization list catatonia as a potential or common side effect. This does not mean that no one has experienced catatonia after receiving a vaccine. It means that the number people reporting catatonia after vaccination is very, very low or it has not occurred. The Vaccine Adverse Event Reporting System (VAERS) Results shows a total of 15 people reporting catatonia as an adverse event after receiving a vaccine. These reports are not verified or validated.

Not all COVID-19 vaccine manufacturers have published peer-reviewed results of their vaccine clinical trial data, making it hard to know if catatonic events occurred in some clinical trials.

Catatonia and COVID-19 vaccines have not been linked in published research, but catatonia has been reported in several studies of people who have been infected with COVID-19. This could be due to inflammation that the virus causes.

Catatonia can last from a couple of hours to years. It can reoccur often after the first episode.

Scientists are currently unsure what causes catatonia. It is thought to occur most often in people with mood disorders like depression and bipolar disorder, and psychotic disorders like schizophrenia. Catatonia used to be associated primarily with schizophrenia, but doctors have now realized that the phenomenon is also associated with other things including different forms of mental illness. About 10% of people with a severe form of mental illness will experience catatonia.

It is thought that certain physical conditions can cause catatonia in people without a mental illness. These include Parkinson's, encephalitis (inflammation of the brain), and types of illnesses that impact your body's functions and chemistry, such as:

  • kidney and thyroid issues
  • autoimmune disorders
  • alcohol withdrawal
  • head injuries
  • blood vessel ailments
  • diabetes

It should be noted that catatonia is almost always linked to other, underlying illnesses.

Though catatonia used to be categorized by different symptoms, it is now defined under one title, despite the range of sometimes opposing symptoms such as:

  • staying still
  • moving fast
  • not speaking
  • imitating others' speech
  • repetitive movements
  • freezing in a rigid position

However, two and three sub-types were previously identified:

  • Akinetic catatonia: This is the most common form. It involves a person not responding or responding minimally, staring blankly, and sometimes sitting in an unmoving position
  • Excited catatonia: This often involves a person moving without direction or repeatedly, and they can seem frustrated, agitated, or mimic the actions of those around them
  • Malignant catatonia: The most dangerous form occurs when catatonia symptoms lead to other problems like decreasing or increasing heart rate and blood pressure. People with long-term catatonia may be more likely to have complications like blood clots, kidney and organ failure, dehydration and malnourishment, and heart rate issues.

Catatonia is usually treated with medication including drugs made for people experiencing anxiety. In some cases, the ailment can be treated with electroconvulsive therapy where electrical impulses are sent to a person's brain while they are asleep.

Catatonia is different than full body paralysis, more commonly known as 'tetraplegia' as paralysis from the neck-down, in a few ways. Tetraplegia is most often caused by nervous system damage, particularly damage to the spinal cord. In comparison, catatonia is usually the result of an underlying illness. Strokes, other diseases, drugs, botulism, and other traumas also cause paralysis. Like catatonia, paralysis can be temporary in duration, but the two are treated with different medications, surgeries, and a variety of treatments.

Paralysis is different from catatonia in other ways as well, including the ability of some people with catatonia to frequently and repeatedly move their limbs and body, while those with full body paralysis cannot. Catatonia also sees some of its sufferers have waxy flexibility, where their body can be moved by someone and it continues to stay there, unlike paralysis. Catatonia is often not permanent while many cases of tetraplegia are permanent. Lastly, catatonia frequently involves symptoms not found in paralysis like mimicking the moves and sounds of others, agitation, mutism, not responding to stimuli, and grimacing.

Context and background

Over the last few years, several videos and articles online have cited catatonia or tetraplegia as a reaction to vaccines, none of which have been verified or were found to be accurate. Though vaccines can, very rarely, produce unique side effects, catatonia is not often listed as one and has only been reported 15 times on VAERS since the world's vaccine rollouts have begun. At this point, it does not appear that vaccines are linked to catatonia and no evidence in literature has found a link between the two.

Catatonia has been recently cited in case studies of people infected with COVID-19. None of these people had received vaccinations at the time of their infections, according to research.

Resources

  1. COVID-19 Catatonia—Would We Even Know? (Biological Psychiatry)
  2. A Case of Catatonia in a Man With COVID-19 (Psychosomatics)
  3. Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study (The Lancet Psychiatry)
  4. Catatonic syndrome as the presentation of encephalitis in association with COVID-19 (BMJ)
  5. Catatonia: Our current understanding of its diagnosis, treatment and pathophysiology (World Journal of Psychiatry)
  6. The ICD-10 Classification of Mental and Behavioural Disorders Diagnostic criteria for research (World Health Organization)
  7. COVID-19 and Catatonia: A Case Series and Systematic Review of Existing Literature (Journal of the Academy of Consultation-Liaison Psychiatry)
  8. Catatonia and the immune system: a review (The Lancet Psychiatry)
  9. WHO lists additional COVID-19 vaccine for emergency use and issues interim policy recommendations (World Health Organization)
  10. Status of COVID-19 Vaccines within WHO EUL-PQ evaluation process (World Health Organization)
  11. Special Medical Conditions Associated with Catatonia in the Internal Medicine Setting: Hyponatremia-Inducing Psychosis and Subsequent Catatonia (The Permanente Journal)
  12. Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK (The Lancet)
  13. COVID-19 vaccines (World Health Organization)
  14. The Vaccine Adverse Event Reporting System (VAERS) Request (United States Centers for Disease Control and Prevention)
  15. What You Need to Know About Catatonia (Healthline)
  16. Excited Catatonia — A Delayed Neuropsychiatric Complication of COVID-19 Infection (Cureus)
  17. Paralysis (NHS)
  18. Catatonia (Penn State University Catatonia Information Center)
  19. What is Tetraplegia, Quadriplegia and Paraplegia? (SpinalCord.com)

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