“Acute psychosis induced by mRNA-based COVID-19 vaccine in adolescents: A pediatric case report”: Comment

Dear Editor,

We would like to share our ideas on your publication “Acute psychosis induced by mRNA-based COVID-19 vaccine in adolescents: A pediatric case report.¹” Lien et al. reported a male adolescent patient to have acute psychosis 2 days after receiving the second dose of BNT162B2 vaccination.¹ Lien et al. reported that when conventional antipsychotic medications are proven to be unsuccessful, psychosis related to COVID-19 mRNA vaccination can be treated with steroids.¹ However, they noted the need for long-term monitoring of the patient's cognitive abilities and behavior.¹ It is fascinating to consider whether COVID-19 immunization is related to the noted clinical issue. Published papers may use case-specific data; however, the effect of confounding variables cannot be established. It may be difficult to identify the specific clinical relationship, which is a crucial element to consider, owing to the lack of clinical data on the physiological and immunological status of vaccine recipients before injection. Even if the data exists, comorbidities are rarely mentioned in the clinical records. Given the limited information available on the health and immunological status of vaccine recipients before COVID-19 vaccination, determining the precise pathopharmacological connection can occasionally be difficult. It is quite challenging to understand how concurrent medical problems affect clinical outcomes.² Genetics is not the least of the consequences.³ However, the paucity of current evidence to support any findings makes it difficult.

Declaration of competing interest

None.