Headache Attributed to Vaccination Against COVID-19 (Coronavirus SARS-CoV-2) with the ChAdOx1 nCoV-19 (AZD1222) Vaccine: A Multicenter Observational Cohort Study

Göbel, Carl; Heinze, Axel; Karstedt, Sarah; Morscheck, Mascha; Tashiro, Lilian; Cirkel, Anna; Hamid, Q.; Halwani, Rabih; Temsah, Mohamad-Hani; Ziemann, Malte; Görg, Siegfried; Münte, Thomas F.; Göbel, Hartmut

doi:10.1007/s40122-021-00296-3

Cited by 36 publications

(72 citation statements)

References 37 publications

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“…Finally, with regard to the features of headache occurring after SARS-CoV-2 vaccines, some inputs were available in four different studies [15,53,120,121], and the main characteristics were described in Table 5. In synthesis, such headaches generally onset within the first day from injection and its duration is below 24 h. It is bilateral in 70-75% of the cases, and pulsating quality is reported by 30-40% of patients.…”

Section: Discussionmentioning

confidence: 99%

“…With regard to treatment for post-vaccination headache, available literature provides little information. The aforementioned studies [15,53,120,121] show that the majority of patients had used analgesics to treat it, but distinction between patients with and without preexisting headache is not reported. Partial or complete response was reported by 97% of patients who took analgesics in the study of Ekizoglu [120], whereas in the two studies of Göbel and colleagues [53,121] it was shown that the two most commonly used drugs were paracetamol and ibuprofen (respectively used by 45.5% and 36% of subjects), whereas the one perceived being the most effective, by 46.2% of users, was acetylsalicylic acid.…”

Section: Discussionmentioning

confidence: 99%

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Headache onset after vaccination against SARS-CoV-2: a systematic literature review and meta-analysis

et al. 2022

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Background Vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are used to reduce the risk of developing Coronavirus Disease 2019 (COVID-19). Despite the significant benefits in terms of reduced risk of hospitalization and death, different adverse events may present after vaccination: among them, headache is one of the most common, but nowadays there is no summary presentation of its incidence and no description of its main features. Methods We searched PubMed and EMBASE covering the period between January 1st 2020 and August 6th, 2021, looking for record in English and with an abstract and using three main search terms (with specific variations): COVID-19/SARS-CoV-2; Vaccination; headache/adverse events. We selected manuscript including information on subjects developing headache after injection, and such information had to be derived from a structured form (i.e. no free reporting). Pooled estimates and 95% confidence intervals were calculated. Analyses were carried out by vaccine vs. placebo, by first vs. second dose, and by mRNA-based vs. “traditional” vaccines; finally, we addressed the impact of age and gender on post-vaccine headache onset. Results Out of 9338 records, 84 papers were included in the review, accounting for 1.57 million participants, 94% of whom received BNT162b2 or ChAdOx1. Headache was generally the third most common AE: it was detected in 22% (95% CI 18–27%) of subjects after the first dose of vaccine and in 29% (95% CI 23–35%) after the second, with an extreme heterogeneity. Those receiving placebo reported headache in 10–12% of cases. No differences were detected across different vaccines or by mRNA-based vs. “traditional” ones. None of the studies reported information on headache features. A lower prevalence of headache after the first injection of BNT162b2 among older participants was shown. Conclusions Our results show that vaccines are associated to a two-fold risk of developing headache within 7 days from injection, and the lack of difference between vaccine types enable to hypothesize that headache is secondary to systemic immunological reaction than to a vaccine-type specific reaction. Some descriptions report onset within the first 24 h and that in around one-third of the cases, headache has migraine-like features with pulsating quality, phono and photophobia; in 40–60% of the cases aggravation with activity is observed. The majority of patients used some medication to treat headache, the one perceived as the most effective being acetylsalicylic acid.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Headache onset after vaccination against SARS-CoV-2: a systematic literature review and meta-analysis

et al. 2022

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“…After the second dose IFN-γ, CXCL-10, IL-15 and IL-6 were elevated to levels several times higher than after the first dose. This pattern is mirrored by headache, which usually occurs within the first 24 hours, remits after a couple of days after the first vaccination [89][90][91][92], and is more prevalent after the second dose [4]. As a side issue, it should be mentioned that CCL-2 and IL-3 were not significantly increased throughout the study, TNF concentrations were only slightly higher, and type I and III IFNs were not analysed at all in this study [96].…”

Section: Post-vaccination Headachementioning

confidence: 62%

“…Patterns similar to COVID-19 can be observed in cases of vaccine-related headache. Headache occurs early after vaccination [89][90][91][92] and is often accompanied by other systemic symptoms (i.e. myalgia and fever [91]).…”

Section: Post-vaccination Headachementioning

confidence: 99%

COVID-19-related headache and innate immune response — a narrative review

Straburzyński

Kuca-Warnawin

Waliszewska‐Prosół

2023

Neurol Neurochir Pol.

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Headache is one of the most prevalent, although often underreported, symptoms of coronavirus disease 2019 . It is generally accepted that this symptom is a form of secondary headache due to systemic viral infection. There are several hypotheses that try to explain its aetiopathogenesis. One of the most compelling is related to innate immune response to viral infection. This rationale is supported by similarities to other viral infections and the temporal overlap between immunological reactions and headache. Moreover, several key factors in innate immunity have been shown to facilitate headache e.g. interferons, interleukin (IL) -1-β, IL-6, and tumour necrosis factor. There is also a possibility that the virus causes headache by the direct activation of afferents through pattern recognition receptors (i.e. Toll-like receptor 7). Moreover, some data on post-COVID-19 headache and after vaccination against SARS-CoV-2 infection suggests a similar cytokine-mediated pathomechanism in these clinical situations. Future research should look for evidence of causality between particular immune response factors and headache. Identifying key molecules responsible for headache during acute viral infection would be an important step towards managing one of the most prevalent secondary headache disorders.

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“…Notably, headache is the commonly reported from COVID-19 vaccine recipients [ 13 , 14 ]. Previous study reported headache started at 14.5 ± 21.6 h after received ChAdOx1 nCoV-19 vaccination and persisted for 16.3 ± 30.4 h and commonly located at forehead with dull aching in character [ 15 ]. Similarly, with BNT162b2 mRNA COVID-19 vaccine, headache begun 18 ± 27 h after vaccination, lasted for 14.2 ± 21.3 h,and most common located at forehead with pressing pain in character [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Inactivated COVID-19 vaccine induced acute stroke-like focal neurologic symptoms: a case series

et al. 2022

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Background A subgroup of individuals experienced stroke-like symptoms after receiving an inactivated COVID-19 vaccine. We present clinical characteristics, neuroimaging, and outcome of these patients. Methods Medical personals who had neurological symptoms after receiving inactivated COVID-19 vaccine were enrolled. Clinical, laboratory investigation and neuroimaging were collected. Subjects were prospectively followed-up on clinical and neuroimaging to detect brain parenchymal or cerebrovascular abnormality. Results Nineteen out of 385 subjects (4.9%) developed neurological symptoms after vaccination. There was a female predominance (89.5%) with mean age of 34 ± 7.5 years. Majority of patients (52.6%) had symptoms within 60 min after vaccination. The most common neurological symptoms were numbness (94.7%) followed by headache (52.6%) and weakness (47.4%). The most common neurological signs were sensory deficit (79%) followed by motor weakness (52.6%) and tongue deviation (26.3%). Recurrent headache was observed in most patients (89.5%) during followed up. Serial brain imaging was done in all patients with median follow-up interval of 18 days. There was no evidence of acute brain infarction in any of the patients, 84.2% had no vascular abnormality, 15.8% had transient focal narrowing of cerebral vessels. Outcome was favorable, modified ranking scale 0–1 for all patients at 4 weeks after vaccination. Conclusions Transient focal neurological symptoms and deficits can be found after COVID-19 vaccination. However, benefit to stop COVID-19 pandemic by vaccination is outweighed by these seemingly reversible side effects. The pathophysiology underlined these phenomena should be further investigated.

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Headache Attributed to Vaccination Against COVID-19 (Coronavirus SARS-CoV-2) with the ChAdOx1 nCoV-19 (AZD1222) Vaccine: A Multicenter Observational Cohort Study

Cited by 36 publications

References 37 publications

Headache onset after vaccination against SARS-CoV-2: a systematic literature review and meta-analysis

Headache onset after vaccination against SARS-CoV-2: a systematic literature review and meta-analysis

COVID-19-related headache and innate immune response — a narrative review

Inactivated COVID-19 vaccine induced acute stroke-like focal neurologic symptoms: a case series

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