tetano
Editor, Senior Moderator
J Headache Pain
. 2022 Mar 31;23(1):41.
doi: 10.1186/s10194-022-01400-4.
Headache onset after vaccination against SARS-CoV-2: a systematic literature review and meta-analysis
Matteo Castaldo[SUP] #[/SUP][SUP] 1 [/SUP], Marta Waliszewska-Prosół[SUP] #[/SUP][SUP] 2 [/SUP], Maria Koutsokera[SUP] 3 [/SUP], Micaela Robotti[SUP] 4 [/SUP], Marcin Straburzyński[SUP] 5 6 [/SUP], Loukia Apostolakopoulou[SUP] 7 [/SUP], Mariarita Capizzi[SUP] 8 [/SUP], Oneda Çibuku[SUP] 9 [/SUP], Fidel Dominique Festin Ambat[SUP] 10 [/SUP], Ilaria Frattale[SUP] 11 [/SUP], Zukhra Gadzhieva[SUP] 12 13 [/SUP], Erica Gallo[SUP] 14 [/SUP], Anna Gryglas-Dworak[SUP] 15 [/SUP], Gleni Halili[SUP] 16 [/SUP], Asel Jusupova[SUP] 17 [/SUP], Yana Koperskaya[SUP] 18 [/SUP], Alo-Rainer Leheste[SUP] 19 [/SUP], Maria Laura Manzo[SUP] 8 [/SUP], Andrea Marcinnò[SUP] 14 [/SUP], Antonio Marino[SUP] 8 [/SUP], Petr Mikulenka[SUP] 20 [/SUP], Bee Eng Ong[SUP] 21 22 [/SUP], Burcu Polat[SUP] 23 [/SUP], Zvonimir Popovic[SUP] 24 25 [/SUP], Eduardo Rivera-Mancilla[SUP] 26 [/SUP], Adina Maria Roceanu[SUP] 27 [/SUP], Eleonora Rollo[SUP] 28 [/SUP], Marina Romozzi[SUP] 28 29 [/SUP], Claudia Ruscitto[SUP] 11 [/SUP], Fabrizio Scotto di Clemente[SUP] 30 [/SUP], Sebastian Strauss[SUP] 31 [/SUP], Valentina Taranta[SUP] 32 [/SUP], Maria Terhart[SUP] 33 [/SUP], Iryna Tychenko[SUP] 34 [/SUP], Simone Vigneri[SUP] 35 [/SUP], Blazej Misiak[SUP] 36 [/SUP], Paolo Martelletti[SUP] #[/SUP][SUP] 37 38 [/SUP], Alberto Raggi[SUP] #[/SUP][SUP] 39 [/SUP], European Headache Federation School of Advanced Studies (EHF-SAS)
Affiliations
Abstract
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 1[SUP]st[/SUP] 2020 and August 6[SUP]th[/SUP], 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.
Keywords: Adverse Event; BNT162b2; COVID-19; ChAdOx1; Headache; SARS-CoV-2; Vaccination.
. 2022 Mar 31;23(1):41.
doi: 10.1186/s10194-022-01400-4.
Headache onset after vaccination against SARS-CoV-2: a systematic literature review and meta-analysis
Matteo Castaldo[SUP] #[/SUP][SUP] 1 [/SUP], Marta Waliszewska-Prosół[SUP] #[/SUP][SUP] 2 [/SUP], Maria Koutsokera[SUP] 3 [/SUP], Micaela Robotti[SUP] 4 [/SUP], Marcin Straburzyński[SUP] 5 6 [/SUP], Loukia Apostolakopoulou[SUP] 7 [/SUP], Mariarita Capizzi[SUP] 8 [/SUP], Oneda Çibuku[SUP] 9 [/SUP], Fidel Dominique Festin Ambat[SUP] 10 [/SUP], Ilaria Frattale[SUP] 11 [/SUP], Zukhra Gadzhieva[SUP] 12 13 [/SUP], Erica Gallo[SUP] 14 [/SUP], Anna Gryglas-Dworak[SUP] 15 [/SUP], Gleni Halili[SUP] 16 [/SUP], Asel Jusupova[SUP] 17 [/SUP], Yana Koperskaya[SUP] 18 [/SUP], Alo-Rainer Leheste[SUP] 19 [/SUP], Maria Laura Manzo[SUP] 8 [/SUP], Andrea Marcinnò[SUP] 14 [/SUP], Antonio Marino[SUP] 8 [/SUP], Petr Mikulenka[SUP] 20 [/SUP], Bee Eng Ong[SUP] 21 22 [/SUP], Burcu Polat[SUP] 23 [/SUP], Zvonimir Popovic[SUP] 24 25 [/SUP], Eduardo Rivera-Mancilla[SUP] 26 [/SUP], Adina Maria Roceanu[SUP] 27 [/SUP], Eleonora Rollo[SUP] 28 [/SUP], Marina Romozzi[SUP] 28 29 [/SUP], Claudia Ruscitto[SUP] 11 [/SUP], Fabrizio Scotto di Clemente[SUP] 30 [/SUP], Sebastian Strauss[SUP] 31 [/SUP], Valentina Taranta[SUP] 32 [/SUP], Maria Terhart[SUP] 33 [/SUP], Iryna Tychenko[SUP] 34 [/SUP], Simone Vigneri[SUP] 35 [/SUP], Blazej Misiak[SUP] 36 [/SUP], Paolo Martelletti[SUP] #[/SUP][SUP] 37 38 [/SUP], Alberto Raggi[SUP] #[/SUP][SUP] 39 [/SUP], European Headache Federation School of Advanced Studies (EHF-SAS)
Affiliations
- PMID: 35361131
- DOI: 10.1186/s10194-022-01400-4
Abstract
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 1[SUP]st[/SUP] 2020 and August 6[SUP]th[/SUP], 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.
Keywords: Adverse Event; BNT162b2; COVID-19; ChAdOx1; Headache; SARS-CoV-2; Vaccination.