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Open Access 01-12-2022 | Vaccination | Review article

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

Authors: Matteo Castaldo, Marta Waliszewska-Prosół, Maria Koutsokera, Micaela Robotti, Marcin Straburzyński, Loukia Apostolakopoulou, Mariarita Capizzi, Oneda Çibuku, Fidel Dominique Festin Ambat, Ilaria Frattale, Zukhra Gadzhieva, Erica Gallo, Anna Gryglas-Dworak, Gleni Halili, Asel Jusupova, Yana Koperskaya, Alo-Rainer Leheste, Maria Laura Manzo, Andrea Marcinnò, Antonio Marino, Petr Mikulenka, Bee Eng Ong, Burcu Polat, Zvonimir Popovic, Eduardo Rivera-Mancilla, Adina Maria Roceanu, Eleonora Rollo, Marina Romozzi, Claudia Ruscitto, Fabrizio Scotto di Clemente, Sebastian Strauss, Valentina Taranta, Maria Terhart, Iryna Tychenko, Simone Vigneri, Blazej Misiak, Paolo Martelletti, Alberto Raggi, On behalf of the European Headache Federation School of Advanced Studies (EHF-SAS)

Published in: The Journal of Headache and Pain | Issue 1/2022

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^st 2020 and August 6^th, 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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Title: Headache onset after vaccination against SARS-CoV-2: a systematic literature review and meta-analysis
Authors: Matteo Castaldo
Marta Waliszewska-Prosół
Maria Koutsokera
Micaela Robotti
Marcin Straburzyński
Loukia Apostolakopoulou
Mariarita Capizzi
Oneda Çibuku
Fidel Dominique Festin Ambat
Ilaria Frattale
Zukhra Gadzhieva
Erica Gallo
Anna Gryglas-Dworak
Gleni Halili
Asel Jusupova
Yana Koperskaya
Alo-Rainer Leheste
Maria Laura Manzo
Andrea Marcinnò
Antonio Marino
Petr Mikulenka
Bee Eng Ong
Burcu Polat
Zvonimir Popovic
Eduardo Rivera-Mancilla
Adina Maria Roceanu
Eleonora Rollo
Marina Romozzi
Claudia Ruscitto
Fabrizio Scotto di Clemente
Sebastian Strauss
Valentina Taranta
Maria Terhart
Iryna Tychenko
Simone Vigneri
Blazej Misiak
Paolo Martelletti
Alberto Raggi
On behalf of the European Headache Federation School of Advanced Studies (EHF-SAS)
Publication date: 01-12-2022
Publisher: Springer Milan
Keywords: Vaccination
SARS-CoV-2
COVID-19
Headache
Published in: The Journal of Headache and Pain / Issue 1/2022
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI: https://doi.org/10.1186/s10194-022-01400-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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