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Göbel CH, Heinze A, Karstedt S, et al. Headache Attributed to Vaccination Against COVID-19 (Coronavirus SARS-CoV-2) with the ChAdOx1 nCoV-19 (AZD1222) Vaccine: A Multicenter Observational Cohort Study. Pain Ther. 2021;10(2):1309-1330doi: 10.1007/s40122-021-00296-3.
Göbel, C. H., Heinze, A., Karstedt, S., Morscheck, M., Tashiro, L., Cirkel, A., Hamid, Q., Halwani, R., Temsah, M. H., Ziemann, M., Görg, S., Münte, T., & Göbel, H. (2021). Headache Attributed to Vaccination Against COVID-19 (Coronavirus SARS-CoV-2) with the ChAdOx1 nCoV-19 (AZD1222) Vaccine: A Multicenter Observational Cohort Study. Pain and therapy, 10(2), 1309-1330. https://doi.org/10.1007/s40122-021-00296-3
Göbel, Carl H, et al. "Headache Attributed to Vaccination Against COVID-19 (Coronavirus SARS-CoV-2) with the ChAdOx1 nCoV-19 (AZD1222) Vaccine: A Multicenter Observational Cohort Study." Pain and therapy vol. 10,2 (2021): 1309-1330. doi: https://doi.org/10.1007/s40122-021-00296-3
Göbel CH, Heinze A, Karstedt S, Morscheck M, Tashiro L, Cirkel A, Hamid Q, Halwani R, Temsah MH, Ziemann M, Görg S, Münte T, Göbel H. Headache Attributed to Vaccination Against COVID-19 (Coronavirus SARS-CoV-2) with the ChAdOx1 nCoV-19 (AZD1222) Vaccine: A Multicenter Observational Cohort Study. Pain Ther. 2021 Dec;10(2):1309-1330. doi: 10.1007/s40122-021-00296-3. Epub 2021 Jul 27. PMID: 34313952; PMCID: PMC8314854.
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Pain Ther. 2021 Dec;10(2):1309-1330. doi: 10.1007/s40122-021-00296-3. Epub 2021 Jul 27.

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

Pain and therapy

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

Affiliations

  1. Department of Neurology, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany. [email protected].
  2. Kiel Migraine and Headache Centre, Kiel, Germany. [email protected].
  3. Kiel Migraine and Headache Centre, Kiel, Germany.
  4. Department of Neurology, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
  5. Sharjah Institute of Medical Research, University of Sharjah, Sharjah, United Arab Emirates.
  6. Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.
  7. College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
  8. Institute of Transfusion Medicine, University Hospital Schleswig-Holstein, Campus, Lübeck, Germany.

PMID: 34313952 PMCID: PMC8314854 DOI: 10.1007/s40122-021-00296-3

Abstract

INTRODUCTION: The most frequently reported neurological adverse event of ChAdOx1 nCoV-19 (AZD1222) vaccine is headache in 57.5%. Several cases of cerebral venous thrombosis (CVT) have developed after vaccination. Headache is the leading symptom of CVT. For the differential diagnosis of headaches attributed to this vaccine and headaches attributed to CVT, it is of central clinical importance whether and, if so, how the phenotypes and course of these headaches can be differentiated. The study aims to examine in detail the phenotype of headache attributed to this vaccine.

METHODS: Data on the clinical features and corresponding variables were recorded using a standardized online questionnaire in this multicenter observational cohort study. The primary outcomes of this study are the clinical features of headaches after vaccination.

FINDINGS: A total of 2464 participants reported headaches after vaccination with the ChAdOx1 nCoV-19 (AZD1222) vaccine. On average, headaches occurred 14.5 ± 21.6 h after vaccination and lasted 16.3 ± 30.4 h. A bilateral location was described by 75.8% of participants. This is most often found on the forehead (40.0%) and temples (31.4%); 50.4% reported a pressing and 37.7% a dull pain character. Headache intensity was most often severe (38.7%), moderate (35.2%), or very severe (15.5%). Accompanying symptoms were most commonly fatigue (44.8%), chills (36.1%), exhaustion (34.9%), and fever (30.4%).

CONCLUSION: Headaches attributed to COVID-19 vaccination with the ChAdOx1 nCoV-19 (AZD1222) vaccine demonstrate an extensive and characteristic complex of symptoms. The findings have several important clinical implications for the differentiation of post-vaccinal headache and other primary as well as secondary headaches.

© 2021. The Author(s).

Keywords: COVID-19; Cerebral venous thrombosis; ChAdOx1 nCoV-19 (AZD1222) vaccine; Headache; ICHD-3; International Classification of Headache Disorders; Novel coronavirus SARS-CoV-2; Side effects; Vaccination

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