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Göbel CH, Heinze A, Heinze-Kuhn K, Karstedt S, Morscheck M, Tashiro L, Cirkel A, Hamid Q, Halwani R, Temsah MH, Ziemann M, Görg S, Münte T, Göbel H. Comparison of Phenotypes of Headaches After COVID-19 Vaccinations Differentiated According to the Vaccine Used. Vaccines (Basel) 2025; 13:113. [PMID: 40006661 PMCID: PMC11861871 DOI: 10.3390/vaccines13020113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2024] [Revised: 01/15/2025] [Accepted: 01/20/2025] [Indexed: 02/27/2025] Open
Abstract
Background/Objectives: In this ongoing, multicenter, global cohort observational study, phenotypes of headaches after COVID-19 vaccination were directly compared between different vaccines. Methods: Phenotypes of postvaccinal headache were recorded in 18,544 participants. The study was launched immediately after the start of the global COVID-19 vaccination campaign on 12 January 2021 and continued until 1 August 2023. Specific aspects of headaches and related variables were collected via an online questionnaire. The clinical headache characteristics of patients vaccinated with the Comirnaty (BioNTech), Jcovden (Johnson & Johnson), Sputnik V (Gamelaya), Covilo (Sinopharm), Spikevax (Moderna), Vaxzevria (AstraZeneca), and Convidecia (CanSino Biologics) vaccines were investigated. Results: Across all vaccines, the median and mean latency of headache onset after vaccine administration were 12 h and 23.3 h, respectively. The median and mean headache duration were 12 h and 23.3 h, respectively. When the nonreplicating viral vector vaccine Sputnik V was used, headaches occurred the fastest, with a latency of 17 h. The latencies for the Vaxzevria and Convidecia nonreplicating viral vector vaccines were 14.9 h and 19.1 h, respectively. The Covilo inactivated whole-virus vaccine had a latency of 20.5 h. The latencies of the mRNA-based Comirnaty and Spikevax vaccines were 26.0 h and 22.02 h, respectively. Analysis of variance revealed no significant differences in the mean duration of postvaccinal headache for the vaccines tested. Compared with the Comirnaty, Covilo, and Vaxzevria vaccines, the Spikevax vaccine induced significantly greater headache intensities. Vaxzevria was associated with a significantly higher frequency of concomitant symptoms than the other vaccines. Conclusions: The phenotype of postvaccinal headache can vary significantly between vaccines. These results have clinical implications for differentiating between postvaccinal headache and other primary and secondary headaches. This knowledge is clinically relevant in differentiating life-threatening vaccination complications, such as thrombotic syndromes, which are also associated with headaches. Based on these results, new diagnostic criteria for postvaccinal headaches can be developed.
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Affiliation(s)
- Carl Hartmut Göbel
- Kiel Migraine and Headache Centre, 24149 Kiel, Germany; (A.H.); (K.H.-K.); (S.K.); (M.M.); (A.C.); (H.G.)
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany
| | - Axel Heinze
- Kiel Migraine and Headache Centre, 24149 Kiel, Germany; (A.H.); (K.H.-K.); (S.K.); (M.M.); (A.C.); (H.G.)
| | - Katja Heinze-Kuhn
- Kiel Migraine and Headache Centre, 24149 Kiel, Germany; (A.H.); (K.H.-K.); (S.K.); (M.M.); (A.C.); (H.G.)
| | - Sarah Karstedt
- Kiel Migraine and Headache Centre, 24149 Kiel, Germany; (A.H.); (K.H.-K.); (S.K.); (M.M.); (A.C.); (H.G.)
| | - Mascha Morscheck
- Kiel Migraine and Headache Centre, 24149 Kiel, Germany; (A.H.); (K.H.-K.); (S.K.); (M.M.); (A.C.); (H.G.)
| | - Lilian Tashiro
- Kiel Migraine and Headache Centre, 24149 Kiel, Germany; (A.H.); (K.H.-K.); (S.K.); (M.M.); (A.C.); (H.G.)
| | - Anna Cirkel
- Kiel Migraine and Headache Centre, 24149 Kiel, Germany; (A.H.); (K.H.-K.); (S.K.); (M.M.); (A.C.); (H.G.)
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Lübeck, 23562 Lübeck, Germany;
| | - Qutyaba Hamid
- Sharjah Institute of Medical Research, University of Sharjah, Sharjah 26666, United Arab Emirates; (Q.H.); (R.H.)
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah 26666, United Arab Emirates
| | - Rabih Halwani
- Sharjah Institute of Medical Research, University of Sharjah, Sharjah 26666, United Arab Emirates; (Q.H.); (R.H.)
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah 26666, United Arab Emirates
| | | | - Malte Ziemann
- Institute of Transfusion Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, 23562 Lübeck, Germany; (M.Z.); (S.G.)
| | - Siegfried Görg
- Institute of Transfusion Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, 23562 Lübeck, Germany; (M.Z.); (S.G.)
| | - Thomas Münte
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Lübeck, 23562 Lübeck, Germany;
| | - Hartmut Göbel
- Kiel Migraine and Headache Centre, 24149 Kiel, Germany; (A.H.); (K.H.-K.); (S.K.); (M.M.); (A.C.); (H.G.)
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Zhou Q, Eggert T, Zhelyazkova A, Choukér A, Adorjan K, Straube A. Questionnaire-based study of COVID-19 vaccination induced headache: evidence of clusters of adverse events. BMC Neurol 2024; 24:84. [PMID: 38431578 PMCID: PMC10908065 DOI: 10.1186/s12883-024-03583-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/23/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND The adverse events (AEs) after a Coronavirus disease 2019 (Covid-19) Pfizer-Biotech mRNA vaccination present a medical and epidemiological issue of increasing interest. Headache is the most frequent neurological adverse effect and generally the third most common adverse event after a Covid-19 vaccination, but only a few studies focus on the link between headache and other AEs after vaccination. This study aims to investigate the correlation between headaches and Covid-19 vaccination, as well as the possible links between headaches and other AEs after Covid-19 vaccination, thereby helping the management of AEs and avoiding further occurrences. METHODS This study is based on a published questionnaire survey of 1,402 healthcare workers. Our study focused on the 5 questions including 12 AEs and headaches extracted from the questionnaire post the first and second Covid-19 vaccination. The severity of the 12 AEs and headaches could be classified by the participants on a five-step scale: "Not at all", "Little", "Average", "Quite", and "Very" (abbreviated as "N", "L", "A", "Q", "V"). We used the Bowker test to study the comparison of headache severity, indicated on a 5-point Likert scale between the first and second vaccinations. We applied an ordinal logistic regression to the 5 categories with headache severity serving as the dependent variable and the ratings of the other 12 AEs serving as the independent variable to further explore to what extent the severity of the 12 AEs is associated with the severity of headaches. Receiver Operating Characteristic (ROC) analysis was conducted to evaluate the predictive value of the ratings of the 12 AEs to headache severity. RESULTS We found that participants rated their headaches as more severe after the second vaccination, and participants who reported experiencing fatigue, flu-like symptoms, pain at the injection site, known tension-type headache, fever, dizziness/balance problems and known migraine are associated with headache symptoms. CONCLUSIONS There are clusters of headache-associated AEs post Covid-19 vaccination. The association of various AEs with headaches may be due to similar causative mechanisms.
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Affiliation(s)
- Qiao Zhou
- Department of Neurology, University Hospital, LMU Munich, Marchioninistr.15, 81377, Munich, Germany
| | - Thomas Eggert
- Department of Neurology, University Hospital, LMU Munich, Marchioninistr.15, 81377, Munich, Germany
| | - Ana Zhelyazkova
- Institut für Notfallmedizin und Medizinmanagement, Klinikum der Universität München, 80336, Munich, Germany
| | - Alexander Choukér
- Laboratory of Translational Research Stress and Immunity, Department of Anaesthesiology, University Hospital Munich, Ludwig Maximilian University of Munich, 81377, Munich, Germany
| | - Kristina Adorjan
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, 80336, Munich, Germany
| | - Andreas Straube
- Department of Neurology, University Hospital, LMU Munich, Marchioninistr.15, 81377, Munich, Germany.
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