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Published on: November 17, 2010
Questionnaire-based study of COVID-19 vaccination induced headache: evidence of clusters of adverse events
Qiao Zhou1, Thomas Eggert1, Ana Zhelyazkova2
1Department of Neurology, University Hospital, LMU Munich, Marchioninistr.15, 81377, Munich, Germany.
Insights
Headaches were more severe after the second dose of the Pfizer-BioNTech COVID-19 vaccine. Fatigue, fever, and injection site pain were linked to increased headache severity following vaccination.
Area of Science:
- Immunology
- Neurology
- Public Health
Background:
- Adverse events (AEs) following COVID-19 vaccination are of significant interest.
- Headache is a common neurological AE after COVID-19 vaccination, yet its association with other AEs requires further investigation.
Purpose of the Study:
- To investigate the correlation between headaches and COVID-19 vaccination.
- To explore the links between headaches and other AEs post-vaccination to aid in AE management.
Main Methods:
- Survey of 1,402 healthcare workers on AEs and headache severity after first and second Pfizer-BioNTech COVID-19 vaccine doses.
- Statistical analysis including Bowker test, ordinal logistic regression, and ROC analysis to assess AE associations with headache severity.
Main Results:
- Headaches were rated as more severe after the second vaccine dose.
- Fatigue, flu-like symptoms, injection site pain, pre-existing headache conditions, fever, and dizziness were associated with headache symptoms post-vaccination.
Conclusions:
- Clusters of AEs are associated with headaches after COVID-19 vaccination.
- Shared underlying mechanisms may explain the association between various AEs and headaches.
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.
