Timing of headache after COVID-19 vaccines and its association with cerebrovascular events: An analysis of 41,700 VAERS reports
- 6 May 2022
- journal article
- research article
- Published by SAGE Publications in Cephalalgia
- Vol. 42 (11-12), 1207-1217
- https://doi.org/10.1177/03331024221099231
Abstract
Background Delayed-onset of headache seems a specific feature of cerebrovascular events after COVID-19 vaccines. Methods All consecutive events reported to the United States Vaccine Adverse Reporting System following COVID-19 vaccines (1 January to 24 June 2021), were assessed. The timing of headache onset post-vaccination in subjects with and without concomitant cerebrovascular events, including cerebral venous thrombosis, ischemic stroke, and intracranial haemorrhage was analysed. The diagnostic accuracy in predicting concurrent cerebrovascular events of the guideline-proposed threshold of three-days from vaccination to headache onset was evaluated. Results There were 314,610 events following 306,907,697 COVID-19 vaccine doses, including 41,700 headaches, and 178/41,700 (0.4%) cerebrovascular events. The median time between the vaccination and the headache onset was shorter in isolated headache (1 day vs. 4 (in cerebral venous thrombosis), 3 (in ischemic stroke), or 10 (in intracranial hemorrhage) days, all P < 0.001). Delayed onset of headache had an area under the curve of 0.83 (95% CI: 0.75-0.97) for cerebral venous thrombosis, 0.70 (95% CI: 0.63-76) for ischemic stroke and 0.76 (95% CI: 0.67-84) for intracranial hemorrhage, and >99% negative predictive value. Conclusion Headache following COVID-19 vaccination occurs within 1 day and is rarely associated with cerebrovascular events. Delayed onset of headache 3 days post-vaccination was an accurate diagnostic biomarker for the occurrence of a concomitant cerebrovascular events.Keywords
This publication has 33 references indexed in Scilit:
- Safety and Efficacy of the BNT162b2 mRNA Covid-19 VaccineThe New England Journal of Medicine, 2020
- COVID-19 vaccine hesitancy among medical studentsJournal of Public Health, 2020
- Presence of red flags in patients with cerebral venous sinus thrombosis admitted to the emergency department because of headacheMedicine, 2020
- Headache after ischemic strokeNeurology, 2020
- Red and orange flags for secondary headaches in clinical practiceNeurology, 2019
- The Prevalence and Impact of Migraine and Severe Headache in the United States: Figures and Trends From Government Health StudiesHeadache: The Journal of Head and Face Pain, 2018
- Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd editionCephalalgia, 2018
- Confidence intervals for predictive values with an emphasis to case–control studiesStatistics in Medicine, 2007
- Headache in United States Emergency DepartmentsCephalalgia, 2006
- Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple TestingJournal of the Royal Statistical Society: Series B (Methodological), 1995