Headache after COVID vaccination
I recently saw a 32-year-old woman who never suffered from headaches until a year ago when she was given an injection of a COVID vaccine (J&J). Her headache started the day after vaccination and it has persisted unabated. Besides severe daily headaches, she developed profound fatigue, muscle aches, and brain fog, making her unable to work. Her headaches had all the features of chronic migraines and I recommended trying Botox injections along with a migraine medication that she has not yet tried.
I’ve seen a few dozen patients who developed less devastating headaches or whose preexisting migraines worsened after vaccination. Some developed a headache after the first or second shot and a few had it only after the booster. I am not suggesting that people should avoid the COVID vaccine. I’ve had three shots myself. I am writing about this because of a study just published by European researchers in the Journal of Headache and Pain – “Headache onset after vaccination against SARS-CoV-2: a systematic literature review and meta-analysis.”
They examined the results of 84 scientific reports that included 1.57 million participants, 94% of whom received Pfizer or Oxford-AstraZeneca vaccines. They discovered that vaccines were associated with a doubling of the risk of developing a headache within 7 days from the injection compared to people who received a placebo injection. They did not find a difference between the two different vaccine types. Some people developed a headache within the first 24 hours. In approximately one-third of the cases, headache had migraine-like features with pulsating quality, phonophobia, and photophobia. In 40 to 60% the headache was aggravated by physical activity, which is another migraine feature.
The majority of patients used some medication to treat their headaches. People reported that the most effective drug was aspirin, although the details about various treatments were not provided. We do know that in Europe doctors are much less likely to prescribe medications, including triptans. It is likely that early and aggressive treatment can prevent these headaches from becoming chronic and disabling.
I received a Moderna booster shot on February, 25,2022. I have had a headache every single day since. It will be a year Saturday. I’ve been seen by numerous doctors, and neurologists. I’ve been treated with steroids, had MRI with and without contrast and there is no obvious reason for my headaches. I would not classify them as migraines, more of an annoyance than debilitating. I do feel fatigue and experience muscle and joint pain in my upper body.(shoulders,elbows, armpits, jaw) I seem to be in a “fog” at times with my memory. A Lyme titre test returned negative. Hoping for it to just go away one day.
I have had flare-ups of CM with each of my 3 Pfizer vaccine doses. Acutely, severe migraine for 3-4 days, but then increased headache days for months afterwards. I have held off on dose #4 as a result, but a very high risk elderly relative moved near me and I need to get the next booster that is more Omicron-specific when it comes out. With my 3rd dose my neuro had me take Frova for 3 days starting the night before and then aleve bid for 2wks and it helped modestly. However, I am pretty maxed out on Triptans per month right now and don’t know if I can use the Frova this time.
I am asking for any ideas or regimens to consider that might make this next dose more tolerable……
Thank you!
I had a full blown migraine following the J&J vaccine, vomiting and severe pain. I was afraid to use medication other than Advil because I didn’t know how medications react with the vaccine or it’s “efficacy”. My migraines have become more frequent since but I also stopped breastfeeding which typically results in a return of my migraines. .
I developed a new headache process temporal to an H1N1 vaccine a little over a decade ago. I was also entering perimenopause. Subsequently, I’ve learned I have mast cell, immune system dysregulation and genetic connective issues. Those coping with vaccine induced headaches may wish to consider reading about mast cell activation and discuss with their physician using the mast cell protocols before their next immunizations.
I have CM and with Pfizer dose #1 I had a migraine the next day that last about 72 hours, with partial abatement with treatment. With dose #2 I had a similar migraine but my overall migraine control was shot to heck for a good 3 months. It affected my ability to work significantly. Then with booster dose 6 months after 2nd dose, I was super worried. My neuro had me take Frova twice a day for 3 days, starting the night before and I also took aleve twice a day for 2 weeks and then slowly weaned off. I still had a general flare, but it wasn’t nearly as horrible as dose #2. I am eager to try Novavax next time if it becomes available as side effects like headache, appear to be less. We will see.
I have chronic migraines but had one of the worst in my life after my second covid vaccination. I wish I could have been prepared with strong painkillers or something that would have helped. I also had a 102° fever. I have wondered if others with chronic migraine had similar experiences. Thankfully it lasted only half a day and lingered as a tension type headache the rest of the week.
This is similar to my experience. Thank you for this—I have not found others with this vaccine reaction beyond vague word of mouth references.
My headpain emerged within 24 hours of the second Moderna vaccine in May 2021 and has persisted. I barely left bed for the first 3 months. After numerous appointments with PCPs, I was referred to a neurologist whose diagnosis was chronic migraines and irretractable headaches. I also experienced mental and physical fatigue, lightheadedness, and brain fog that hindered basic functioning (dialogue, driving, etc.) Also, my blood pressure plummeted, and after a misdiagnosis, a cardiologist working with long covid patients reassessed my diagnosis to be an autonomic nervous system dysfunction where my BP drops as heart rate increases.
After much trial and error, we found the emgality monthly injection helps along with nurtec for my ~2/week breakthrough migraines. After numerous appeals, my insurance has just approved Botox for my chronic headaches, which have not diminished with the migraine medication. Fingers crossed!