Silvestro Marcello, Tessitore Alessandro, Orologio Ilaria, Sozio Pasquale, Napolitano Giuseppe, Siciliano Mattia, Tedeschi Gioacchino, Russo Antonio
Headache Center, Department of Advanced Medical and Surgical Sciences (DAMS), University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.
Intensity Care Unit, Department of Emergency and Acceptance "Antonio Cardarelli" Hospital, 80131 Naples, Italy.
J Clin Med. 2021 Dec 16;10(24):5914. doi: 10.3390/jcm10245914.
Vaccines have represented the breakthrough in the fight against COVID-19. Based on reported headache attacks after vaccination in randomized controlled trials, we focused on the effects of COVID-19 vaccine administration on the migraine population, using an online questionnaire published on Italian Facebook groups oriented to headache patients. We collected data about the demographics and clinical parameters of migraine severity, COVID-19 infection, vaccination, and characteristics of headaches following vaccination. Out of 841 migraine patients filling in the questionnaire, 66.47% and 60.15% patients experienced a headache attack (from 1 hour to 7 days) after the first and the second vaccine dose, respectively. The main finding concerns headaches perceived by 57.60% of patients: attacks following vaccination were referred to as more severe (50.62% of patients), long-lasting (52.80% of patients) and hardwearing (49.69% of patients) compared to the usually experienced migraine attacks. This could be related to the production of inflammatory mediators such as type Iβ interferon. Considering the high prevalence of migraine in the general population, awareness of the possibility of headaches worsening following COVID-19 vaccination in these patients may allow both patients and clinicians to face this clinical entity with conscious serenity, and to reduce the waste of resources towards inappropriate health-care.
疫苗是抗击新冠疫情的重大突破。基于随机对照试验中报告的接种疫苗后的头痛发作情况，我们利用在面向头痛患者的意大利脸书群组上发布的在线问卷，重点研究了接种新冠疫苗对偏头痛人群的影响。我们收集了有关偏头痛严重程度、新冠病毒感染、疫苗接种以及接种疫苗后头痛特征的人口统计学和临床参数数据。在填写问卷的841名偏头痛患者中，分别有66.47%和60.15%的患者在接种第一剂和第二剂疫苗后出现了头痛发作（发作时间从1小时到7天）。主要发现涉及57.60%的患者感觉到的头痛：与通常经历的偏头痛发作相比，接种疫苗后的发作被认为更严重（50.62%的患者）、持续时间更长（52.80%的患者）且更难缓解（49.69%的患者）。这可能与Iβ型干扰素等炎症介质的产生有关。鉴于偏头痛在普通人群中的高患病率，了解这些患者在接种新冠疫苗后头痛可能加重的情况，或许能让患者和临床医生都能坦然面对这一临床情况，并减少在不适当医疗保健方面的资源浪费。
