偏头痛患者接种 SARS-CoV-2 疫苗后出现与疫苗和剂量相关的特定头痛模式的持续性头痛。

Prolonged headache with vaccine- and dose-specific headache pattern associated with vaccine against SARS-CoV-2 in patients with migraine.

机构信息

Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.

Institute of Public Health, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.

出版信息

Cephalalgia. 2023 Oct;43(10):3331024231208110. doi: 10.1177/03331024231208110.

DOI:10.1177/03331024231208110

PMID:37851648

Abstract

OBJECTIVE

To examine SARS-CoV-2 vaccine-related headache characteristics and risk factors in migraine patients.

METHODS

This retrospective cohort study included 732 migraine patients who had AstraZeneca Vaxzevria, Pfizer-BioNTech Comirnaty, or Moderna Spikevax vaccines. Participants provided information through questionnaires and headache diaries. Headache frequency before and after vaccination and factors associated with headache risk were examined.

RESULTS

Approximately a third of patients reported increased headache the day after having primary and booster doses, with mean increase ± SD of 1.9 ± 1.2 and 1.8 ± 1.1 days/week, respectively. Proportions of migraine patients with headache (after vaccination vs. before vaccination) increased after having primary-dose Vaxzevria (35.3% vs. 22.8%, < 0.001) but not Spikevax (23.8% vs. 26.7%, = 0.700) or Comirnaty (33.2% vs. 25.8%, = 0.058). Headache proportion increased after having all three boosters (Vaxzevria 27.1% vs. 17.9% = 0.003; Comirnaty 34.1% vs. 24.5% = 0.009; Spikevax 35.2% vs. 24.8% = 0.031). For primary dose with Vaxzevria and Comirnaty, headache risk increased on the vaccination day, peaked on the day after vaccination, and subsided within a week, while for Spikevax headache risk rose gradually after vaccination, peaked on the seventh post-vaccination day and subsided subsequently. For booster dose, headache risk generally increased on the vaccination day, peaked on the day after vaccination, and subsided gradually with fluctuating pattern within a month. Our study also showed that headache increased on the day before primary dose but not booster dose vaccination and it may be attributable to stress associated with having to undertake new vaccines. Multivariable analyses showed that depression was associated with headache.

CONCLUSION

Prolonged headache with vaccine- and dose-specific headache pattern was found. Patients with higher risks of vaccine-related headache must be informed of the potential worsening headache.

摘要

目的

研究 SARS-CoV-2 疫苗相关头痛特征和偏头痛患者的风险因素。

方法

本回顾性队列研究纳入了 732 名接种过阿斯利康 Vaxzevria、辉瑞-生物科技 Comirnaty 或 Moderna Spikevax 疫苗的偏头痛患者。参与者通过问卷调查和头痛日记提供信息。研究检测了接种前后头痛的发生频率以及与头痛风险相关的因素。

结果

大约三分之一的患者报告在接种初级和加强剂量后第二天头痛加重，分别平均增加 1.9 ± 1.2 和 1.8 ± 1.1 天/周。接种 Vaxzevria 后，有头痛的偏头痛患者比例（接种后 vs. 接种前）增加（35.3% vs. 22.8%，<0.001），但 Spikevax（23.8% vs. 26.7%，=0.700）或 Comirnaty（33.2% vs. 25.8%，=0.058）则无显著差异。接种三次加强针后，头痛比例均增加（Vaxzevria 27.1% vs. 17.9%，=0.003；Comirnaty 34.1% vs. 24.5%，=0.009；Spikevax 35.2% vs. 24.8%，=0.031）。接种 Vaxzevria 和 Comirnaty 时，初级剂量头痛风险在接种日增加，在接种后第二天达到高峰，并在一周内消退，而接种 Spikevax 后，头痛风险逐渐增加，在接种后第七天达到高峰，随后逐渐消退。对于加强剂量，头痛风险通常在接种日增加，在接种后第二天达到高峰，并在一个月内逐渐消退，呈波动模式。我们的研究还表明，初级剂量接种前一天头痛增加，但加强剂量接种前一天头痛不增加，这可能归因于需要接种新疫苗带来的压力。多变量分析显示，抑郁与头痛相关。