Study: COVID-19 Vaccination Not to Blame for Worsening Migraines

Neurological symptoms are a common adverse effect following COVID-19 infection and vaccination. Individuals with migraines may be more at risk for neurological symptoms, including headaches. Patients report having prolonged, disabling headaches after COVID-19 exposure through vaccination or infection.

A team of researchers from Spain published a study that indicates COVID-19 may not be the source of a long-term increase in headaches. This study was published in the August 2023 issue of European Journal of Neurology.

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Researchers sent an online survey to migraine patients in a headache clinic (N = 550). The survey collected data on SARS-CoV-2 infection and vaccination rates. In total, 44.9% of patients self-reported having COVID-19 and 83.3% received at least 1 dose of the COVID-19 vaccine. Patients tracked their migraine frequency and severity before and after vaccination or infection in an electronic diary. The researchers compared patients who reported migraines to patients without migraines.

The researchers found that headaches became more intense following COVID-19 infection or vaccination. They reported a temporary increase in nausea, photophobia, and phonophobia. The actual number of headache days did not increase. These changes to headache patterns were self-limiting and may not be related to COVID-19.

In fact, the increase in headaches may have been psychosomatic, a manifestation called the nocebo effect, in which concerns about the pandemic and the vaccine may have triggered a headache. Anxiety surrounding worsening headaches was a significant risk factor for increased headaches. Widespread reports of increased headaches may be anecdotal, not indicative of cause and effect.

Health care workers can tell patients the COVID-19 vaccine may temporarily affect their migraines, but the change won’t last. Stress may have more of an effect on migraines than COVID-19 infection or vaccination. Informing the patient should comfort them and lower their risk of developing a psychosomatic headache. Pharmacists should continue to recommend COVID-19 vaccination to patients with migraines and other headache disorders.

About the Author

Janelle McSwiggin, MSN, RN, is a medical writer at Haymarket: Infectious Disease Advisor, Practical Neurology, and Alphanumerics.

Reference

Melgarejo L, Caronna E, Rosell‐Mirmi J, et al. Migraine worsening after Covid‐19 and Covid‐19 vaccination: Are we facing a nocebo effect? European Journal of Neurology. 2023;30(12):3877-3885. doi:10.1111/ene.16058