(0301) Analyzing Headaches Following COVID-19 Infection and Vaccination Among a Large Cohort

Introduction: We aim to characterize the rates of tension and migraine headache symptoms experienced immediately following COVID-19 infection and vaccination in an effort to inform screening and treatment protocols.

Methods: In this cohort study, self-reported surveys were administered to participants ≥18 years of age who tested positive for COVID-19 infection or were vaccinated between January 2020 and September 2022. Pearson’s chi square tests were conducted to evaluate preexisting history of headache symptoms, compare incidence between males and females, and quantify chronology of symptom onset.

Results: Among a cohort of 1,027 participants comprising post-infection (N = 673) and post-vaccination (N = 354) subgroups, the median age was 55 years, 75% were female, and 83% were White. Of these, 47.2% of the post-infection subgroup and 49.1% of the post-vaccination subgroup reported a preexisting history of recurring headache symptoms. Female sex was associated with higher frequencies of tension headaches post-vaccination (78% vs 22%, p < 0.05), migraine headaches post-vaccination (85% vs 15%, p < 0.05), and migraine headaches post-infection (85% vs 15%, p < 0.05). Patients in the post-infection subgroup experienced earlier onset of tension headaches than the post-vaccination subgroup (mean of 0.03 days vs 2.22 days, p < 0.01), but did not experience significantly earlier onset of migraine headaches.

Conclusions: To our knowledge, this is the largest cohort study investigating headache symptoms post-COVID-19 infection and vaccination. These findings indicate that prior history of tension or migraine headaches and female sex may be associated with higher incidence of symptoms following both infection and vaccination. Additionally, this study may improve our understanding of headache symptom onset among these subgroups.