Persistent Headaches After Vaccination: When to Seek Medical Attention?

I have been experiencing a persistent headache for four days after receiving the vaccine?

Hello doctor, after receiving the second dose of the AZ vaccine on November 18, I experienced no symptoms and felt fine.
However, four days later, I started having headaches, chest tightness, and abdominal pain.
The headache was located in the upper right side, above the temple, and felt like a lightning bolt.
After a few days of persistent symptoms, I was concerned it might be a vaccine-related thrombosis, so I went to the emergency room on November 25.
After blood tests, an electrocardiogram, and a chest X-ray, the doctor said everything was normal and suggested it might be due to stress, prescribing painkillers before I went home.
The abdominal pain and chest tightness disappeared, but the headache continued daily, shifting to the right posterior part of my head, with intermittent sharp and dull pain.
Painkillers have not been effective, and the pain worsens when I move my head, especially when looking to the right, where the dull pain intensifies.
I used to have migraines that felt like pressure and would resolve after a day of rest, typically occurring on weekends.
This headache is different as it is persistent every day.
I would like to ask if I need to go to the hospital for a brain scan.
I work as a graphic designer, spending over 8 hours a day on the computer, and I have a family history of high blood pressure.
Could these factors be related to my current headache?

Selene, 20~29 year old female. Ask Date: 2021/12/11

Dr. Jiang Junyi reply Neurology

Dear Ms.
Selene,
You mentioned experiencing intermittent sharp and dull pain in the right occipital region, along with working over 8 hours a day on the computer.
This may indicate cervical myofascial pain syndrome.
Prolonged periods of looking down can lead to overuse of the trapezius muscle in the neck, resulting in neck and shoulder discomfort.
Initially, resting may alleviate the pain, but it can progressively worsen, affecting daily activities.
Some patients report waking up with severe neck pain, stiffness, tightness, and intolerable pain levels.
I recommend the following:
1.
Change Positions: Alter your posture every 15 minutes to allow the neck tissues to rest.
Maintaining any position (including a neutral one) for too long can lead to fatigue and inflammation, so brief movements can reduce the risk of muscle inflammation.
2.
Rest: Resting allows the muscles to utilize their self-repair capabilities.
Avoid vigorous exercise during this time.
3.
Neck Heat Therapy: Apply heat for 15 to 20 minutes, ensuring the temperature is safe to prevent burns.
4.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Muscle Relaxants: For individuals without a history of peptic ulcers, allergies to NSAIDs, or normal kidney function, consider using NSAIDs to reduce inflammation and alleviate pain if necessary.
5.
Neck Muscle Stretching Exercises: After the acute pain phase, develop a habit of performing slow and gentle neck stretches every 15 to 20 minutes, ensuring the angles do not cause discomfort.
Stretch in all directions: up, down, left, and right.
I suggest consulting a neurologist or a rehabilitation specialist for further evaluation and treatment options.
Thank you for your inquiry, and feel free to discuss any related questions.
Wishing you good health and peace,
Dr.
Chih-Yi Jiang, Taoyuan Medical Center

Reply Date: 2021/12/11

More Info

Persistent headaches following vaccination can be concerning, especially when they deviate from your typical headache patterns. In your case, the onset of headaches four days after receiving the second dose of the AstraZeneca (AZ) vaccine, accompanied by other symptoms like chest tightness and abdominal pain, warrants careful consideration.

First, it’s important to note that headaches can be a common side effect of vaccinations, including the AZ vaccine. These headaches are usually mild to moderate and resolve within a few days. However, your description of the headaches evolving into a more severe, persistent pain, particularly with specific characteristics (e.g., sharp, lightning-like pain in the right upper temple area, and later dull pain in the right posterior area) suggests that this may not be a typical post-vaccination reaction.

Given that you have already sought medical attention and underwent several diagnostic tests (blood tests, ECG, chest X-ray), which returned normal results, it is reassuring that there are no immediate signs of serious complications such as vaccine-induced thrombosis with thrombocytopenia (VITT), which is a rare but serious condition associated with the AZ vaccine. However, your ongoing symptoms, particularly the persistent nature of the headaches and their specific location, suggest that further evaluation may be warranted.

Your profession as a graphic designer, which involves prolonged computer use, could contribute to tension-type headaches or even exacerbate pre-existing migraine conditions. The fact that you have a history of migraines, albeit different in nature from your current symptoms, adds another layer of complexity. It is also worth considering that stress and posture related to long hours at the computer could lead to muscle tension in the neck and shoulders, which can refer pain to the head.

Here are some recommendations for managing your situation:
1. Consult a Neurologist: Given the persistence and change in your headache pattern, it would be prudent to see a neurologist. They can perform a thorough evaluation, including a detailed history and possibly imaging studies like a CT scan or MRI of the brain, to rule out any underlying conditions.

2. Monitor Symptoms: Keep a headache diary noting the frequency, intensity, duration, and any associated symptoms (like nausea, visual changes, etc.). This information can be invaluable for your healthcare provider.

3. Lifestyle Modifications: Since you spend significant time on the computer, consider implementing ergonomic adjustments to your workstation. Take regular breaks (every 30-60 minutes) to stretch and change positions. This can help alleviate tension in your neck and shoulders.

4. Stress Management: Engage in stress-reducing activities such as yoga, meditation, or deep-breathing exercises. These can help mitigate tension headaches and improve overall well-being.

5. Hydration and Nutrition: Ensure you are well-hydrated and maintain a balanced diet. Dehydration and certain dietary triggers can exacerbate headaches.

6. Follow-Up: If your headaches worsen or new symptoms arise (such as visual disturbances, severe nausea, or neurological deficits), seek immediate medical attention.

In summary, while it is common to experience headaches after vaccination, the persistence and change in your headache pattern merit further investigation. Consulting with a neurologist will help clarify the cause of your symptoms and guide appropriate management. Your history of prolonged computer use and potential stress factors may also play a significant role in your current condition, so addressing these lifestyle factors is equally important.

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