![]() ![]() SMR is also known as observed-to-expected analysis, which analyses the ratio between the observed number of cases in the population over the number of cases that would be expected based on the baseline incidence according to databases and prior studies. There was a higher mortality rate than in other CVT series reported in the literature and an increased standardized morbidity ratio (SMR) in patients aged between 30 and 49. The association was based on the presence of thrombocytopenia, anti-platelet factor 4 antibodies, and multiple organ thrombosis (vaccine-induced immune thrombotic thrombocytopenia (VITT)). Several cases of cerebral venous thrombosis (CVT) have been reported in non-replicant adenovirus vector-based COVID-19 vaccine recipients (Oxford-AstraZeneca ChAdOx1-S and Johnson & Johnson (J&J) Janssen Ad26.COV2S). Headache typically presents within the first 72 h post-vaccination and may be associated with additional symptoms, such as fatigue, fever, myalgia, arthralgia, or diarrhea. It is reported by approximately half of the vaccine recipients, both in clinical trials and real-world data. Headache is within the most frequent adverse effects following coronavirus disease 2019 (COVID-19) immunization. Patients with new-onset headache, 1 week after vaccination with an adenovirus vector-based vaccine, should receive a thorough clinical evaluation and CVT must be ruled out. Conclusionĭelayed onset of headache following an adenovirus vector-based COVID-19 vaccine is associated with development of CVT. The median time between vaccination and CVT-related headache onset was 8 (interquartile range 7.0–9.7) days. Multiple organ thrombosis was reported in 19/77 (24.7%) cases, intracranial hemorrhage in 33/77 (42.9%) cases and 19/77 (24.7%) patients died. Headache was described in 38/77 (49.4%) cases, and in 35/38 (92.1%) was associated with other symptoms. We identified 77 cases of CVT after COVID-19 vaccination. We assessed whether the presence of headache was associated with higher probability of death or intracranial hemorrhage. We assessed demographic, clinical variables and the interval between the vaccination and onset of headache. We reviewed all vaccine related CVT published cases by April 30, 2021. Cases of cerebral venous thrombosis (CVT) have been reported in adenovirus vector-based COVID-19 vaccine recipients. Headache is a frequent symptom following COVID-19 immunization with a typical onset within days post-vaccination. ![]()
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