Migraine Treatment and COVID-19 Vaccines

As COVID-19 vaccines have become available — including Pfizer, Moderna, and Johnson & Johnson — many individuals who experience migraines and other headache disorders have wondered if those vaccines will impact their current, or potential, migraine treatments. Although there’s currently no published data looking at whether COVID-19 vaccines adversely impact migraine treatment efficacy or inversely, whether migraine treatments impair the safety or efficacy of the vaccine, experts have weighed in to provide helpful information for patients who experience migraines and other headache disorders.

Acetaminophen and NSAIDs

If you’re worried about getting a headache after having the COVID-19 vaccine, it is important to avoid pre-medicating. The CDC does not recommend that you use acetaminophen (also known as Tylenol) or NSAIDs (like ibuprofen and naproxen, also known as Motrin and Aleve) to pre-medicate before you receive the vaccine. However, if you develop a headache after the vaccine, these medicines can be taken to treat your symptoms. In some trials, Acetaminophen was used after the vaccine was administered to treat mild side effects without any signs of affecting the body’s antibody response. Of course, if you have questions about other oral migraine treatments you take and whether you should take them right after receiving the vaccine, you should speak with your healthcare professional.

Botox Injections

Botox injections, also known as onabotulinumtoxinA injections, are often used to treat migraines. Some patients have questioned whether they need to avoid or delay getting their vaccine if they receive these injections. Currently, there’s no reason to believe that Botox injections for migraine treatment will impair the body’s immune response when receiving the COVID-19 vaccine.

The FDA reported that two vaccine trial participants had some facial swelling in areas where they received dermal fillers after getting the vaccine. However, onabotulinumtoxinA injections for migraines aren’t considered dermal fillers, so this reaction observation isn’t pertinent to you if you’re receiving this type of injection to treat your migraines.

CGRP Monoclonal Antibodies (Aimovig, Ajovy, Vyepti, Emgality)

During the clinical trials of COVID-19 vaccines, participants weren’t permitted to have other types of vaccines within the two weeks before or after receiving the COVID-19 vaccine. It’s important to note that CGRP monoclonal antibody (mAb) treatments, a common treatment for migraine sufferers, weren’t specifically excluded or prohibited. Some scientists believe that theoretically, there may be a risk that the vaccine causes an immune response that may weaken the efficacy of CGRP antibodies, but no direct evidence has been found.

To avoid any problems, it’s good to discuss the timing of your CGRP injections with your doctor before and after you plan to receive the vaccine. It’s also recommended to inject subcutaneous mABs on the opposite arm from the one in which the COVID-19 vaccine was given, or choose the abdomen or thigh for injection instead.

According to experts, at this time, there’s no reason to be concerned about getting the COVID-19 vaccine, even if you get Botox injections, receive CGRP monoclonal antibodies, or use other types of migraine and treatments. If you still feel concerned, discuss the vaccine and your treatment timing with your physician.

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