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Covid-19 Primary Care Resources

Post AstraZeneca vaccination headache

Consider a face-to-face appointment for patients with post-vaccination headache

This information is sourced from the MHRA, Pulse today the RCGP and the University of Cambridge:

  • The benefits of the vaccine significantly outweigh risks, but the risk-benefit balance changes with age
  • The MHRA is investigating five cases of CSVT associated with thrombocytopaenia in the UK, which have occurred in the days after vaccination
  • This incidence is less than four per million people vaccinated
  • The MHRA have advised that anyone who has symptoms which develop four days or more after vaccination to seek medical attention
  • The headache of CSVT usually has features of raised intracranial pressure; generalised, progressive and worsens on lying down or straining. Some patients may have a ‘thunderclap’ headache
  • Some patients with CSVT will present with just an isolated headache
  • Abnormalities of eye movements should raise a red flag for hospital review
  • The RCGP advises that a normal FBC, D dimer and fibrinogen may be use to exclude thromboembolism with thrombocytopaenia in primary care but only if the patient is not acutely unwell and the blood results with be available, reviewed and acted upon the same day
  • A firm diagnosis of CSVT requires CT or MRI venography, or cerebral angiography
Red flags
• New onset of severe headache, which is getting worse and does not respond to simple painkillers
• An unusual headache that seems worse when lying down or bending over, or accompanied by blurred vision, nausea and vomiting, difficulty with speech, weakness, drowsiness or seizures
• New onset of unexplained pinprick bruising or bleeding
• Shortness of breath, chest pain, leg swelling or persistent abdominal pain

See also:

Covid vaccine resources for patients