87 Effect of COVID vaccination on monthly migraine days 4 Table 2. Change in Monthly Migraine Days (MMD), Monthly Headache Days (MHD), and Monthly Acute Medication Days (MAMD) for month 1 and month 2 post COVID-19 infection compared to the baseline month. One month is defined as 28 days. Total months of E-diary data was n=150 months from n=59 participants. Estimates 95% confidence interval P-value Monthly Migraine Days (MMD) Month 1 0.08 -0.84 – 0.99 0.867 Month 2 -0.54 -2.06 – 0.99 0.490 Monthly Headache Days (MHD) Month 1 0.85 -0.20 – 1.90 0.112 Month 2 0.85 -0.92 – 2.62 0.342 Monthly Acute Medication Days (MAMD) Month 1 1.11 0.32 – 1.89 0.006 Month 2 -0.28 -1.59 – 1.04 0.678 Effect of COVID-19 vaccination We found an increase in MMD in month 1 after vaccination compared to the baseline month (1.06; 95% CI = 0.57–1.55; p < 0.001) (Figure 2a). Analysis of marginal effects showed a significant difference in MMD between month 1 and month 2 post-vaccination (0.59; 95% CI = 0.00–1.17; p = 0.049), indicating that, in month 1, more MMD occurred compared to month 2 post-vaccination. Additionally, we found an increase in both MHD (1.52; 95% CI = 0.91–2.14, p < 0.001) and MAMD (0.72; 95% CI = 0.33–1.12; p < 0.001) in month 1 post-vaccination. Crude means without statistical modelling are visualized in Figure 2, adjusted estimates per outcome are shown in Table 3. Subgroup analysis showed an increase in both analgetic intake (0.49; 95% CI = 0.15–0.84; p = 0.005) and triptan intake (0.51; 95% CI = 0.22–0.80; p = 0.001) in month 1 after vaccination compared to the baseline month. Lastly, solely for the mRNA vaccination we found an increase in MMD in month 1 after vaccination compared to the baseline month (0.50; 95% CI = −0.54 to 1.55; p = 0.347) (supplementary Table 2). Analysis of marginal effects showed no evidence to suggest a difference between the effect of the mRNA vaccines and the viral vector vaccines on the number of MMD (0.50; 95% CI = 0.00–1.00; p = 0.35).
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