Background & Aims

The development of COVID-19 vaccines has succeeded against the SARS-CoV-2 pandemic by decreasing the risk of mortality and severe illness. However, COVID-19 vaccines may as all other vaccinations cause some adverse effects (1). One frequent adverse effect after COVID-19 vaccines is pain. A meta-analysis found headache to be the third most common adverse event effect COVID-19 vaccine with an incidence of 22% after the first dose and 29% after the second dose (2). Musculoskeletal pain symptoms have been reported as adverse effects after COVID-19 vaccination (3).
This study aimed to analyze the development of pain symptoms after consecutive doses of the COVID-19 vaccine in a large cohort of Danish COVID-19 survivors on average 20 months after the SARS-CoV-2 infection.

Methods

Participants were included if they had at least one SARS-CoV-2 infection (a positive reverse transcription polymerase chain reaction test, RT-PCR) between March 2020 and December 2021. A self-administered survey (SurveyXact, Rambøll Management Consulting A/S) open for five weeks was sent via Digital Post (a national public system for electronic mail to citizens) to all. The survey investigated the presence, location, and features of pain symptoms developed after each given COVID-19 vaccine dose in a time interval ranging between 8 and 32 months after the initial infection. Clinical data were collected from medical records and the Danish Health Data Authority (DHDA). For each dose or booster COVID-19 vaccine (one, two, three, or more), the location of pain symptoms was analyzed.

Results

Data from 17,938 COVID-19 survivors were included. The prevalence of pain symptoms was higher after the first dose of after COVID-19 vaccine and decreased progressively with consecutive doses or booster(s) (all, P<0.01) within all post-vaccination pain types except breathing pain (4.8%, over 5.3%, to 4.2% in individuals having received 1, 2 or 3 vaccination doses, respectively (P<0.01). According to the number of vaccine doses (1, 2, or 3) headache prevalence was reduced from 29.7% to 17.8% (P<0.001), joint pain from 25.7% to 21.1% (p=0.003), widespread muscle pain from 24.0% to 20.5% (P<0.004), neck or shoulder pain from 18.7% to 12.5% (P<0.001), back pain from 10.6% to 8.1% (P<0.001), and throat pain from 6.5% to 3.8% (P<0.001)Given the time since the development of COVID-19 vaccines, more people have received multiple boosters over time, hence the number of individuals in each group increases.

Conclusions

This study is the first to specifically investigate the incidence of pain symptoms in a large nationwide cohort population considering the number of vaccine doses (booster) received. The results revealed that the presence of pain as an adverse event of COVID-19 was lower with consecutive doses.

References

This study is the first to specifically investigate the incidence of pain symptoms in a large nationwide cohort population considering the number of vaccine doses (booster) received. The results revealed that the presence of pain as an adverse event of COVID-19 was lower with consecutive doses.
References
1: Yasmin F, Najeeb H, Naeem U, Moeed A, Atif AR, Asghar MS, Nimri N, Saleem M, Bandyopadhyay D, Krittanawong C, Fadelallah Eljack MM, Tahir MJ, Waqar F. Adverse events following COVID-19 mRNA vaccines: A systematic review of cardiovascular complication, thrombosis, and thrombocytopenia. Immun Inflamm Dis. 2023; 11: e807.
2: Castaldo M, Waliszewska-Prosó? M, Koutsokera M, Robotti M, Straburzy?ski M, Apostolakopoulou L, Capizzi M, Çibuku O, Ambat FDF, Frattale I, Gadzhieva Z, Gallo E, Gryglas-Dworak A, Halili G, Jusupova A, Koperskaya Y, Leheste AR, Manzo ML, Marcinnò A, Marino A, Mikulenka P, Ong BE, Polat B, Popovic Z, Rivera-Mancilla E, Roceanu AM, Rollo E, Romozzi M, Ruscitto C, Scotto di Clemente F, Strauss S, Taranta V, Terhart M, Tychenko I, Vigneri S, Misiak B, Martelletti P, Raggi A; European Headache Federation School of Advanced Studies (EHF-SAS). Headache onset after vaccination against SARS-CoV-2: a systematic literature review and meta-analysis. J Headache Pain. 2022; 23: 41.
3: Bass JR, Poland GA. Shoulder injury related to vaccine administration (SIRVA) after COVID-19 vaccination. Vaccine. 2022; 40: 4964-4971.

Presenting Author

Brian Duborg Ebbesen

Poster Authors

Brian Ebbesen

MSc

Aalborg University

Lead Author

E-mail

Rocco Giordano

Center for Neuroplasticity and Pain, HST, Faculty of Medicine, Aalborg University, Aalborg, DK

Lead Author

E-mail

Juan Antonio Valera-Calero

prof

Universidad Complutense de Madrid, Madrid, Spain

Lead Author

E-mail

César Fernández-de-las-Peñas

dr med sci

Universidad Rey Juan Carlos (URJC), Madrid, Spain

Lead Author

E-mail

Lars Arendt-Nielsen

PhD

Aalborg University

Lead Author

E-mail

Topics

  • Epidemiology