Does COVID-19 or COVID-19 vaccination worsen migraines? ======================================================= **OCTOBER 04, 2023 -** Among 550 adults who had received migraine-related care at a Spanish headache clinic, 44.9% (247) reported COVID-19 at least once and 83.3% (458) had been vaccinated; 61 patients (24.7%) reported migraine worsening since COVID-19 and 52 (11.4%) since vaccination. In participants who perceived that their migraines worsened, those who had been infected were 2.5-times more likely to be concerned about migraine worsening and patients who had been vaccinated were 17.3-times more likely to have this concern. When investigators examined patients’ e-diary information, they observed no significant difference in headache frequency one month before and after infection or vaccination, even when comparing patients with and without self-reported migraine worsening. “In the case of COVID-19, we reported previously that indeed headache is a frequent and disabling symptom of the infection; yet, it may not necessarily be linked to an increase in migraine frequency,” the authors wrote. “In light of our results, we believe that clinicians should deliver to patients a more reassuring message that COVID-19 and COVID-19 vaccines may marginally affect migraine course and that probably the impact of the infection and vaccines is less than the individual rhythmicity to have attacks. This information may help minimize their worry.” *Full Citation: “Migraine worsening after COVID-19 and COVID-19 vaccination: Are we facing a nocebo effect?” Laura Melgarejo, Edoardo Caronna, Joana Rosell-Mirmi, Iker Elosua-Bayés, Alicia Alpuente, Marta Torres-Ferrus, Víctor J. Gallardo, and Patricia Pozo-Rosich. ean; Published Online: October 04, 2023 (DOI: [10.1111/ene.16058](http://smj.org.sa/lookup/doi/https://doi.org/10.1111/ene.16058)).* *URL Upon Publication: [http://doi.wiley.com/10.1111/ene.16058](http://doi.wiley.com/10.1111/ene.16058)* *Copyright © 2021 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd., reproduced with permission.* * Copyright: © Saudi Medical Journal This is an Open Access journal and articles published are distributed under the terms of the Creative Commons Attribution-NonCommercial License (CC BY-NC). Readers may copy, distribute, and display the work for non-commercial purposes with the proper citation of the original work.