How do corticoids affect vaccination against SARS-CoV-2 for migraines, cluster headaches and other headaches?
- Therapy with prednisolone and other corticoids (“cortisone”), for example for the treatment of status migraenosus, cluster headaches or for the treatment of rebound headaches during a medication break in the case of medication overuse headache (MÜK), should not be carried out approximately 8 weeks before to 2 weeks after vaccinations with live vaccines become.
- However, the vaccines approved against SARS-CoV-2 so far are not live vaccines . Such non-live vaccines can be used without restrictions in patients with migraines and other headaches.
- Classic non-live vaccines (inactivated vaccines) that are in development for vaccination against SARS-CoV-2 are vaccines based on adjuvanted proteins.
- Vaccines based on non-replicable vectors (Astra-Zeneca) and mRNA vaccines (e.g. BioNTech/Pfizer and Moderna) are differentiated from live vaccines. Their use corresponds to that of inactivated vaccines.
- Vaccinations with such inactivated vaccines are generally possible for migraines, cluster headaches and other headaches.
- However, it should be noted that the immune response and thus the success of the vaccination can be impaired with higher doses of corticosteroids. For fundamental considerations regarding the effectiveness of a vaccination, the dosage of corticoids at the time of vaccination should therefore be as low as possible.
- There are no findings from the approval studies for treatments with immunomodulating/suppressing therapies such as corticosteroids.
- Treatment with corticosteroids can fundamentally influence vaccination responses. Vaccinations against Covid-19 should therefore take place at the earliest two weeks, preferably four weeks, after treatment with corticosteroids.
- After vaccination, corticosteroids should only be used after 14 days in order not to reduce the vaccination response.
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