{
  "abstract": "Cluster headache (CH) is among the most severe primary pain disorders and can be highly refractory to conventional treatment. Although SARS-CoV-2 infection and mRNA vaccination have been predominantly linked to the exacerbation or new onset of CH, we here report the case of a 26-year-old male with a seven-year history of refractory chronic CH (cCH) who experienced a rapid and sustained complete remission (CR) following SARS-CoV-2 mRNA booster vaccination. This remission, documented by daily pain intensity ratings on a numerical rating scale (NRS, 0–10) derived from a prospectively maintained headache diary, was characterized by an abrupt cessation of high-intensity nocturnal attacks immediately following vaccination. After sustained remission of the previous chronic nightly attack pattern, the patient subsequently developed recurrent CH activity; a subsequent JN.1-adapted mRNA vaccination was again followed by rapid remission. The repeated close temporal association between vaccination and remission is notable, although spontaneous disease fluctuation cannot be excluded in a single-patient observation. To characterize the immunological environment accompanying clinical remission, we performed longitudinal multiparametric immunophenotyping of peripheral blood at three time points surrounding the 2025 vaccination event. We observed a transient expansion of natural killer (NK) cells and monocytes, upregulation of the checkpoint marker PD-1 on CD4+ T cells, and expansion of myeloid-derived suppressor cells (MDSCs), observed in temporal association with the onset of CR. Antigen-specific stimulation assays revealed a concurrent induction of IFN-γ and TNF-α producing CD4+ T cells, consistent with a TH1-polarized immune response. To our knowledge, this is the first report of a reproducible, vaccination-induced CR in chronic CH, supported by high-resolution clinical and immunological longitudinal data. The findings suggest that targeted immune activation may be capable of resetting pathological neuro-immune circuits in refractory headache disorders and warrant prospective investigation.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "Case Report",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "name": "Simon Göttlich"
    },
    {
      "name": "Jernej Pusnik"
    },
    {
      "name": "Emmanuil Osypchuk"
    },
    {
      "name": "Hendrik Streeck"
    },
    {
      "name": "Stefanie Andrea Erika Held"
    },
    {
      "name": "Anne-Katrin Pröbstel"
    },
    {
      "name": "Peter Brossart"
    },
    {
      "name": "Christian R. Klein"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/8vha6at6k68xd.bib",
  "cited_by": 0,
  "doi": "10.3389/fimmu.2026.1969032",
  "fulltext_url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1969032/full",
  "id": "8vha6at6k68xd",
  "issns": [
    "1664-3224"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1969032",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "feed-journal",
      "biology/immunology"
    ],
    [
      "lcc",
      "RC581-607"
    ]
  ],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-05",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/8vha6at6k68xd.ris",
  "sources": [
    {
      "first_seen": "2026-11-05T12:20:13Z",
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      "url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1969032"
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      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1969032/full"
    },
    {
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      "url": "https://doi.org/10.3389/fimmu.2026.1969032"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "feed-journal:biology/immunology",
      "subfield": "immunology"
    },
    {
      "field": "medicine",
      "origin": "lcc:RC581-607",
      "subfield": "general"
    }
  ],
  "title": "Reproducible cluster headache remission following SARS-CoV-2 mRNA vaccination: a case report",
  "title_text": "Reproducible cluster headache remission following SARS-CoV-2 mRNA vaccination: a case report",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T14:20:36Z",
  "url": "https://research.draconitic.com/paper/8vha6at6k68xd",
  "venue": "Frontiers in Immunology",
  "versions": []
}