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Risk of Febrile Seizures and Epilepsy after Vaccination with Diphtheria, Tetanus, Acellular Pertussis, Inactivated Poliovirus, and Haemophilus Influenzae Type B

2012; Elsevier BV; Volume: 43; Issue: 1 Linguagem: Inglês

10.1016/j.jemermed.2012.05.027

2352-5029

Austin Johnson,

SARS-CoV-2 and COVID-19 Research

Prior studies have demonstrated an increased risk of febrile seizures with whole-cell pertussis vaccine, but no studies to date have clearly demonstrated a significant increase in febrile seizures with an acellular pertussis vaccine. In this large cohort study from Denmark, 378,834 children were followed after 3, 5, and 12-month vaccinations with an acellular-pertussis-containing combination vaccine. Outcome measures included febrile seizures within 7 days of receiving the vaccine as well as rates of epilepsy diagnosis. Children outside the 7-day time window were used as controls. Over a 5-year time period, 7811 children under the age of 18 months were diagnosed with febrile seizures. Of these children, 17 were diagnosed within the first 7 days after the first vaccine, 32 children after the second vaccine, and 201 children after the third vaccine. Calculated hazard ratios (HR) of febrile seizures within the first week after each vaccination were not statistically significant. The risk of seizure on the first day after each vaccination, however, was increased after the 3-month vaccine (3-month vaccine HR 6.02, 95% confidence interval [CI] 2.86–12.65) and after the 5-month vaccine (HR 3.94, 95% CI 2.18–7.10), but not after the 12-month vaccine (HR 1.07, 95% CI 0.73–1.57). Patients were followed for 7 years after vaccination to monitor for the rate of epilepsy. There were 2117 children diagnosed with epilepsy, with 813 occurring between 3 and 15 months. When compared to children not vaccinated, vaccinated children had a lower risk of epilepsy between 3 and 15 months (HR 0.63, 95% CI 0.50–0.79), and there was no difference in epilepsy diagnosis later in life (HR 1.01, 95% CI 0.66–1.56). The authors concluded that although there is a small increased risk of febrile seizures after the first and second vaccinations, there was no increased risk of epilepsy overall later in life.