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Febrile seizures following vaccination do not impact on children’s development or behaviour

2020; American Academy of Pediatrics; Volume: 146; Issue: 1_MeetingAbstract Linguagem: Inglês

10.1542/peds.146.1ma7.588b

1098-4275

Lucy Deng, Nicholas Wood, Kristine Macartney, Michael Gold, Nigel W. Crawford, Jim Buttery, Peter Richmond, Belinda Barton,

Influenza Virus Research Studies

Purpose Febrile seizures (FSs) occur in 3-5% of children under 6 years of age, with peak incidence in the second year of life. This coincides with the timing of the first dose of measles-containing vaccine in the United States, which has been shown to have a two-fold increased risk of FS in the two weeks following vaccination. Whole-cell pertussis and some influenza vaccines in combination with pneumococcal vaccines have also been associated with an increased rate of FSs when fever peaks after vaccination. Concerns about potential adverse neurocognitive outcomes following a vaccine proximate febrile seizure (VP-FS) can affect public and immunisation provider confidence in vaccine safety and impact on receipt of further vaccines. In this study, we compared the developmental and behavioural outcomes of children who have experienced an initial VP-FS to children who have had a non-vaccine proximate FS (NVP-FS) and to healthy controls who have not had a seizure. Methods This first ever prospective case-control study was conducted across four tertiary paediatric hospitals. Children who had their first FS before 30 months of age between May 2013 and April 2016 were recruited. They were either recruited as a VP-FS case, defined as a FS occurring on day 0-2 following receipt of an inactivated vaccine, day 5-14 following a live-attenuated vaccine or day 0-14 following a combination of inactivated and live-attenuated vaccines or an NVP-FS participant, defined as a FS outside of this period. Similar aged children with no history of seizures were recruited as controls. The Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) was administered to all FS participants 12-24 months following their initial FS and controls of similar age to VP-FS cases at the time of their assessment. Pre-academic skills of children were assessed using Woodcock-Johnson Tests of Achievement, Third Edition. Parents rated their child’s behaviour and executive functioning using Behaviour Rating Inventory of Executive Function, Preschool Version and Child Behaviour Checklist – Preschool. The primary outcome was the Bayley-III cognitive score. Results There was no significant difference in cognitive function between VP-FS (n=62), NVP-FS (n=70) and controls (n=86) (F(2,215)= 2.142, P=0.12). There was no significant difference between the groups for all other measures and no increased risk of borderline/significant developmental impairment or clinically significant behaviour in children with VP-FS or NVP-FS when compared to controls. Socio-economic status (maternal education) was the only significant predictor of cognitive functioning for children who had a FS (B=1.628, P=0.04). Conclusion VP-FS were not associated with an increased risk of cognitive, developmental or behavioural problems in young children compared to children with NVP-FS or healthy controls. This study provides important reassurance for parents and providers on the absence of adverse effects of VP-FS on the developmental functioning of children.