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Effect of inactivated COVID-19 vaccines on seizure frequency in patients with epilepsy: A multicenter, prospective study.
Fang, Xiqin; Hu, Shimin; Han, Tao; Yang, Tingting; Hu, Junji; Song, Yucheng; Li, Chunxiang; Ma, Aihua; Li, Yufeng; Kong, Qingxia; Tang, Liou; Chen, Wei; Sun, Wenxiu; Fang, Chunyan; Sun, Yanping; Chen, Juan; Sun, Wenying; Yan, Yibing; Gao, Yuxing; Geng, Jianhong; Li, Nan; Li, Qiubo; Jiang, Zhaolun; Lv, Shishen; Li, Wenke; Lang, Xiaoling; Wang, Suli; Chen, Yanxiu; Li, Baomin; Li, Ling; Liu, Xinjie; Liu, Yong; Zhan, Yan; Gao, Zaifen; Qu, Lixin; Fu, Qingxi; Liu, Xuewu.
  • Fang X; Department of Neurology, Qilu Hospital, Shandong University, Jinan, China.
  • Hu S; Institute of Epilepsy, Shandong University, Jinan, China.
  • Han T; Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
  • Yang T; Beijing Key Laboratory of Neuromodulation, Beijing, China.
  • Hu J; Institute of Sleep and Consciousness Disorders, Center of Epilepsy, Beijing institute for Brain Disorders, Capital Medical University, Beijing, China.
  • Song Y; Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China.
  • Li C; Department of Neurology, Qilu Hospital, Shandong University, Jinan, China.
  • Ma A; Institute of Epilepsy, Shandong University, Jinan, China.
  • Li Y; Department of Neurology, Zibo Changguo Hospital, Zibo, China.
  • Kong Q; Department of Neurology, Jining City Dai Zhuang Hospital, Jining, China.
  • Tang L; Department of Pediatrics, Yantai Yuhuangding Hospital, Yantai, China.
  • Chen W; Department of Pediatrics, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China.
  • Sun W; Department of Pediatrics, Linyi People's Hospital, Linyi, China.
  • Fang C; Department of Neurology, Affiliated Hospital of Jining Medical, Jining, China.
  • Sun Y; Department of Neurology, Affiliated Hospital of Qingdao University, Qingdao, China.
  • Chen J; Department of Neurosurgery, Liaocheng People's Hospital, Liaocheng, China.
  • Sun W; Department of Pediatrics, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China.
  • Yan Y; Department of Neurology, Zhucheng People's Hospital, Zhucheng, China.
  • Gao Y; Department of Neurology, Affiliated Hospital of Qingdao University, Qingdao, China.
  • Geng J; Department of Neurology, Heze Third People's Hospital, Heze, China.
  • Li N; Department of Pediatrics, Liaocheng People's Hospital, Liaocheng, China.
  • Li Q; Department of Neurosurgery, The First Affiliated Hospital of Shandong First Medical University, Jinan, China.
  • Jiang Z; Department of Pediatrics, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China.
  • Lv S; Department of Neurology, Affiliated Hospital of Weifang Medical College, Weifang, China.
  • Li W; Department of Neurology, Shengli Oilfield Central Hospital, Dongying, China.
  • Lang X; Department of Pediatrics, Affiliated Hospital of Jining Medical, Jining, China.
  • Wang S; Department of Pediatrics, Tengzhou Central People's Hospital, Zaozhuang, China.
  • Chen Y; Department of Pediatrics, Tengzhou Central People's Hospital, Zaozhuang, China.
  • Li B; Department of Pediatrics, Tengzhou Central People's Hospital, Zaozhuang, China.
  • Li L; Department of Neurology, Laizhou People's Hospital, Qingdao, China.
  • Liu X; Department of Pediatrics, Weifang Maternal and Child Health Care Hospital, Weifang, China.
  • Liu Y; Department of Neurology, Liaocheng People's Hospital, Liaocheng, China.
  • Zhan Y; Department of Pediatrics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
  • Gao Z; Department of Neurology, Qilu Hospital of Shandong University (Qingdao), Qingdao, China.
  • Qu L; Department of Pediatrics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
  • Fu Q; Department of Pediatrics, Qilu Children's Hospital of Shandong University, Jinan, China.
  • Liu X; Department of Neurology, Affiliated Hospital of Binzhou Medical College, Yantai, China.
Front Immunol ; 13: 984789, 2022.
Article in English | MEDLINE | ID: covidwho-2198860
ABSTRACT

Objectives:

Several COVID-19 vaccines list "uncontrolled epilepsy" as a contraindication for vaccination. This consequently restricts vaccination against COVID-19 in patients with epilepsy (PWE). However, there is no strong evidence that COVID-19 vaccination can exacerbate conditions in PWE. This study aims to determine the impact of COVID-19 vaccination on PWE.

Methods:

PWE were prospectively recruited from 25 epilepsy centers. We recorded the seizure frequency at three time periods (one month before the first vaccination and one month after the first and second vaccinations). A generalized linear mixed-effects model (GLMM) was used for analysis, and the adjusted incidence rate ratio (AIRR) with 95% CI was presented and interpreted accordingly.

Results:

Overall, 859 PWE were included in the analysis. Thirty-one (3.6%) and 35 (4.1%) patients were found to have increased seizure frequency after the two doses, respectively. Age had an interaction with time. The seizure frequency in adults decreased by 81% after the first dose (AIRR=0.19, 95% CI0.11-0.34) and 85% after the second dose (AIRR=0.16, 95% CI0.08-0.30). In juveniles (<18), it was 25% (AIRR=0.75, 95% CI0.42-1.34) and 51% (AIRR=0.49, 95% CI0.25-0.95), respectively. Interval between the last seizure before vaccination and the first dose of vaccination (ILSFV) had a significant effect on seizure frequency after vaccination. Seizure frequency in PWE with hereditary epilepsy after vaccination was significantly higher than that in PWE with unknown etiology (AIRR=1.95, 95% CI 1.17-3.24). Two hundred and seventeen (25.3%) patients experienced non-epileptic but not serious adverse reactions.

Discussion:

The inactivated COVID-19 vaccine does not significantly increase seizure frequency in PWE. The limitations of vaccination in PWE should focus on aspects other than control status. Juvenile PWE should be of greater concern after vaccination because they have lower safety. Finally, PWE should not reduce the dosage of anti-seizure medication during the peri-vaccination period.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Epilepsy / COVID-19 Type of study: Cohort study / Etiology study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid / Vaccines Limits: Adult / Humans Language: English Journal: Front Immunol Year: 2022 Document Type: Article Affiliation country: Fimmu.2022.984789

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Epilepsy / COVID-19 Type of study: Cohort study / Etiology study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid / Vaccines Limits: Adult / Humans Language: English Journal: Front Immunol Year: 2022 Document Type: Article Affiliation country: Fimmu.2022.984789