Immediate and 6-month seizure outcomes following first and second SARS-CoV2 mRNA vaccinations: A multicenter study with a nationwide survey

Nonaka, Megumi; Neshige, Shuichiro; Yamada, Hidetada; Ishibashi, H.; Takebayashi, Yoshiko; Nakamori, Masahiro; Aoki, Shiro; Yamazaki, Yu; Shishido, Takeo; Agari, Dai; Ochi, Kazuhide; Iida, Koji; Makino, Hírofumi

doi:10.1016/j.yebeh.2022.109070

Cited by 3 publications

(1 citation statement)

References 36 publications

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“…Meanwhile, seizure freedom for 3 months prior to vaccination was associated with a lower risk of PVSA. This trend was consistent with previous studies [ 21 , 25 ]. This finding was also independent of drug-resistant status, epilepsy classification and etiology.…”

Section: Discussionsupporting

confidence: 94%

Risk of Seizure Aggravation after COVID-19 Vaccinations in Patients with Epilepsy

Leung,

Ho,

Leung

et al. 2024

Vaccines

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Although Coronavirus disease 2019 (COVID-19) vaccinations are generally recommended for persons with epilepsy (PwE), a significant vaccination gap remains due to patient concerns over the risk of post-vaccination seizure aggravation (PVSA). In this single-centre, retrospective cohort study, we aimed to determine the early (7-day) and delayed (30-day) risk of PVSA, and to identify clinical predictors of PVSA among PwE. Adult epilepsy patients aged ≥18 years without a history of COVID-19 infection were recruited from a specialty epilepsy clinic in early 2022. Demographic, epilepsy characteristics, and vaccination data were extracted from a centralized electronic patient record. Seizure frequency before and after vaccination, vaccination-related adverse effects, and reasons for or against vaccination were obtained by a structured questionnaire. A total of 786 PwEs were included, of which 27.0% were drug-resistant. At the time of recruitment, 74.6% had at least 1 dose of the COVID-19 vaccine. Subjects with higher seizure frequency (p < 0.0005), on more anti-seizure medications (p = 0.004), or had drug-resistant epilepsy (p = 0.001) were less likely to be vaccinated. No significant increase in seizure frequency was observed in the early (7 days) and delayed phases (30 days) after vaccination in our cohort. On the contrary, there was an overall significant reduction in seizure frequency 30 days after vaccination (1.31 vs. 1.89, t = 3.436; p = 0.001). This difference was seen in both types of vaccine (BNT162b2 and CoronaVac) and drug-resistant epilepsy, but just missed significance for the second dose (1.13 vs. 1.87, t = 1.921; p = 0.055). Only 5.3% had PVSA after either dose of vaccine. Higher pre-vaccination seizure frequency of ≥1 per week (OR 3.01, 95% CI 1.05–8.62; p = 0.04) and drug-resistant status (OR 3.32, 95% CI 1.45–249 7.61; p = 0.005) were predictive of PVSA. Meanwhile, seizure freedom for 3 months before vaccination was independently associated with a lower risk of PVSA (OR 0.11, 95% CI 0.04–0.28; p < 0.0005). This may guide epilepsy treatment strategies to achieve better seizure control for at least 3 months prior to vaccination. As COVID-19 shifts to an endemic phase, this study provides important data demonstrating the overall safety of COVID-19 vaccinations among PwE. Identification of high-risk patients with subsequent individualized approaches in treatment and monitoring strategies may alleviate vaccination hesitancy among PwE.

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Section: Discussionsupporting

confidence: 94%

Risk of Seizure Aggravation after COVID-19 Vaccinations in Patients with Epilepsy

Leung,

Ho,

Leung

et al. 2024

Vaccines

View full text Add to dashboard Cite

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The COVID-19 pfizer BioNTech mRNA vaccine and the frequency of seizures

Doron,

Eviatar-Ribak,

Vituri

et al. 2023

Clinical Neurology and Neurosurgery

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Deaths Related to New-Onset Seizures After Vaccination

Prahlow

2024

Academic Forensic Pathology

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Background: Adverse effects following vaccination are well-known. While most effects are mild and transient, some may be severe or even lethal. Particularly with regard to coronavirus disease 2019 (COVID-19) vaccinations, which were “fast-tracked,” it is incumbent upon the medical community to be diligent in identifying potential vaccine-associated adverse events so that physicians and patients can make truly informed decisions when considering the risks versus benefits of vaccination. Objective: To provide an in-depth discussion about post-vaccination seizures, particularly with regard to COVID-19 vaccinations. Research Design: Retrospective review of two cases where death was deemed to be the result of new-onset seizures; in each case, the seizures began shortly following vaccination. Subjects: In one case, death was certified by the primary care physician, without implicating the recent COVID-19 vaccination. In the other case, certified by the medical examiner, recent simultaneous vaccination with a COVID-19 vaccine and an influenza vaccine were considered to be contributory to death. Measures: The case specifics are presented for each case, including clinical work-up (both cases) and autopsy findings (one case). Conclusions: When attempting to determine whether or not a seizure-related death is due to a vaccine-induced new-onset seizure disorder, forensic pathologists need to rule-out other explanations for the seizures. Although a temporal association between seizures and vaccination is not sufficient, in and of itself, to prove causality, the temporal association, in combination with the absence of another explanation for seizures, and knowledge of similar cases in the medical literature, is sufficient to ascribe a causal role to the vaccination.

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Immediate and 6-month seizure outcomes following first and second SARS-CoV2 mRNA vaccinations: A multicenter study with a nationwide survey

Cited by 3 publications

References 36 publications

Risk of Seizure Aggravation after COVID-19 Vaccinations in Patients with Epilepsy

Risk of Seizure Aggravation after COVID-19 Vaccinations in Patients with Epilepsy

The COVID-19 pfizer BioNTech mRNA vaccine and the frequency of seizures

Deaths Related to New-Onset Seizures After Vaccination

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