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Risk of seizures and encephalopathy after immunization with the diphtheria-tetanus-pertussis vaccine
M R Griffin1, W A Ray, E A Mortimer
1Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, Tenn 37232-2637.
Insights
Diphtheria-tetanus-pertussis (DTP) immunizations were evaluated for neurological risks in children. While febrile seizures showed a slight increase shortly after DTP, no evidence linked it to epilepsy or developmental issues.
Area of Science:
- Pediatric Neurology
- Immunization Safety
- Public Health
Background:
- Concerns exist regarding potential neurological adverse events following childhood immunizations.
- The diphtheria-tetanus-pertussis (DTP) vaccine is a routine childhood immunization.
- Understanding the safety profile of DTP is crucial for public health policy.
Purpose of the Study:
- To assess the risk of seizures and other neurological events following DTP immunization in young children.
- To determine if DTP immunization is associated with an increased incidence of febrile seizures, afebrile seizures, or acute symptomatic seizures.
- To investigate the potential link between DTP immunization and the onset of epilepsy or other neurological abnormalities.
Main Methods:
- A retrospective cohort study was conducted using data from 38,171 Tennessee Medicaid children.
- The study analyzed 107,154 DTP immunizations administered within the first 3 years of life.
- Risk periods were compared: 0-3 days post-DTP versus a control period of 30+ days post-DTP.
Main Results:
- A small, statistically non-significant increase in febrile seizures was observed within 0-3 days post-DTP (Risk Ratio = 1.5).
- No increased risk of afebrile seizures or acute symptomatic seizures was detected in the immediate post-immunization period.
- No previously healthy children without a seizure history experienced seizures that marked the onset of epilepsy or developmental abnormalities following DTP.
Conclusions:
- DTP immunization is not associated with an increased risk of afebrile seizures or acute symptomatic seizures.
- The observed slight increase in febrile seizures following DTP is not linked to the development of epilepsy or long-term neurological issues.
- The study supports the safety of DTP immunization regarding neurological adverse events in children.
Abstract:
We evaluated the risks of seizures and other neurological events following diphtheria-tetanus-pertussis (DTP) immunization for 38,171 Tennessee Medicaid children who received 107,154 DTP immunizations in their first 3 years of life. There were 2 children with encephalitis; both had disease onset more than 2 weeks following DTP immunization. There were 277 children who had febrile seizures, 42 with afebrile seizures, and 37 with seizures associated with other acute neurological illness (acute symptomatic). The risk of febrile seizures in the 0 to 3 days following DTP immunization (n = 6) was 1.5 (95% confidence interval, 0.6 to 3.3) times that of the control period 30 or more days following DTP immunization. There was no evidence that in the 0 to 3 days following DTP immunization the risk of afebrile seizures (n = 1) or acute symptomatic seizures (n = 0) was increased. No child who was previously normal without a prior history of seizures had a seizure in the 0 to 3 days following immunization that marked the onset of either epilepsy or other neurological or developmental abnormality.