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Febrile Seizure Risk After Vaccination in Children 6 to 23 Months

Jonathan Duffy1, Eric Weintraub2, Simon J Hambidge3

  • 1Immunization Safety Office, US Centers for Disease Control and Prevention, Atlanta, Georgia; jduffy@cdc.gov.

Pediatrics
|June 9, 2016
PubMed

Insights

Concomitant administration of the trivalent inactivated influenza vaccine (IIV3) with pneumococcal conjugate vaccine (PCV) or DTaP-containing vaccines increases febrile seizure (FS) risk in young children. The absolute risk remains small, but separate vaccination days are recommended for IIV3 combinations.

Area of Science:

  • Pediatric Vaccinology
  • Immunology
  • Epidemiology

Background:

  • Febrile seizures (FS) are a concern in young children post-vaccination.
  • Previous findings suggested an increased FS risk with co-administration of trivalent inactivated influenza vaccine (IIV3) and pneumococcal conjugate vaccine (PCV) 13-valent.

Purpose of the Study:

  • To investigate if co-administration of IIV3 with other routine vaccines impacts FS risk in children aged 6-23 months.

Main Methods:

  • A population-based self-controlled risk interval analysis was employed over five influenza seasons (2006-2011).
  • Risk intervals were analyzed for 0-1 day post-vaccination compared to a control interval of 14-20 days post-vaccination.
  • Multivariable regression controlled for concomitant vaccines and tested for interactions.

Main Results:

  • Pneumococcal conjugate vaccine (PCV) 7-valent showed an independent FS risk (IRR 1.98).
  • IIV3 alone did not show an independent risk (IRR 0.46).
  • Concomitant IIV3 with PCV or DTaP-containing vaccines significantly increased FS risk (IRR 3.50 for both). The excess risk was estimated at 30 FS per 100,000 persons.

Conclusions:

  • Administering IIV3 on the same day as PCV or DTaP-containing vaccines is associated with a higher risk of FS compared to separate administration days.
  • The absolute risk of post-vaccination FS with these combined vaccine schedules is low.
  • Consideration of separate vaccination days for IIV3 with PCV or DTaP vaccines may be warranted to minimize FS risk.
Abstract

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