Seizures following vaccination in children: Risks, outcomes and management of subsequent revaccination

Area of Science:

• Pediatric Neurology
• Vaccinology
• Epileptology

Background:

• Seizures and status epilepticus can occur within 14 days of inactivated and live-attenuated vaccine administration.
• These events, termed vaccine-proximate seizures, can impact parental vaccine confidence and future immunization decisions.
• Vaccine-proximate status epilepticus (VP-SE) is rare but can be an initial sign of genetic developmental epileptic encephalopathies, such as Dravet syndrome.

Purpose of the Study:

• To review the risks and outcomes associated with vaccine-proximate seizures.
• To outline management strategies for subsequent revaccination in children experiencing these events, using clinical scenarios.

Main Methods:

• Literature review of vaccine-proximate seizures and status epilepticus.
• Analysis of clinical outcomes and revaccination protocols.
• Case study approach to illustrate management.

Main Results:

• Vaccine-proximate febrile seizures (VP-FSs) have outcomes similar to other febrile seizures, with no increased developmental or behavioral concerns.
• Children with VP-FSs can be safely vaccinated in community settings.
• Vaccine-proximate status epilepticus (VP-SE) necessitates specialist consultation, genetic epilepsy testing, and supervised revaccination.

Conclusions:

• Careful evaluation of seizure type, duration, and vaccine is crucial for determining safe revaccination strategies.
• Distinguishing between VP-FSs and VP-SE is essential for appropriate management and parental counseling.
• Specialist referral and supervised vaccination are recommended for VP-SE cases to ensure safety and address underlying genetic conditions.