Status epilepticus outcomes among vaccinated and unvaccinated children: A population-based study

Area of Science:

• Pediatric Neurology
• Vaccinology
• Epidemiology

Background:

• Status epilepticus (SE) is a neurological emergency requiring prompt diagnosis and management.
• The relationship between vaccination and the incidence of SE requires further investigation.
• Understanding SE in relation to vaccination can inform public health strategies and clinical care.

Purpose of the Study:

• To determine the proportion of first-time SE cases that occur proximate to vaccination (VP-SE).
• To compare clinical outcomes, including severity and recurrence, between VP-SE and non-vaccine-proximate SE (NVP-SE) cases.
• To analyze vaccination coverage rates following SE events.

Main Methods:

• Probabilistic linkage of birth records (1,440,807 children, 1998-2012) with hospitalization and vaccination data.
• Categorization of first SE hospitalizations as VP-SE or NVP-SE.
• Comparison of clinical severity (e.g., ICU admission, coinfection) and 12-month SE recurrence rates between groups.

Main Results:

• 3.6% of 867 first SE cases were VP-SE; most followed measles vaccine dose 1.
• VP-SE cases were significantly younger and had longer hospitalizations than NVP-SE cases.
• ICU admission was associated with coinfection and younger age, not VP-SE; SE recurrence rates were similar, but post-SE vaccine uptake decreased significantly.

Conclusions:

• While proportionally few SE cases are vaccine-proximate, they present with distinct characteristics, including younger age and higher coinfection rates.
• Intensive care unit admission in VP-SE is primarily linked to younger age and coinfection, rather than the vaccine proximity itself.
• There is a critical need for targeted vaccination plans to improve vaccine uptake in children following an SE event.