Jonathan Duffy1, Simon J Hambidge2, Lisa A Jackson3, Elyse O Kharbanda4, Nicola P Klein5, Allison Naleway6, Saad B Omer7, Eric Weintraub8. 1. Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia. Electronic address: jduffy@cdc.gov. 2. Institute for Health Research, Kaiser Permanente Colorado and Ambulatory Care Services, Denver Health, Denver, Colorado. 3. Kaiser Permanente Washington Health Research Institute, Seattle, Washington. 4. HealthPartners Institute, Minneapolis, Minnesota. 5. Kaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California, Oakland, California. 6. Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon. 7. Kaiser Permanente Georgia and Emory University, Atlanta, Georgia. 8. Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia.
Abstract
BACKGROUND: The risk of febrile seizure is temporarily increased for a few days after the administration of certain vaccines in children aged six to 23 months. Our objective was to determine the febrile seizure risk following vaccination in children aged one to five months, when six different vaccines are typically administered. METHODS: We identified emergency department visits and inpatient admissions with International Classification of Diseases, Ninth Revision, febrile seizure codes among children enrolled in nine Vaccine Safety Datalink participating health care organizations from 2006 through 2011. Febrile seizures were confirmed by medical record abstraction. We used the self-controlled risk-interval method to compare the incidence of febrile seizure during postvaccination days 0 to 1 (risk interval) versus days 14 to 20 (control interval). RESULTS: We identified 15 febrile seizure cases that occurred after 585,342 vaccination visits. The case patients were aged three to five months. The patients had received a median of four (range two to six) vaccines simultaneously. The incidence rate ratio of febrile seizure after vaccination was 23 (95% confidence interval 5.13 to 100.8), and the attributable risk was 3.92 (95% confidence interval 1.68 to 6.17) febrile seizure cases per 100,000 persons vaccinated. CONCLUSIONS: Vaccination in children aged three to five months was associated with a large relative risk of febrile seizure on the day of and the day after vaccination, but the risk was small in absolute terms. Postvaccination febrile seizure should not be a concern for the vast majority of children receiving vaccines, but clinicians might take this risk into consideration when evaluating and treating children susceptible to seizures precipitated by fever. Published by Elsevier Inc.
BACKGROUND: The risk of febrile seizure is temporarily increased for a few days after the administration of certain vaccines in children aged six to 23 months. Our objective was to determine the febrile seizure risk following vaccination in children aged one to five months, when six different vaccines are typically administered. METHODS: We identified emergency department visits and inpatient admissions with International Classification of Diseases, Ninth Revision, febrile seizure codes among children enrolled in nine Vaccine Safety Datalink participating health care organizations from 2006 through 2011. Febrile seizures were confirmed by medical record abstraction. We used the self-controlled risk-interval method to compare the incidence of febrile seizure during postvaccination days 0 to 1 (risk interval) versus days 14 to 20 (control interval). RESULTS: We identified 15 febrile seizure cases that occurred after 585,342 vaccination visits. The case patients were aged three to five months. The patients had received a median of four (range two to six) vaccines simultaneously. The incidence rate ratio of febrile seizure after vaccination was 23 (95% confidence interval 5.13 to 100.8), and the attributable risk was 3.92 (95% confidence interval 1.68 to 6.17) febrile seizure cases per 100,000 persons vaccinated. CONCLUSIONS: Vaccination in children aged three to five months was associated with a large relative risk of febrile seizure on the day of and the day after vaccination, but the risk was small in absolute terms. Postvaccination febrile seizure should not be a concern for the vast majority of children receiving vaccines, but clinicians might take this risk into consideration when evaluating and treating children susceptible to seizures precipitated by fever. Published by Elsevier Inc.