Lucy Deng1,2, Heather Gidding3,4,5, Kristine Macartney3,2, Nigel Crawford6,7, Jim Buttery6,8, Michael Gold9,10, Peter Richmond11,12, Nicholas Wood3,2. 1. National Centre for Immunisation Research and Surveillance, Children's Hospital at Westmead, Sydney, Australia; lucy.deng@health.nsw.gov.au. 2. Children's Hospital Westmead Clinical School and. 3. National Centre for Immunisation Research and Surveillance, Children's Hospital at Westmead, Sydney, Australia. 4. Northern Clinical School, the University of Sydney, Sydney, Australia. 5. Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, Sydney, Australia. 6. Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Australia. 7. Department of Paediatrics, University of Melbourne, Melbourne, Australia. 8. Department of Infection and Immunity, Monash Children's Hospital and School of Population Health and Preventive Medicine, Monash University, Clayton, Australia. 9. Department of Paediatrics, Women's and Children's Hospital, Adelaide, Australia. 10. Department of Paediatrics, University of Adelaide, Adelaide, Australia. 11. Telethon Kids Institute, Wesfarmers Centre of Vaccines and Infectious Disease, West Perth, Australia; and. 12. Division of Paediatrics, School of Medicine, University of Western Australia, Perth, Australia.
Abstract
BACKGROUND: Febrile seizures (FSs) are a common pediatric condition caused by a sudden rise in temperature, affecting 3% to 5% of children aged ≤6 years. Although vaccination can cause FSs, little is known on whether FSs occurring in the time soon after vaccination (vaccine-proximate febrile seizures [VP-FSs] differ clinically from non-vaccine-proximate febrile seizures [NVP-FSs]). We compared the clinical profile and outcomes of VP-FS to NVP-FS. METHODS: Prospective cohort study of children aged ≤6 years presenting with their first FS at 1 of 5 Australian pediatric hospitals between May 2013 and June 2014. Clinical features, management, and outcomes were compared between VP-FS and NVP-FS. RESULTS: Of 1022 first FS cases (median age 19.8 months; interquartile range 13.6-27.6), 67 (6%) were VP-FSs. When comparing VP-FS to NVP-FS, there was no increased risk of prolonged (>1 day) hospitalization (odds ratio [OR] 1.61; 95% confidence interval [95% CI] 0.84-3.10), ICU admission (OR 0.72; 95% CI 0.10-5.48), seizure duration >15 minutes (OR 1.47; 95% CI 0.73-2.98), repeat FS within 24 hours (OR 0.80; 95% CI 0.34-1.89), or requirement for antiepileptic treatment on discharge (OR 1.81; 95% CI 0.41-8.02). VP-FS patients with a laboratory-confirmed infection (12%) were more likely to have a prolonged admission compared with those without. CONCLUSIONS: VP-FS accounted for a small proportion of all FS hospital presentations. There was no difference in outcomes of VP-FS compared with NVP-FS. This is reassuring data for clinicians and parents of children who experience FS after vaccination and can help guide decisions on revaccination.
BACKGROUND:Febrile seizures (FSs) are a common pediatric condition caused by a sudden rise in temperature, affecting 3% to 5% of children aged ≤6 years. Although vaccination can cause FSs, little is known on whether FSs occurring in the time soon after vaccination (vaccine-proximate febrile seizures [VP-FSs] differ clinically from non-vaccine-proximate febrile seizures [NVP-FSs]). We compared the clinical profile and outcomes of VP-FS to NVP-FS. METHODS: Prospective cohort study of children aged ≤6 years presenting with their first FS at 1 of 5 Australian pediatric hospitals between May 2013 and June 2014. Clinical features, management, and outcomes were compared between VP-FS and NVP-FS. RESULTS: Of 1022 first FS cases (median age 19.8 months; interquartile range 13.6-27.6), 67 (6%) were VP-FSs. When comparing VP-FS to NVP-FS, there was no increased risk of prolonged (>1 day) hospitalization (odds ratio [OR] 1.61; 95% confidence interval [95% CI] 0.84-3.10), ICU admission (OR 0.72; 95% CI 0.10-5.48), seizure duration >15 minutes (OR 1.47; 95% CI 0.73-2.98), repeat FS within 24 hours (OR 0.80; 95% CI 0.34-1.89), or requirement for antiepileptic treatment on discharge (OR 1.81; 95% CI 0.41-8.02). VP-FSpatients with a laboratory-confirmed infection (12%) were more likely to have a prolonged admission compared with those without. CONCLUSIONS:VP-FS accounted for a small proportion of all FS hospital presentations. There was no difference in outcomes of VP-FS compared with NVP-FS. This is reassuring data for clinicians and parents of children who experience FS after vaccination and can help guide decisions on revaccination.
Authors: Karina A Top; Kristine Macartney; Julie A Bettinger; Ben Tan; Christopher C Blyth; Helen S Marshall; Wendy Vaudry; Scott A Halperin; Peter McIntyre Journal: Euro Surveill Date: 2020-06