May 01, 2019
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Vaccine-related, -unrelated febrile seizures have similar outcomes

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Lucy Deng

Few children experience vaccine-proximate febrile seizures, or VP-FS, but those who do have similar outcomes compared with children who experience febrile seizures that did not occur after vaccination, according to research published in Pediatrics.

Lucy Deng, MBBS, a pediatrician at the National Center for Immunization Research and Surveillance at the Children’s Hospital at Westmead, Australia, and colleagues wrote that febrile seizures affect 3% to 5% of children aged 6 years and younger. Previous studies have demonstrated that most children who experience them have normal behavior, intelligence and academic achievement, and they do not develop epilepsy.

Febrile seizures can occur after vaccination. However, the researchers noted that it was unclear whether VP-FS were clinically different compared with nonvaccine-proximate febrile seizures (NVP-FS).

Deng and colleagues conducted a prospective cohort study that included children aged 6 years and younger who had their first febrile seizure and presented to one of five pediatric hospitals in Australia. All seizures occurred between May 2013 and June 2014.

During the study period, 1,022 children presented with their first febrile seizures (median age = 19.8 months), with 6% identified as VP-FS. Children who experienced VP-FS had no increased risk of hospitalization lasting more than 1 day (OR = 1.61; 95% CI, 0.84-3.1), ICU admission (OR = 0.72; 95% CI, 0.10-5.48), a seizure lasting more than 15 minutes (OR = 1.47; 95% CI, 0.73-2.98) or another febrile seizure within 24 hours (OR = 0.8; 95% CI, 0.34-1.89) compared with children who had NPV-FS. Additionally, children with VP-FS were not at increased risk for needing antiepileptic treatment at discharge (OR = 1.81; 95% CI, 0.41-8.02).

Deng and colleagues found that 12% of children had laboratory-confirmed infection and were at increased risk for longer lengths of stay compared with children without laboratory-confirmed infection.

“The risk of recurrence in this group was the same whether you had a VP-FS or NVP-FS,” Deng told Infectious Diseases in Children. “Parents should consider VP-FS as the same as any other febrile seizure, with a similar prognosis. We hope the findings of this study give parents and immunization providers the confidence to continue vaccinating children who have had a febrile seizure after vaccination.” – by Katherine Bortz

Disclosures: The authors report no relevant financial disclosures.