Safety and Tolerability of COVID-19 Vaccination in Adolescents and Young Adults with Epilepsy: A Multicenter Questionnaire Study

Abstract

Background Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 and was first recorded in December 2019. COVID-19 became a pandemic involving almost all countries, including Japan. We evaluated the tolerability and safety of coronavirus vaccines in terms of seizures in adolescents and young adults with epilepsy (AYAWE).

Methods We administered a questionnaire to AYAWE who visited the pediatrics departments of Hiroshima University Hospital, Hiroshima Prefectural Hospital, and Hiroshima City Funairi Citizens Hospital in January and February 2022. Tolerability and safety after immunization were assessed.

Results In total, 114 vaccinations were delivered to 57 AYAWE aged 12 to 25 years (mean, 15 ± 3.1 years). Fifty-two (91.2%) experienced more than or equal to 1 adverse event postvaccination. The most commonly reported adverse events were fever (dose 1, 33.3%; dose 2, 73.7%) and fatigue (dose 1, 24.6%; dose 2, 50.9%). The incidences of headache (5.2 vs. 21.0%, p = 0.024), fever (33.3 vs. 73.7%, p < 0.001), and fatigue (24.6 vs. 50.9%, p = 0.004) differed significantly between the first and second doses. Only 5.2% of patients experienced transient seizure worsening, and only one patient reported a change in seizure semiology.

Conclusion COVID-19 vaccines were well-tolerated in our cohort. The vaccines did not affect the number or manifestations of seizures. Similar to other illnesses, vaccination for COVID-19 can be administered to AYAWE without worsening their seizures.

Keywords

epilepsy - COVID-19 - vaccination - adolescents - young adults

Authors' Contributions

Y.K. was involved in study design and conceptualization and writing of the first draft. Y.T., H.I., Y.E., Y.F., and H.O. helped in data acquisition. Y.K., N.I., H.O., Y.F., and S.O. contributed to data interpretation and manuscript revision. All authors approved the manuscript as submitted.

Publication History

Received: 01 March 2023

Accepted: 18 May 2023

Article published online:
26 June 2023

• References

• 1 Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents 2020; 55 (03) 105924
• 2 Prime Minister's Office of Japan. About inoculation schedule of COVID-19 vaccine [In Japanese]. Accessed June 2, 2023 at: https://www.kantei.go.jp/jp/headline/kansensho/vaccinesupply.html
• 3 Ministry of Health. Labour and Welfare of Japan. Visualizing the data: information on COVID-19 infections [In Japanese]. Accessed June 2, 2023 at: https://covid19.mhlw.go.jp
• 4 Armstrong PK, Dowse GK, Effler PV. et al. Epidemiological study of severe febrile reactions in young children in Western Australia caused by a 2010 trivalent inactivated influenza vaccine. BMJ Open 2011; 1 (01) e000016
• 5 MacDonald SE, Dover DC, Simmonds KA, Svenson LW. Risk of febrile seizures after first dose of measles-mumps-rubella-varicella vaccine: a population-based cohort study. CMAJ 2014; 186 (11) 824-829
• 6 Barlow WE, Davis RL, Glasser JW. et al; Centers for Disease Control and Prevention Vaccine Safety Datalink Working Group. The risk of seizures after receipt of whole-cell pertussis or measles, mumps, and rubella vaccine. N Engl J Med 2001; 345 (09) 656-661
• 7 Verbeek NE, Jansen FE, Vermeer-de Bondt PE. et al. Etiologies for seizures around the time of vaccination. Pediatrics 2014; 134 (04) 658-666
• 8 Massoud F, Ahmad SF, Hassan AM, Alexander KJ, Al-Hashel J, Arabi M. Safety and tolerability of the novel 2019 coronavirus disease (COVID-19) vaccines among people with epilepsy (PwE): a cross-sectional study. Seizure 2021; 92: 2-9
• 9 Folegatti PM, Ewer KJ, Aley PK. et al; Oxford COVID Vaccine Trial Group. Safety and immunogenicity of the ChAdOx1 nCoV-19 vaccine against SARS-CoV-2: a preliminary report of a phase 1/2, single-blind, randomised controlled trial. Lancet 2020; 396 (10249): 467-478
• 10 Menni C, Klaser K, May A. et al. Vaccine side-effects and SARS-CoV-2 infection after vaccination in users of the COVID Symptom Study app in the UK: a prospective observational study. Lancet Infect Dis 2021; 21 (07) 939-949
• 11 Riad A, Pokorná A, Attia S, Klugarová J, Koščík M, Klugar M. Prevalence of COVID-19 vaccine side effects among healthcare workers in the Czech Republic. J Clin Med 2021; 10 (07) 1428
• 12 Ramasamy MN, Minassian AM, Ewer KJ. et al; Oxford COVID Vaccine Trial Group. Safety and immunogenicity of ChAdOx1 nCoV-19 vaccine administered in a prime-boost regimen in young and old adults (COV002): a single-blind, randomised, controlled, phase 2/3 trial. Lancet 2021; 396 (10267): 1979-1993
• 13 Polack FP, Thomas SJ, Kitchin N. et al; C4591001 Clinical Trial Group. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. N Engl J Med 2020; 383 (27) 2603-2615
• 14 Özdemir HN, Dere B, Gökçay F, Gökçay A. Are COVID-19 vaccines safe for people with epilepsy? A cross-sectional study. Neurol Sci 2022; 43 (06) 3489-3496
• 15 Frucht MM, Quigg M, Schwaner C, Fountain NB. Distribution of seizure precipitants among epilepsy syndromes. Epilepsia 2000; 41 (12) 1534-1539
• 16 Balamurugan E, Aggarwal M, Lamba A, Dang N, Tripathi M. Perceived trigger factors of seizures in persons with epilepsy. Seizure 2013; 22 (09) 743-747
• 17 Aziz H, Ali SM, Frances P, Khan MI, Hasan KZ. Epilepsy in Pakistan: a population-based epidemiologic study. Epilepsia 1994; 35 (05) 950-958
• 18 Fang PC, Chen YJ, Lee IC. Seizure precipitants in children with intractable epilepsy. Brain Dev 2008; 30 (08) 527-532
• 19 Stanuszek A, Wnękowicz E, Kuźniar E, Krakowska K, Gergont A, Kaciński M. Seizure-precipitating factors in relation to medical recommendations: especially those limiting physical activity. J Child Neurol 2015; 30 (12) 1569-1573