Pediatric febrile seizures: outcomes similar whether vaccine-proximate or not

  • Deng L & al.
  • Pediatrics
  • 19.04.2019

  • von Susan London
  • Clinical Essentials
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Takeaway

  • Children aged 6 years and younger with a first febrile seizure fared similarly well whether the seizure occurred shortly after vaccination or not.

Why this matters

  • Parental concern about febrile seizure may be a barrier to vaccination.

Key results

  • 6% of febrile seizures were vaccine-proximate.
  • Vs nonvaccine-proximate, vaccine-proximate febrile seizures did not carry higher multivariate risk for:
    • Prolonged (>1-day) admission (OR, 1.50; P=.24).
    • ICU admission (OR, 0.67; P=.20).
    • Seizure duration >15 minutes (OR, 1.40; P=.34).
    • Repeat febrile seizure within 24 hours (OR, 0.88; P=.44).
    • Need for antiepileptic treatment on discharge (OR, 1.68; P=.50).
  • Among children with vaccine-proximate febrile seizures, prolonged admission was more likely for those with a laboratory-confirmed infection (75% vs 26%).

Study design

  • Australian prospective cohort study of 1022 children aged ≤6 years (median, 19.8 months) presenting with first febrile seizure at tertiary pediatric hospitals.
  • Vaccine-proximate febrile seizure definition defined as occurring:
    • Days 0-2 after receipt of inactivated vaccine,
    • Days 5-14 after live-attenuated vaccine, or
    • Days 0-14 after combination of inactivated, live-attenuated vaccines.
  • Main outcomes: clinical features, management, outcomes at ≤6 months.
  • Funding: None.

Limitations

  • Some seizures not captured.
  • Possibly limited power.
  • Attrition.
  • Limited follow-up.
  • Unknown generalizability.