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.
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