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Leung WC, Ho RWH, Leung AKL, Chu FHN, Lo CNR, Chan AA, Chan CYC, Chan DYH, Chui JHY, Li WTV, Yeung EHL, Teo KC, Lau GKK, Chang RSK. Risk of Seizure Aggravation after COVID-19 Vaccinations in Patients with Epilepsy. Vaccines (Basel) 2024; 12:593. [PMID: 38932322 PMCID: PMC11209536 DOI: 10.3390/vaccines12060593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 05/26/2024] [Accepted: 05/28/2024] [Indexed: 06/28/2024] Open
Abstract
Although Coronavirus disease 2019 (COVID-19) vaccinations are generally recommended for persons with epilepsy (PwE), a significant vaccination gap remains due to patient concerns over the risk of post-vaccination seizure aggravation (PVSA). In this single-centre, retrospective cohort study, we aimed to determine the early (7-day) and delayed (30-day) risk of PVSA, and to identify clinical predictors of PVSA among PwE. Adult epilepsy patients aged ≥18 years without a history of COVID-19 infection were recruited from a specialty epilepsy clinic in early 2022. Demographic, epilepsy characteristics, and vaccination data were extracted from a centralized electronic patient record. Seizure frequency before and after vaccination, vaccination-related adverse effects, and reasons for or against vaccination were obtained by a structured questionnaire. A total of 786 PwEs were included, of which 27.0% were drug-resistant. At the time of recruitment, 74.6% had at least 1 dose of the COVID-19 vaccine. Subjects with higher seizure frequency (p < 0.0005), on more anti-seizure medications (p = 0.004), or had drug-resistant epilepsy (p = 0.001) were less likely to be vaccinated. No significant increase in seizure frequency was observed in the early (7 days) and delayed phases (30 days) after vaccination in our cohort. On the contrary, there was an overall significant reduction in seizure frequency 30 days after vaccination (1.31 vs. 1.89, t = 3.436; p = 0.001). This difference was seen in both types of vaccine (BNT162b2 and CoronaVac) and drug-resistant epilepsy, but just missed significance for the second dose (1.13 vs. 1.87, t = 1.921; p = 0.055). Only 5.3% had PVSA after either dose of vaccine. Higher pre-vaccination seizure frequency of ≥1 per week (OR 3.01, 95% CI 1.05-8.62; p = 0.04) and drug-resistant status (OR 3.32, 95% CI 1.45-249 7.61; p = 0.005) were predictive of PVSA. Meanwhile, seizure freedom for 3 months before vaccination was independently associated with a lower risk of PVSA (OR 0.11, 95% CI 0.04-0.28; p < 0.0005). This may guide epilepsy treatment strategies to achieve better seizure control for at least 3 months prior to vaccination. As COVID-19 shifts to an endemic phase, this study provides important data demonstrating the overall safety of COVID-19 vaccinations among PwE. Identification of high-risk patients with subsequent individualized approaches in treatment and monitoring strategies may alleviate vaccination hesitancy among PwE.
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Affiliation(s)
- William C.Y. Leung
- Division of Neurology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China; (R.W.-H.H.); (A.K.-L.L.); (F.H.-N.C.); (C.N.R.L.); (K.C.T.); (G.K.-K.L.)
| | - Ryan Wui-Hang Ho
- Division of Neurology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China; (R.W.-H.H.); (A.K.-L.L.); (F.H.-N.C.); (C.N.R.L.); (K.C.T.); (G.K.-K.L.)
| | - Anthony Ka-Long Leung
- Division of Neurology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China; (R.W.-H.H.); (A.K.-L.L.); (F.H.-N.C.); (C.N.R.L.); (K.C.T.); (G.K.-K.L.)
| | - Florinda Hui-Ning Chu
- Division of Neurology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China; (R.W.-H.H.); (A.K.-L.L.); (F.H.-N.C.); (C.N.R.L.); (K.C.T.); (G.K.-K.L.)
| | - Cheuk Nam Rachel Lo
- Division of Neurology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China; (R.W.-H.H.); (A.K.-L.L.); (F.H.-N.C.); (C.N.R.L.); (K.C.T.); (G.K.-K.L.)
| | - Andrian A. Chan
- School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; (A.A.C.); (C.Y.C.C.); (D.Y.H.C.); (J.H.Y.C.); (W.T.V.L.); (E.H.L.Y.)
| | - Cheuk Yan Claudia Chan
- School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; (A.A.C.); (C.Y.C.C.); (D.Y.H.C.); (J.H.Y.C.); (W.T.V.L.); (E.H.L.Y.)
| | - Desmond Yin Hei Chan
- School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; (A.A.C.); (C.Y.C.C.); (D.Y.H.C.); (J.H.Y.C.); (W.T.V.L.); (E.H.L.Y.)
| | - Jacklyn Hoi Ying Chui
- School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; (A.A.C.); (C.Y.C.C.); (D.Y.H.C.); (J.H.Y.C.); (W.T.V.L.); (E.H.L.Y.)
| | - Wai Tak Victor Li
- School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; (A.A.C.); (C.Y.C.C.); (D.Y.H.C.); (J.H.Y.C.); (W.T.V.L.); (E.H.L.Y.)
| | - Elton Hau Lam Yeung
- School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; (A.A.C.); (C.Y.C.C.); (D.Y.H.C.); (J.H.Y.C.); (W.T.V.L.); (E.H.L.Y.)
| | - Kay Cheong Teo
- Division of Neurology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China; (R.W.-H.H.); (A.K.-L.L.); (F.H.-N.C.); (C.N.R.L.); (K.C.T.); (G.K.-K.L.)
- School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; (A.A.C.); (C.Y.C.C.); (D.Y.H.C.); (J.H.Y.C.); (W.T.V.L.); (E.H.L.Y.)
| | - Gary Kui-Kai Lau
- Division of Neurology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China; (R.W.-H.H.); (A.K.-L.L.); (F.H.-N.C.); (C.N.R.L.); (K.C.T.); (G.K.-K.L.)
- School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; (A.A.C.); (C.Y.C.C.); (D.Y.H.C.); (J.H.Y.C.); (W.T.V.L.); (E.H.L.Y.)
| | - Richard Shek-Kwan Chang
- Division of Neurology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, China; (R.W.-H.H.); (A.K.-L.L.); (F.H.-N.C.); (C.N.R.L.); (K.C.T.); (G.K.-K.L.)
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Liu Y, He J, Zhou X, Wu Y, Cai H, Sun Y, Cui X. Analysis of new-onset seizures following use of COVID-19 vaccinations in children based on VAERS. Expert Opin Drug Saf 2024:1-6. [PMID: 38666296 DOI: 10.1080/14740338.2024.2348568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 03/19/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Recently, there have been some reports of seizures related with COVID-19 vaccinations. However, no studies have systematically investigated the relationship between seizures and various COVID-19 vaccines. RESEARCH DESIGN AND METHODS This research aimed to analyze the characteristics and risk signals of new-onset seizures in children caused by various COVID-19 vaccines based on the data of the Vaccine Adverse Event Reporting System (VAERS). To identify potential risk signals, a disproportionality analysis was conducted. The reporting odds ratio (ROR) and the Proportional Reporting Ratio (PRR) were used to detect signals. RESULTS A total of 695 children with new-onset seizures events associated with COVID-19 vaccinations were retrieved from the VAERS database. Compared with influenza vaccinations, the percentage and rate of COVID-19 vaccinations related seizures was all reduced. The median onset time of seizures was 1 day after COVID-19 vaccines. No signal was detected for an association between the COVID-19 vaccines and new-onset seizures, neither when compared with influenza vaccines nor with non-COVID-19 vaccines. CONCLUSION No statistically significant risk signal of COVID-19 vaccine-related seizures was found in this study. However, it is still necessary to monitor the possibility of new-onset seizures when children are immunized with COVID-19 vaccines.
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Affiliation(s)
- Yanhui Liu
- Department of Clinical Pharmacy, Anhui Provincial Children's Hospital, Hefei, Anhui, China
| | - Jinyang He
- School of Mathematical Sciences, Beihang University, Beijing, China
| | - Xiaozhu Zhou
- Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yi Wu
- Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Heping Cai
- Department of Clinical Pharmacy, Anhui Provincial Children's Hospital, Hefei, Anhui, China
| | - Yuquan Sun
- School of Mathematical Sciences, Beihang University, Beijing, China
| | - Xiangli Cui
- Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Zheng Q, Cheng YR, Wang M, Ma X, Ye L, Xu Z, Feng Z. COVID-19 vaccinations for patients with epilepsy in Guizhou Province, China: A cross-sectional study. Heliyon 2024; 10:e29354. [PMID: 38623193 PMCID: PMC11016729 DOI: 10.1016/j.heliyon.2024.e29354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 03/28/2024] [Accepted: 04/05/2024] [Indexed: 04/17/2024] Open
Abstract
Several COVID-19 vaccines have been approved for emergency use according to China's immunization programs. These vaccines has created hope for patients with epilepsy, because the vaccines can help to reduce their risk of becoming infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The aim of this study was to investigate the COVID-19 vaccine safety in patients with epilepsy. Here, we assessed the time of symptom control and the features of adverse events of seizure patients following their COVID-19 vaccinations. The results showed that adverse events of COVID-19 vaccinations for epilepsy patients included local pain at the injection site, dizziness and headache, epileptic attack, somnolence, limb weakness, limb pain, allergy, and fever. In addition, the average recovery time of the adverse events was approximately 42 h. More importantly, our study showed that it was relatively safe to vaccinate epilepsy patients who did not experience seizures for approximately 12 months prior to the immunization date.
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Affiliation(s)
- Qian Zheng
- Department of Neurology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
- School of clinical medicine, Guizhou Medical University, Guiyang, China
| | - Yong-Ran Cheng
- School of Public Health, Hangzhou Medical College, Hangzhou, China
| | - Mingwei Wang
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Xuntai Ma
- Department of Neurology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Lan Ye
- School of Basic Medicine, Guizhou Medical University, Guiyang, China
| | - Zucai Xu
- Department of Neurology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Zhanhui Feng
- Department of Neurology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
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Delil MS, Turk BG, Kochan-Kizilkilic E, Abbaszade H, Yeni SN, Ozkara C. The effect of the coronavirus vaccinations on seizures in patients with epilepsy. Heliyon 2024; 10:e28337. [PMID: 38560696 PMCID: PMC10979212 DOI: 10.1016/j.heliyon.2024.e28337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 03/15/2024] [Accepted: 03/15/2024] [Indexed: 04/04/2024] Open
Abstract
Purpose Information on COVID-19 vaccine tolerance and complications in patients with epilepsy is not yet sufficient to provide a recommendation for vaccination guidelines. The aim of this study was to investigate the effect of two types of COVID vaccines currently used in Turkey (mRNA vaccine from Pfizer/BioNTech and inactivated vaccine from Sinovac) on epileptic seizures. Methods We included 318 patients with epilepsy who were admitted to our epilepsy outpatient clinic. Clinical characteristics such as age, gender, age at seizure onset and the duration of epilepsy were noted. Types and the numbers of the anti-seizure drugs were recorded. Patients were evaluated either by face-to-face or by teleconference interviews. The seizure frequency in the first thirty days after any dose of vaccination was questioned. Results A total of 318 patients (149 females, 46.8%) with a confirmed diagnosis of epilepsy were enrolled in the study. An increase in seizure frequency was reported after the COVID-19 vaccine in 19 patients. Of these 19 patients, 2 were vaccinated with Sinovac, while 17 were vaccinated with BioNTech/Pfizer mRNA vaccine. There was no significant relationship between age, age at seizure onset, duration of epilepsy, type of seizures, seizure frequency or seizure induction. Status epilepticus was not reported in any of the participants. Conclusion Physicians need strong scientific evidence to advocate the importance of vaccine for COVID-19, that's why accumulation of knowledge related to this issue is important not only from medical but also from medico-legal point of interest. We aimed to contribute the current literature with our study to strengthen the physicians' hand while recommending COVID vaccines to PWE. Our results show that there is no significant increase in the risk of triggering seizures with COVID-19 vaccines. These data show that vaccination against COVID-19 with both vaccine types in patients with epilepsy is safe and well tolerated.
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Affiliation(s)
- Memet Sakir Delil
- Department of Neurology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Bengi Gul Turk
- Department of Neurology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | | | - Hikmet Abbaszade
- Department of Neurology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Seher Naz Yeni
- Department of Neurology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Cigdem Ozkara
- Department of Neurology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Wang M, Wang J, Ren Y, Lu L, Xiong W, Li L, Xu S, Tang M, Yuan Y, Xie Y, Li W, Chen L, Zhou D, Ying B, Li J. Current clinical findings of acute neurological syndromes after SARS-CoV-2 infection. MedComm (Beijing) 2024; 5:e508. [PMID: 38463395 PMCID: PMC10924641 DOI: 10.1002/mco2.508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 01/25/2024] [Accepted: 02/02/2024] [Indexed: 03/12/2024] Open
Abstract
Neuro-COVID, a condition marked by persistent symptoms post-COVID-19 infection, notably affects various organs, with a particular focus on the central nervous system (CNS). Despite scant evidence of SARS-CoV-2 invasion in the CNS, the increasing incidence of Neuro-COVID cases indicates the onset of acute neurological symptoms early in infection. The Omicron variant, distinguished by heightened neurotropism, penetrates the CNS via the olfactory bulb. This direct invasion induces inflammation and neuronal damage, emphasizing the need for vigilance regarding potential neurological complications. Our multicenter study represents a groundbreaking revelation, documenting the definite presence of SARS-CoV-2 in the cerebrospinal fluid (CSF) of a significant proportion of Neuro-COVID patients. Furthermore, notable differences emerged between RNA-CSF-positive and negative patients, encompassing aspects such as blood-brain barrier integrity, extent of neuronal damage, and the activation status of inflammation. Despite inherent limitations, this research provides pivotal insights into the intricate interplay between SARS-CoV-2 and the CNS, underscoring the necessity for ongoing research to fully comprehend the virus's enduring effects on the CNS. The findings underscore the urgency of continuous investigation Neuro-COVID to unravel the complexities of this relationship, and pivotal in addressing the long-term consequences of COVID-19 on neurological health.
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Affiliation(s)
- Minjin Wang
- Department of NeurologyWest China Hospital of Sichuan UniversityChengduSichuanChina
- Department of Laboratory MedicineWest China Hospital of Sichuan UniversityChengduSichuanChina
- Institute of Brain Science and Brain‐inspired TechnologyWest China Hospital of Sichuan UniversityChengduSichuanChina
| | - Jierui Wang
- Department of NeurologyWest China Hospital of Sichuan UniversityChengduSichuanChina
- Institute of Brain Science and Brain‐inspired TechnologyWest China Hospital of Sichuan UniversityChengduSichuanChina
| | - Yan Ren
- Department of Laboratory MedicineWest China Hospital of Sichuan UniversityChengduSichuanChina
| | - Lu Lu
- Department of NeurologyWest China Hospital of Sichuan UniversityChengduSichuanChina
- Institute of Brain Science and Brain‐inspired TechnologyWest China Hospital of Sichuan UniversityChengduSichuanChina
| | - Weixi Xiong
- Department of NeurologyWest China Hospital of Sichuan UniversityChengduSichuanChina
- Institute of Brain Science and Brain‐inspired TechnologyWest China Hospital of Sichuan UniversityChengduSichuanChina
| | - Lifeng Li
- Genskey Medical biotechnology Company LimitedBeijingChina
| | - Songtao Xu
- National Institute for Viral Disease Control and PreventionChinese Center for Disease Control and PreventionBeijingChina
| | - Meng Tang
- Department of Laboratory MedicineWest China Hospital of Sichuan UniversityChengduSichuanChina
| | - Yushang Yuan
- Department of Laboratory MedicineWest China Hospital of Sichuan UniversityChengduSichuanChina
| | - Yi Xie
- Department of Laboratory MedicineWest China Hospital of Sichuan UniversityChengduSichuanChina
| | - Weimin Li
- Department of Respiratory and Critical Care MedicineWest China HospitalSichuan UniversityChengduSichuanChina
| | - Lei Chen
- Department of NeurologyWest China Hospital of Sichuan UniversityChengduSichuanChina
- Institute of Brain Science and Brain‐inspired TechnologyWest China Hospital of Sichuan UniversityChengduSichuanChina
| | - Dong Zhou
- Department of NeurologyWest China Hospital of Sichuan UniversityChengduSichuanChina
- Institute of Brain Science and Brain‐inspired TechnologyWest China Hospital of Sichuan UniversityChengduSichuanChina
| | - Binwu Ying
- Department of Laboratory MedicineWest China Hospital of Sichuan UniversityChengduSichuanChina
| | - Jinmei Li
- Department of NeurologyWest China Hospital of Sichuan UniversityChengduSichuanChina
- Institute of Brain Science and Brain‐inspired TechnologyWest China Hospital of Sichuan UniversityChengduSichuanChina
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Lu L, Chen L, Wang P, Qi Z, Chen Y, Wu X, Liu X, Wang M, Li J, Yan B, Guo J, Teng S, Li W, Sander JW, Zhou D, Xiong W. Neurological complications during the Omicron COVID-19 wave in China: A cohort study. Eur J Neurol 2024; 31:e16096. [PMID: 37877685 DOI: 10.1111/ene.16096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/10/2023] [Accepted: 09/23/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND AND PURPOSE The aim was to investigate the neurological complications associated with coronavirus disease 19 (COVID-19) during the 2022 Omicron wave. METHODS AND ANALYSIS The medical records of a cohort of people admitted to neurological wards of three participating tertiary centres in Sichuan from 12 December 2022 to 12 January 2023 were reviewed. Demographics and clinical data were obtained and analysed with an interest in COVID-19-related new-onset or worse neurological symptoms. The current data were also compared in two centres with similar data from the same period 12 months earlier. RESULTS In all, 790 people were enrolled, of whom 436 were positive for COVID-19. Ninety-nine had new onset COVID-related neurological problems, or their known neurological condition deteriorated during the wave. There was a significant difference in demographics from the findings amongst admissions 12 months earlier as there was an increase in the average age, the incidence of encephalitis and encephalopathy, and mortality rates. One hundred and one received COVID-specific antivirals, intravenous glucocorticoids and intravenous immunoglobulin therapy. No differences were seen between these and those who did not use them. CONCLUSION New-onset neurological conditions, particularly encephalitis and encephalopathy, increased significantly during this period. Deterioration of existing neurological conditions, such as seizure exacerbation, was also observed. A large-scale treatment trial of people with COVID-19 infection presenting with neurological disorders is still needed.
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Affiliation(s)
- Lu Lu
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Institute of Brain Science and Brain-inspired Technology of West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lei Chen
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Institute of Brain Science and Brain-inspired Technology of West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Peiyu Wang
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Institute of Brain Science and Brain-inspired Technology of West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhang Qi
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Institute of Brain Science and Brain-inspired Technology of West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yujie Chen
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Institute of Brain Science and Brain-inspired Technology of West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xintong Wu
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Institute of Brain Science and Brain-inspired Technology of West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xu Liu
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Institute of Brain Science and Brain-inspired Technology of West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Minjin Wang
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Institute of Brain Science and Brain-inspired Technology of West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jinmei Li
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Institute of Brain Science and Brain-inspired Technology of West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bo Yan
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Institute of Brain Science and Brain-inspired Technology of West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Neurology, Chengdu ShangJin NanFu Hospital, Chengdu, Sichuan, China
| | - Jian Guo
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Institute of Brain Science and Brain-inspired Technology of West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Neurology, West China Tianfu Hospital, Chengdu, Sichuan, China
| | - Sisi Teng
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Institute of Brain Science and Brain-inspired Technology of West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Neurology, Chengdu ShangJin NanFu Hospital, Chengdu, Sichuan, China
| | - Weimin Li
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Tianfu Jincheng Laboratory, Chengdu Frontier Medical Center, Chengdu, Sichuan, China
| | - Josemir W Sander
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- UCL Queen Square Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Chalfont St Peter, UK
- Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands
| | - Dong Zhou
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Institute of Brain Science and Brain-inspired Technology of West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Weixi Xiong
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Institute of Brain Science and Brain-inspired Technology of West China Hospital, Sichuan University, Chengdu, Sichuan, China
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7
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Han C, Zhao ZZ, Chan P, Li F, Chi CL, Zhang X, Zhao Y, Chen J, Ma JH. A large survey on COVID-19 vaccination in patients with Parkinson's disease and healthy population. Vaccine 2023; 41:6483-6494. [PMID: 37726180 DOI: 10.1016/j.vaccine.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/29/2023] [Accepted: 09/02/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND A full rollout of COVID-19 vaccination offers the most promising prospect of bringing the pandemic to an end. This study aimed to compare the coverage, safety, and confidence of COVID-19 vaccination between patients with Parkinson's disease (PD) and healthy individuals so as to give suggestions for future immunization programs. METHODS A web-based, nationwide, multicenter survey was carried out in China from 2021 to 2022. The age and sex-standardized vaccination rate was calculated. Multivariate stepwise logistic regression models were used to estimate the influencing factors of vaccination status. We also investigated vaccination safety, willingness, confidence, and reasons for hesitancy with some ad hoc questions. RESULTS A total of 962 PD patients and 1208 healthy individuals participated in this survey with a vaccination rate of 71.1% vs 94.4% respectively. PD patients living in first-tier cities, with comorbidities, experiencing unstable PD with a longer course and levodopa use were less likely to get vaccinated, while healthy individuals living in first-tier cities and feeling physically poor exhibited a lower vaccination rate. For PD patients, concern about the adverse impact on existing illness and disagreement from doctors were the most common reasons for vaccination hesitancy. Whereas, no evidence was present that they experienced any local or systematic adverse events more frequently or seriously than healthy individuals, or their state of PD and comorbidities was seriously exacerbated after vaccination. A prominent transition from a little concerned to unconcerned about the security and efficacy of vaccines was evident among both two populations from pre-vaccination to post-vaccination. CONCLUSIONS The COVID-19 vaccination rate was remarkably lower in PD patients than healthy individuals in China. The approved vaccines have shown an acceptable safety profile. Our findings would offer a reference to guide future clinical decision-making of COVID-19 vaccination and improve the immunization management of PD patients.
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Affiliation(s)
- Chao Han
- National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Zhen Zhen Zhao
- Department of Geriatrics Center, The Fourth People's Hospital of Shenyang, Shenyang, Liaoning, China
| | - Piu Chan
- National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital of Capital Medical University, Beijing, China; Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Fang Li
- Department of Neurology, Yueyang Central Hospital, Yueyang City, China
| | - Chun Ling Chi
- Department of Neurology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xin Zhang
- Department of Neurology, Baoding No.1 Central Hospital, Baoding, China
| | - Yan Zhao
- Department of Neurology, The Third Hospital of Jinan, Jinan, China
| | - Jing Chen
- Department of Neurology, Zhumadian Central Hospital, Zhumadian, China
| | - Jing Hong Ma
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China.
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Lu Q, Dun S, Wang QH, Wang YY, Chen HM, Zhang Q, Zou LP. Challenges in the Management of Children and Adolescents With Epilepsy in China During the COVID-19 Pandemic: An Online Survey-Based Study. J Child Neurol 2023; 38:590-596. [PMID: 37624690 DOI: 10.1177/08830738231193229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
INTRODUCTION To investigate the challenges in the management of children and adolescents with epilepsy in China during the coronavirus disease (COVID-19) pandemic. METHODS We conducted a cross-sectional survey among 845 patients with epilepsy using an online-based questionnaire. The questionnaire focused on sociodemographic characteristics, epilepsy-related conditions, health care access, COVID-19 vaccination, and the mental health of caregivers. Depression was assessed using Patient Health Questionnaire-9. RESULTS During the pandemic, 24.73% of the patients had increased seizures. The majority of patients (68.89%) experienced difficulty obtaining antiseizure medications. In addition, 94.79% of the patients had difficulty consulting a doctor. A total of 52.78% of the patients selected telemedicine services, and most found these services to be helpful. Moreover, 76.11% of the patients failed to complete the COVID-19 vaccination. More than half of the caregivers had anxiety and depressive symptoms. The risk factors for depression comprised irregularity in taking antiseizure medications, difficulty in obtaining antiseizure medications, and failure to consult a doctor on time. CONCLUSIONS The COVID-19 pandemic presented a great challenge in the management of children and adolescents with epilepsy in China. The findings highlight the importance of improving health care systems and medication management and the mental health of their caregivers.
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Affiliation(s)
- Qian Lu
- Medical School of Chinese PLA, Beijing, China
- Department of Pediatrics, the First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Shuo Dun
- Medical School of Chinese PLA, Beijing, China
- Department of Pediatrics, the First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Qiu-Hong Wang
- Medical School of Chinese PLA, Beijing, China
- Department of Pediatrics, the First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yang-Yang Wang
- Department of Pediatrics, the First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Hui-Min Chen
- Department of Pediatrics, the First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Qi Zhang
- Medical School of Chinese PLA, Beijing, China
- Department of Pediatrics, the First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Li-Ping Zou
- Medical School of Chinese PLA, Beijing, China
- Department of Pediatrics, the First Medical Center of Chinese PLA General Hospital, Beijing, China
- Beijing Institute for Brain Disorders, Center for Brain Disorders Research, Capital Medical University, Beijing, China
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9
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Liu X, Wang Q, Ren L, Fang X, He Z, Ding J, Wang K, Xu H, Zhang H, Song Y, Lu Q, Sun M, Han X, Cao L, Lin W, Li X, Zhang Q, Ding Y, Wang F, Wang T, Wang J, Liu X, Wu Y, Chen Y, Feng Z, Wang S, Wang X, Guan Y, Xie X, Huang H, Zhang M, Wang X, Hong Z, Jiang W, Han Y, Deng Y, Zhao J, Liao J, Wang Y, Lian Y. COVID-19 vaccination for patients with epilepsy: A Chinese expert consensus. Epilepsy Behav 2023; 147:109387. [PMID: 37625346 DOI: 10.1016/j.yebeh.2023.109387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 07/29/2023] [Accepted: 07/30/2023] [Indexed: 08/27/2023]
Abstract
Coronavirus disease-2019 (COVID-19) first emerged in late 2019 and has since spread worldwide. More than 600 million people have been diagnosed with COVID-19, and over 6 million have died. Vaccination against COVID-19 is one of the best ways to protect humans. Epilepsy is a common disease, and there are approximately 10 million patients with epilepsy (PWE) in China. However, China has listed "uncontrolled epilepsy" as a contraindication for COVID-19 vaccination, which makes many PWE reluctant to get COVID-19 vaccination, greatly affecting the health of these patients in the COVID-19 epidemic. However, recent clinical practice has shown that although a small percentage of PWE may experience an increased frequency of seizures after COVID-19 vaccination, the benefits of COVID-19 vaccination for PWE far outweigh the risks, suggesting that COVID-19 vaccination is safe and recommended for PWE. Nonetheless, vaccination strategies vary for different PWE, and this consensus provides specific recommendations for PWE to be vaccinated against COVID-19.
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Affiliation(s)
- Xuewu Liu
- Department of Neurology, Shandong Provincial Hospital, Affiliated to Shandong First Medical University, Jinan, China.
| | - Qun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China.
| | - Liankun Ren
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Clinical Research Center for Epilepsy, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Disorders, Beijing, China
| | - Xiqin Fang
- Department of Neurology, Qilu Hospital, Shandong University, Jinan, China; Institute of Epilepsy, Shandong University, Jinan, China
| | - Zhiyi He
- Department of Neurology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jing Ding
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Kang Wang
- Department of Neurology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Huiqin Xu
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hua Zhang
- Department of Neurosurgery, The First Affiliated Hospital of Xi'an JiaoTong University, Xi'an, China
| | - Yijun Song
- Hematology Hospital, Chinese Academy of Medical Sciences (Institute of Hematology, Chinese Academy of Medical Sciences), Tianjing, China
| | - Qiang Lu
- Department of Neurosurgery, Peking Union Medical College Hospital, Beijing, China
| | - Meizhen Sun
- Departmen of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Xiong Han
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Lili Cao
- Department of Neurology, Qilu Hospital, Shandong University, Jinan, China
| | - Weihong Lin
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Xiaoyi Li
- Department of Neurology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Qing Zhang
- Department of Neurology, General Hospital of Ningxia Medical University, Yinchuang, China
| | - Yao Ding
- Department of Neurology, Epilepsy Center, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, China
| | - Furong Wang
- Department of Neurology, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Tiancheng Wang
- Department of Neurology, Lanzhou University Second Hospital, Lanzhou, China
| | - Jiwen Wang
- Department of Neurology, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiaorong Liu
- Department of Neurology, Second Affiliated Hospital of Guangzhou Medical University, China
| | - Yuan Wu
- Department of Neurology, The First Affiliated Hospital, Guangxi Medical University, Guangzhou, China
| | - Yangmei Chen
- Department of Neurology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhanhui Feng
- Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Shoulei Wang
- Department of Pediatrics, Qinghai Province Women and Children's Hospital, Xining, China
| | - Xiangqing Wang
- Department of Neurology, The First Medical Center of PLA General Hospital, Beijnig, China
| | - Yuguang Guan
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijnig, China
| | - Xufang Xie
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Huapin Huang
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Ming Zhang
- Department of Neurology, Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiaoshan Wang
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Zhen Hong
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Wen Jiang
- Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Yanbing Han
- Department of Neurology, First Affiliated Hospital Kunming Medical University, Kunming, China
| | - Yulei Deng
- Department of Neurology & Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiangming Zhao
- Department of Neurology, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), Hefei, China
| | - Jianxiang Liao
- Department of Pediatrics, Shenzhen Children's Hospital, Shenzhen, China
| | - Yu Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yajun Lian
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Rafati A, Jameie M, Amanollahi M, Jameie M, Pasebani Y, Sakhaei D, Ilkhani S, Rashedi S, Pasebani MY, Azadi M, Rahimlou M, Kwon CS. Association of seizure with COVID-19 vaccines in persons with epilepsy: A systematic review and meta-analysis. J Med Virol 2023; 95:e29118. [PMID: 37732629 DOI: 10.1002/jmv.29118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/28/2023] [Accepted: 09/12/2023] [Indexed: 09/22/2023]
Abstract
Seizure aggravation following coronavirus disease 2019 (COVID-19) vaccines is a major cause behind vaccine hesitancy among persons with epilepsy (PwE), resulting in lower immunization rates. We systematically reviewed seizure-activity-related events in PwE following COVID-19 vaccination. We systematically searched PubMed, Web of Science, Scopus, and Cochrane Library, until January 31, 2023, and included articles reporting seizure activity-related events in PwE receiving COVID-19 vaccination. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses were followed. The protocol was registered with PROSPERO (CRD42022312475). Outcomes included pooled incidence proportions of (a) increased seizure frequency, (b) status epilepticus (SE), and (c) change in seizure type. Of the 2207 studies, 16 entered the meta-analysis. The pooled incidence proportion of increased seizure frequency (16 studies-3245 PwE) was 5% (95% CI: 3%-7%, I2 = 52%). Regarding increased seizure frequency, no significant difference was observed between mRNA and viral vector (OR: 1.11, 95% CI: 0.49-2.52, I2 = 0%), and between mRNA and inactivated virus (OR: 1.60, 95% CI: 0.27-9.37; I2 = 0%). The pooled incidence proportion of SE (15 studies-2387 PwE) was 0.08% (95% CI: 0.02%-0.33%, I2 = 0%). Ultimately, the pooled incidence proportion of change in seizure type (7 studies-1172 PwE) was 1% (95% CI: 1%-2%, I2 = 0%). The meta-analysis revealed post-COVID-19-vaccination increased seizure frequency in 5% of PwE, with no difference between mRNA and viral vector or inactivated virus vaccines. Furthermore, we found 0.08% and 1% incidence proportions for postvaccination SE and change in seizure type, respectively. While noteworthy, these values are far less than reports for COVID-19 infection, emphasizing vaccination importance in preventing COVID-19 consequences in PwE.
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Affiliation(s)
- Ali Rafati
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Melika Jameie
- Neuroscience Research Center, Iran University of Medical Sciences, Tehran, Iran
- Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mobina Amanollahi
- Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mana Jameie
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Yeganeh Pasebani
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Delaram Sakhaei
- School of Medicine, Sari Branch, Islamic Azad University, Sari, Iran
| | - Saba Ilkhani
- Center for Surgery and Public Health, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Sina Rashedi
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Mehran Rahimlou
- Department of Nutrition, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Churl-Su Kwon
- Departments of Neurology, Epidemiology, Neurosurgery, The Gertrude H. Sergievsky Center, Columbia University, New York, New York, USA
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11
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Chen C, Chen N, Xie L, Luo Y, Ma J, Li T. Vaccination against COVID-19 and potential protective effects on seizure recurrence in children with epilepsy: A cross-sectional survey. Epilepsia Open 2023; 8:1133-1141. [PMID: 37483062 PMCID: PMC10472363 DOI: 10.1002/epi4.12794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 07/18/2023] [Indexed: 07/25/2023] Open
Abstract
OBJECTIVE Despite strong evidence on the safety and tolerability of the COVID-19 vaccine, data on vaccination in children with epilepsy, particular younger children with specific epilepsy syndromes, are limited. The protective effects of vaccination against seizure increase upon COVID-19 infection also remain to be elucidated. METHODS Questionnaire surveys were distributed online via an established WeChat group for patient management as well as in our outpatient clinic. The data collected included demographics and clinical information related to COVID-19 vaccination and infection. Detailed information related to epilepsy diagnosis and treatment was also collected from our patient database. Logistic regression analysis was performed to determine the factors associated with non-vaccination. The characteristics of seizures following COVID-19 infection were described. RESULTS In total, 354 suitable questionnaires were included in the study. The median age at survey was 6 years (interquartile range 4, 9). The most common epilepsy syndrome was self-limited epilepsy (n = 153, 43.2%), followed by developmental and/or epileptic encephalopathy (D/EE, n = 81, 22.9%) and genetic generalized epilepsy (n = 59, 16.7%). The vaccine uptake rate was 43.8% (n = 155), and all related side-effects (n = 11, 7.1%) remitted spontaneously. Younger age (odds ratio [OR] = 0.877, P = 0.001), D/EE (OR = 5.096, P = 0.008), and less than six months seizure-freedom before vaccination (OR = 3.026, P = 0.005) were associated with unwillingness to be vaccinated. There were no significant differences in the rate of COVID-19 infection (33.7% vs 32.7%, P = 0.879) and resultant increased seizure activity following infection between the vaccinated and unvaccinated groups after propensity score matching (9.1% vs 15.6%, P = 0.428).Three unvaccinated cases of Dravet syndrome developed status epilepticus following COVID-19 infection. SIGNIFICANCE Vaccination against COVID-19 is safe and well tolerated in children, even in younger patients with D/EE. Although the risk of worsening seizures following COVID-19 infection may not be reduced by immunization, education focused on increased vaccination in pediatric epilepsy is still warranted.
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Affiliation(s)
- Congjie Chen
- Department of RehabilitationChildren's Hospital of Chongqing Medical University (CHCMU)ChongqingChina
- Ministry of Education Key Laboratory of Child Development and DisordersChongqingChina
- National Clinical Research Center for Child Health and Disorders (Chongqing)ChongqingChina
- International Science and Technology Cooperation Base of Child Development and Critical DisordersChongqingChina
- Chongqing Key Laboratory of PediatricsChongqingChina
| | - Ningning Chen
- Department of RehabilitationChildren's Hospital of Chongqing Medical University (CHCMU)ChongqingChina
- Ministry of Education Key Laboratory of Child Development and DisordersChongqingChina
- National Clinical Research Center for Child Health and Disorders (Chongqing)ChongqingChina
- International Science and Technology Cooperation Base of Child Development and Critical DisordersChongqingChina
- Chongqing Key Laboratory of PediatricsChongqingChina
| | - Li Xie
- Department of RehabilitationChildren's Hospital of Chongqing Medical University (CHCMU)ChongqingChina
- Ministry of Education Key Laboratory of Child Development and DisordersChongqingChina
- National Clinical Research Center for Child Health and Disorders (Chongqing)ChongqingChina
- International Science and Technology Cooperation Base of Child Development and Critical DisordersChongqingChina
- Chongqing Key Laboratory of PediatricsChongqingChina
| | - Yuanyuan Luo
- Ministry of Education Key Laboratory of Child Development and DisordersChongqingChina
- National Clinical Research Center for Child Health and Disorders (Chongqing)ChongqingChina
- International Science and Technology Cooperation Base of Child Development and Critical DisordersChongqingChina
- Chongqing Key Laboratory of PediatricsChongqingChina
- Department of NeurologyCHCMUChongqingChina
| | - Jiannan Ma
- Ministry of Education Key Laboratory of Child Development and DisordersChongqingChina
- National Clinical Research Center for Child Health and Disorders (Chongqing)ChongqingChina
- International Science and Technology Cooperation Base of Child Development and Critical DisordersChongqingChina
- Chongqing Key Laboratory of PediatricsChongqingChina
- Department of NeurologyCHCMUChongqingChina
| | - Tingsong Li
- Department of RehabilitationChildren's Hospital of Chongqing Medical University (CHCMU)ChongqingChina
- Ministry of Education Key Laboratory of Child Development and DisordersChongqingChina
- National Clinical Research Center for Child Health and Disorders (Chongqing)ChongqingChina
- International Science and Technology Cooperation Base of Child Development and Critical DisordersChongqingChina
- Chongqing Key Laboratory of PediatricsChongqingChina
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12
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Yang Y, Lv J, He C, Shen C, Xu S, Guo Y, Ding Y, Zheng Z, Zhu J, Wang S, Ding M, Wang S. Predictors and prevalence of COVID-19 vaccination in patients with focal epilepsy following resection surgery. Epilepsy Behav 2023; 145:109344. [PMID: 37459719 DOI: 10.1016/j.yebeh.2023.109344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/23/2023] [Accepted: 06/25/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND AND PURPOSE In light of the ongoing COVID-19 pandemic, vaccination has emerged as the primary and most effective solution. The aim of this study was to examine compliance rates of vaccination and explore the factors that predict vaccine uptake among patients with epilepsy (PWE) who have undergone resection surgery. METHOD To examine the variations in vaccination coverage, safety concerns, and factors influencing vaccination hesitancy among PWE who have undergone resection surgery, this study recruited patients with at least one-year follow-up. We utilized questionnaires to gather clinical characteristics and obtain information regarding COVID-19 vaccines. RESULTS Among the 303 patients included in the study, a majority of 229 (75.58%) achieved a seizure-free outcome (Engel Ia). Of these patients, 178 (58.75%) received at least one dose of COVID-19 vaccine, and the vaccination rate has remained relatively consistent over the past six months. Nearly 94.95% of those who received the vaccine completed the full vaccination regimen, with the majority (n = 174, 97.75%) opting for an inactivated vaccine. Only three patients reported side effects unrelated to epilepsy, and one patient experienced a worsening of typical aura seizures within one month after vaccination. Notably, significant positive associations were observed between COVID-19 vaccine acceptance and adulthood (age 18 years or older) (OR = 1.820, 95% CI = 1.018-3.252, p = 0.043) as well as achieving a seizure-free outcome (OR = 2.823, 95% CI = 1.619-4.921, p < 0.001). Regarding the unvaccinated patients, approximately one-fifth expressed willingness to receive a future COVID-19 vaccine, while the remainder were hesitant (41.60%) or unsure (39.20%) about vaccination. These reservations mainly stemmed from concerns about the potential worsening of seizures and vaccine safety. CONCLUSIONS Inactivated vaccines can be considered safe for individuals with epilepsy who have undergone resection surgery. The likelihood of being vaccinated was found to be comparatively higher among the cohort with seizure-free status or adults. To promote COVID-19 vaccination among children, it is crucial to implement comprehensive education and public awareness campaigns that emphasize the safety of vaccines. These efforts will help encourage widespread acceptance of vaccination and ensure the well-being of individuals with epilepsy.
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Affiliation(s)
- Yuyu Yang
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jin Lv
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Chenmin He
- Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Chunhong Shen
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Sha Xu
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yi Guo
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yao Ding
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhe Zheng
- Epilepsy Center, Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Junming Zhu
- Epilepsy Center, Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shuang Wang
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Meiping Ding
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
| | - Shan Wang
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
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Ortiz-de la Rosa JS, Ramón-Gómez JL, Martínez-Córdoba N, Lince-Rivera I. SARS-CoV-2 vaccination in paediatric patients with epilepsy: experience of a tertiary center in Colombia. Rev Neurol 2023; 77:13-18. [PMID: 37365720 PMCID: PMC10663804 DOI: 10.33588/rn.7701.2023127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Indexed: 06/28/2023]
Abstract
AIM The objective of this study is to evaluate effects of SARS-CoV-2 vaccination on seizure pattern in paediatric patients with epilepsy that attended our tertiary center in the city of Bogota, Colombia. PATIENTS AND METHODS Children with epilepsy who were treated at our center and have had SARS-CoV-2 vaccination and their caregivers were asked to report their experience following vaccination. We documented age, sex, age at onset of epilepsy, duration of epilepsy, epilepsy type, seizure frequency, number of medications, time from last crisis, vaccination schemes, and seizures two weeks after vaccination. RESULTS One hundred and one patients with epilepsy were included (58%, male; and 42%, female). The average age was 11 years, 73% had focal epilepsy, and 27%, generalized. Twenty-one fulfilled criteria for refractory epilepsy and 11 had a personal history of febrile seizures. Forty-seven patients had been vaccinated with Sinovac's vaccine; 41 patients, with Pfizer's; 12 patients, with Moderna's; and one, with CoronaVac's. Three patients presented seizures 24 hours after the application of the vaccine with no clear relation between vaccination and seizure frequency, and one patient required admission to the hospital for a prolonged seizure. CONCLUSION Vaccination against SARS-CoV-2 in paediatric patients with epilepsy is safe. Approximately 3% of patients with epilepsy could eventually have seizures in the post-vaccination period.
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14
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Strafford H, Lacey AS, Hollinghurst J, Akbari A, Watkins A, Paterson J, Jennings D, Lyons RA, Powell HR, Kerr MP, Chin RW, Pickrell WO. COVID-19 vaccination uptake in people with epilepsy in wales. Seizure 2023; 108:49-52. [PMID: 37080124 PMCID: PMC10076248 DOI: 10.1016/j.seizure.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 04/03/2023] [Accepted: 04/05/2023] [Indexed: 04/09/2023] Open
Abstract
PURPOSE People with epilepsy (PWE) are at increased risk of severe COVID-19. Assessing COVID-19 vaccine uptake is therefore important. We compared COVID-19 vaccination uptake for PWE in Wales with a matched control cohort. METHODS We performed a retrospective, population, cohort study using linked, anonymised, Welsh electronic health records within the Secure Anonymised Information Linkage (SAIL) Databank (Welsh population=3.1 million).We identified PWE in Wales between 1st March 2020 and 31st December 2021 and created a control cohort using exact 5:1 matching (sex, age and socioeconomic status). We recorded 1st, 2nd and booster COVID-19 vaccinations. RESULTS There were 25,404 adults with epilepsy (127,020 controls). 23,454 (92.3%) had a first vaccination, 22,826 (89.9%) a second, and 17,797 (70.1%) a booster. Comparative figures for controls were: 112,334 (87.8%), 109,057 (85.2%) and 79,980 (62.4%).PWE had higher vaccination rates in all age, sex and socioeconomic subgroups apart from booster uptake in older subgroups. Vaccination rates were higher in older subgroups, women and less deprived areas for both cohorts. People with intellectual disability and epilepsy had higher vaccination rates when compared with controls with intellectual disability. CONCLUSIONS COVID-19 vaccination uptake for PWE in Wales was higher than that for a matched control group.
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Affiliation(s)
- H Strafford
- Neurology Research Group, Swansea University Medical School, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, Wales SA2 8PP, UK.
| | - A S Lacey
- Neurology Research Group, Swansea University Medical School, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, Wales SA2 8PP, UK
| | - J Hollinghurst
- Neurology Research Group, Swansea University Medical School, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, Wales SA2 8PP, UK
| | - A Akbari
- Neurology Research Group, Swansea University Medical School, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, Wales SA2 8PP, UK
| | - A Watkins
- Neurology Research Group, Swansea University Medical School, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, Wales SA2 8PP, UK
| | - J Paterson
- Epilepsy Action, New Anstey House, Gate Way Drive, Yeadon, Leeds, England, UK
| | - D Jennings
- Epilepsy Action, New Anstey House, Gate Way Drive, Yeadon, Leeds, England, UK
| | - R A Lyons
- Neurology Research Group, Swansea University Medical School, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, Wales SA2 8PP, UK
| | - H R Powell
- Neurology Research Group, Swansea University Medical School, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, Wales SA2 8PP, UK; Morriston Hospital, Swansea Bay University Health Board, Swansea, Wales, UK
| | - M P Kerr
- Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, Wales, UK
| | - R W Chin
- Muir Maxwell Epilepsy Centre, Centre for Clinical Brain Sciences and Department of Child Life and Health, The University of Edinburgh, Scotland, UK; Royal Hospital for Children and Young People, Edinburgh, Scotland, UK
| | - W O Pickrell
- Neurology Research Group, Swansea University Medical School, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, Wales SA2 8PP, UK; Morriston Hospital, Swansea Bay University Health Board, Swansea, Wales, UK
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15
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Boruah AP, Heydari K, Wapniarski AE, Caldwell M, Thakur KT. Neurological Considerations with COVID-19 Vaccinations. Semin Neurol 2023. [PMID: 37094803 DOI: 10.1055/s-0043-1767725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
The benefits of coronavirus disease 2019 (COVID-19) vaccination significantly outweigh its risks on a public health scale, and vaccination has been crucial in controlling the spread of SARS-CoV-2. Nonetheless, several reports of adverse events following vaccination have been published.To summarize reports to date and assess the extent and quality of evidence regarding possible serious adverse neurological events following COVID-19 vaccination, focusing on Food and Drug Administration (FDA)-approved vaccines in the United States (BNT162b2, mRNA-1273, and Ad26.COV2.S).A review of literature from five major electronic databases (PubMed, Medline, Embase, Cochrane Library, and Google Scholar) was conducted between December 1, 2020 and June 5, 2022. Articles included in the review were systematic reviews and meta-analysis, cohort studies, retrospective studies, case-control studies, case series, and reports. Editorials, letters, and animal studies were excluded, since these studies did not include quantitative data regarding adverse side effects of vaccination in human subjects.Of 149 total articles and 97 (65%) were case reports or case series. Three phase 3 trials initially conducted for BNT162b2, MRNA-1273, and Ad26.COV2.S were included in the analysis.The amount and quality of evidence for possible neurological adverse events in the context of FDA-approved COVID-19 vaccinations is overall low tier. The current body of evidence continues to suggest that COVID-19 vaccinations have a high neurological safety profile; however, the risks and benefits of vaccination must continue to be closely monitored.
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Affiliation(s)
- Abhilasha P Boruah
- Department of Neurology, Columbia University Irving Medical Center/New York Presbyterian Hospital (CUIMC/NYP), New York, NY
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Kimia Heydari
- Department of Neurology, Columbia University Irving Medical Center/New York Presbyterian Hospital (CUIMC/NYP), New York, NY
| | - Anne E Wapniarski
- Department of Neurology, Columbia University Irving Medical Center/New York Presbyterian Hospital (CUIMC/NYP), New York, NY
| | - Marissa Caldwell
- Department of Neurology, Columbia University Irving Medical Center/New York Presbyterian Hospital (CUIMC/NYP), New York, NY
| | - Kiran T Thakur
- Department of Neurology, Columbia University Irving Medical Center/New York Presbyterian Hospital (CUIMC/NYP), New York, NY
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Wang Z, Fang X, Han T, Lv S, Li C, Ma A, Jiang Z, Li W, Sun W, Sun W, Gao Y, Gao Z, Liu Y, Li Q, Wang S, Li B, Liu X, Liu X. Safety and Tolerability of COVID-19 Vaccine in Children With Epilepsy: A Prospective, Multicenter Study. Pediatr Neurol 2023; 140:3-8. [PMID: 36577181 PMCID: PMC9721163 DOI: 10.1016/j.pediatrneurol.2022.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND We designed this study to investigate the effects of the coronavirus disease 2019 (COVID-19) vaccine on epileptic seizures, as well as its adverse effects, in children with epilepsy (<18 years). METHODS This anonymous questionnaire study involved a multicenter prospective survey of outpatients and inpatients with epilepsy (<18 years) registered in epilepsy clinics in eight hospitals in six cities of Shandong Province. RESULTS A total of 224 children with epilepsy were included in the study. Fifty of them experienced general adverse events after vaccination. The most common local adverse events were pain or tenderness at the injection site. The most common systemic adverse effects were muscle soreness and headache. No severe adverse events were reported. There were no significant differences in the number of antiseizure medications (P = 0.459), gender (P = 0.336), etiology (P = 0.449), age (P = 0.499), duration of disease (P = 0.546), or seizure type (P = 0.475) between the patients with and without general adverse events. We found that the risk of seizure after vaccination was decreased in children who were seizure free for more than six months before vaccination. There was no significant difference in the number of seizures during the first month before vaccination, the first month after the first dose, and the first month after the second dose (P = 0.091). CONCLUSION The benefits of vaccination against COVID-19 outweighed the risks of seizures/relapses and severe adverse events after vaccination for children with epilepsy.
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Affiliation(s)
- Zhihao Wang
- Department of Neurology, Qilu Hospital of Shandong University, Jinan, China
| | - Xiqin Fang
- Department of Neurology, Qilu Hospital of Shandong University, Jinan, China
| | - Tao Han
- Department of Neurology, Shandong Provincial Hospital, Jinan, China
| | - Shishen Lv
- Department of Pediatrics, Tengzhou Central People's Hospital, Tengzhou, China
| | - Chunxiang Li
- Department of Pediatrics, Yantai Yuhuangding Hospital, Yantai, China
| | - Aihua Ma
- Department of Pediatrics, Shandong Provincial Hospital, Jinan, China
| | - Zhaolun Jiang
- Department of Pediatrics, Tengzhou Central People's Hospital, Tengzhou, China
| | - Wenke Li
- Department of Pediatrics, Tengzhou Central People's Hospital, Tengzhou, China
| | - Wenxiu Sun
- Department of Pediatrics, Shandong Provincial Hospital, Jinan, China
| | - Wenying Sun
- Department of Pediatrics, Liaocheng People's Hospital, Liaocheng, China
| | - Yuxing Gao
- Department of Pediatrics, Shandong Provincial Hospital, Jinan, China
| | - Zaifen Gao
- Department of Pediatrics, Qilu Children's Hospital of Shandong University, Jinan, China
| | - Yong Liu
- Department of Pediatrics, Qilu Children's Hospital of Shandong University, Jinan, China
| | - Qiubo Li
- Department of Neurology, Affiliated Hospital of Jining Medical, Jining, China
| | - Suli Wang
- Department of Pediatrics, Weifang Maternal and Child Health Care Hospital, Weifang, China
| | - Baomin Li
- Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, China
| | - Xinjie Liu
- Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, China
| | - Xuewu Liu
- Department of Neurology, Qilu Hospital of Shandong University, Jinan, China; Institute of Epilepsy, Shandong University, Jinan, China.
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Ong MJY, Khoo CS, Lee YX, Poongkuntran V, Tang CK, Choong YJ, Hod R, Tan HJ. Safety and adverse events following COVID-19 vaccination among people with epilepsy: A cross-sectional study. Epilepsia Open 2023; 8:60-76. [PMID: 36214033 PMCID: PMC9874900 DOI: 10.1002/epi4.12658] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 10/05/2022] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE Epilepsy is a non-communicable disease costing a massive burden globally. It is known that there is increased prevalence of morbidity and mortality following COVID-19 infection among people with epilepsy (PWE). However, there is limited information about the adverse events following COVID-19 immunization among PWE. Hence, this study aimed to assess the safety and adverse events following immunization (AEFI) of various COVID-19 vaccines among PWE from our centre, focusing on neurological AEFI. METHODS This cross-sectional study recruited 120 adult PWE from the Neurology Clinic of the Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Consent-taking was conducted via synchronous or asynchronous approaches, followed by a phone call interview session. The interview collected socio-demographic information, epilepsy-related variables, and vaccination-related variables. Univariate analysis and multiple logistic regression analysis were done to confirm factors associated with the AEFI of COVID-19 vaccination. RESULTS Among all types of COVID-19 vaccines, most of the PWE received the Cominarty® COVID-19 vaccination (52.5%). Overall, local AEFI was the quickest to develop, with an average onset within a day. PWE with normal body mass index (BMI) had a higher risk of developing both local and systemic AEFI compared to those underweight and obese PWE (OR: 15.09, 95% CI 1.70-134.28, P = 0.02). SIGNIFICANCE COVID-19 vaccines are safe for PWE. AEFI among PWE are similar to those of the general population following COVID-19 vaccination. Therefore, clinicians should encourage PWE to take COVID-19 vaccines.
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Affiliation(s)
- Marjorie Jia Yi Ong
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.,Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Ching Soong Khoo
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Yi Xuan Lee
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Vaanee Poongkuntran
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Chia Khoi Tang
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Yu Joe Choong
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Rozita Hod
- Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Hui Jan Tan
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
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Liu X, Guo K, Lu L, Luo R, Liu J, Zhou D, Hong Z. Safety of inactivated COVID-19 vaccines in autoimmune encephalitis: A real-world cross-sectional survey. Mult Scler Relat Disord 2023; 70:104495. [PMID: 36603293 PMCID: PMC9801688 DOI: 10.1016/j.msard.2022.104495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 12/26/2022] [Accepted: 12/29/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To assess safety data of the inactivated COVID-19 vaccines in a real-world sample of people with autoimmune encephalitis (pwAE). METHODS A cross-sectional study was performed between 1 March and 30 April 2022. We invited pwAE from our previous ONE-WC (Outcome of Autoimmune Encephalitis Study in Western China) registration study database, to attend neurological clinics, at West China Hospital to participate in a face-to-face survey using a custom-designed questionnaire for this study. The ONE-WC study began in October 2011 and prospectively enrolled pwAE from four large comprehensive neurological centers in Sichuan province, China. RESULTS Of the 387 pwAE, 240 (62.0%) completed the questionnaire. Half the 240 participants (121, 50.4%) reported receiving at least one dose of COVID-19 vaccine, which in all but two patients received inactivated COVID-19 vaccine. Among vaccinated pwAE, the median age was 35 years (range 15-69) and 57.8% of them were women. The most frequent reasons that unvaccinated individuals reported for not receiving the COVID-19 vaccine were concern about vaccine-induced relapse of AE (50.4%) and advice from a physician to delay vaccination (21.0%). Small proportions of vaccinated individuals reported adverse events after the first dose (11.5%) or the second dose (10.2%), and none of the adverse events was serious. Across the entire sample, one individual reported relapsing within 30 days after the first dose and three individuals reported relapsing more than 120 days after the first dose. CONCLUSIONS This real-world survey indicates an overall favorable safety profile of the inactivated COVID-19 vaccine for pwAE.
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Affiliation(s)
- Xu Liu
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, China
| | - Kundian Guo
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, China
| | - Lu Lu
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, China
| | - Rong Luo
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Jie Liu
- Department of Neurology, Sichuan Provincial Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
| | - Dong Zhou
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, China
| | - Zhen Hong
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, China; Department of Neurology, Chengdu Shangjin Nanfu Hospital, Chengdu, Sichuan 611730, China.
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19
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Nonaka M, Neshige S, Yamada H, Ishibashi H, Takebayashi Y, Nakamori M, Aoki S, Yamazaki Y, Shishido T, Agari D, Ochi K, Iida K, Maruyama H. Immediate and 6-month seizure outcomes following first and second SARS-CoV2 mRNA vaccinations: A multicenter study with a nationwide survey. Epilepsy Behav 2023; 139:109070. [PMID: 36701937 PMCID: PMC9808415 DOI: 10.1016/j.yebeh.2022.109070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 12/23/2022] [Accepted: 12/23/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVE This study aimed to identify seizure outcomes in people with epilepsy (PWE) following severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) messenger RNA vaccination. METHODS We examined PWE (n = 332, age ≥ 14 years) treated in four tertiary hospitals between 2021 and 2022 to assess the incidence of seizure worsening following vaccination using closed questions. We identified the clinical factors associated with worsening and 6-month vaccination outcomes. We also conducted a nationwide survey on self-reported seizure worsening using open questions, to which 261 general practitioners from 99 institutes contributed. RESULTS Of the 282 PWE vaccinated in the four hospitals, 16 (5.7%) exhibited seizure worsening; most of them emerged within 48 h of vaccination and were not sustained. Thus, all PWE were at baseline condition 6 months after their vaccination. PWE with seizure worsening were more significantly associated with focal impaired awareness seizures (p < 0.001), high seizure frequency (p = 0.025), and drug-resistant epilepsy (p = 0.007) at baseline compared to PWE without worsening. Multivariate logistic regression analysis revealed that focal impaired awareness seizures were independently associated with worsening (odds ratio, 7.0; 95% confidence interval, 1.50-32.77). A nationwide survey of 5156 PWE data (real-world data) confirmed an extremely low incidence rate of self-reported seizure worsening (0.43%). SIGNIFICANCE Some PWE, particularly refractory focal epilepsy, exhibit seizure worsening. However, the worsening events were infrequent, non-sustainable, and probably under-reported by PWE, suggesting that there is little evidence that worsening seizures discourage current and future vaccinations.
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Affiliation(s)
- Megumi Nonaka
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan
| | - Shuichiro Neshige
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan; Epilepsy Center, Hiroshima University Hospital, Japan.
| | - Hidetada Yamada
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan
| | - Haruka Ishibashi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan
| | - Yoshiko Takebayashi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan
| | - Masahiro Nakamori
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan
| | - Shiro Aoki
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan
| | - Yu Yamazaki
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan
| | | | - Dai Agari
- Hiroshima City Hiroshima Citizens Hospital, Japan; Hiroshima City Funairi Citizens Hospital, Japan
| | | | - Koji Iida
- Epilepsy Center, Hiroshima University Hospital, Japan; Department of Neurosurgery, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan; Epilepsy Center, Hiroshima University Hospital, Japan
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20
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COVID-19 vaccine uptake and vaccine hesitancy in rural-to-urban migrant workers at the first round of COVID-19 vaccination in China. BMC Public Health 2023; 23:139. [PMID: 36658507 PMCID: PMC9851897 DOI: 10.1186/s12889-023-15068-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/16/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Migration can be linked to the transmission of COVID-19. COVID-19 vaccine uptake and hesitancy among rural-to-urban migrant workers in China, the largest group of internal migrants in the world, has not been characterized. OBJECTIVE To investigate COVID-19 vaccine uptake and identify vaccine hesitancy-associated factors among rural-to-urban migrant workers in the first round of COVID-19 vaccination in China. METHODS A cross-sectional questionnaire-based survey was conducted, including 14,917 participants. Socio-demographics, COVID-19 vaccine uptake, vaccine hesitancy and its associated factors based on Vaccine Hesitancy Determinants Matrix (VHDM) were applied for the survey. Data were principally analyzed by logistic regression analysis. RESULTS The COVID-19 vaccine uptake and vaccine hesitancy rates were 7.1% and 57.7%, respectively. Vaccine hesitancy was strongly associated with VHDM, including individual factors (female, higher annual income and fewer medical knowledge), group factors (less family support, friend support and public opinion support), COVID-19 epidemic factors (lower fatality, infection and emotional distress) and vaccine factors (less vaccine necessity, vaccine safety, vaccine efficacy, vaccine importance and vaccine reliability). CONCLUSION The VHDM model has the potential utility in efforts to reduce COVID-19 vaccine hesitancy. Greater efforts should be put into addressing positive predictors associated with vaccine hesitancy.
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21
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Pang EW, Lawn ND, Chan J, Lee J, Dunne JW. COVID-19 vaccination-related exacerbation of seizures in persons with epilepsy. Epilepsy Behav 2023; 138:109024. [PMID: 36495798 PMCID: PMC9705196 DOI: 10.1016/j.yebeh.2022.109024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 11/17/2022] [Accepted: 11/23/2022] [Indexed: 11/30/2022]
Abstract
Although vaccines are generally safe in persons with epilepsy (PWE), seizures can be associated with vaccination, including COVID-19. This study assessed the occurrence of COVID-19 vaccination-related seizure exacerbations in PWE. Adult PWE who had received a COVID-19 vaccine were consecutively recruited at a tertiary epilepsy clinic between June 2021 and April 2022. Patient demographics, including epilepsy history, vaccination details, and reported adverse effects were recorded. Seizure exacerbation, defined as occurring within one week of vaccination, was assessed. Five hundred and thirty PWE received the COVID-19 vaccine. 75 % received the Comirnaty (Pfizer) vaccine as their initial dose. Most patients (72 %) were taking ≥ 2 antiseizure medications (ASM) and had focal epilepsy (73 %). One-third were 12 months seizure free at their first vaccination. 13 patients (2.5 %) reported a seizure exacerbation following their first vaccination, three of whom required admission. None were seizure-free at baseline. Six of these patients (46 %) had a further exacerbation of seizures with their second vaccine. An additional four patients reported increased seizures only with the second vaccine dose. Seizure exacerbations are infrequently associated with COVID-19 vaccination, mainly in patients with ongoing seizures. The likelihood of COVID-19 infection complications in PWE outweighs the risk of vaccination-related seizure exacerbations.
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Affiliation(s)
- E W Pang
- Western Australian Adult Epilepsy Service, Perth, Western Australia, Australia; Neurology Department, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
| | - N D Lawn
- Western Australian Adult Epilepsy Service, Perth, Western Australia, Australia; Neurology Department, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - J Chan
- Western Australian Adult Epilepsy Service, Perth, Western Australia, Australia; Neurology Department, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - J Lee
- Western Australian Adult Epilepsy Service, Perth, Western Australia, Australia
| | - J W Dunne
- Western Australian Adult Epilepsy Service, Perth, Western Australia, Australia; Discipline of Internal Medicine, Medical School, Royal Perth Hospital Unit, The University of Western Australia, Perth, Western Australia, Australia
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22
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Wang S, Lv J, He C, Yang Y, Zheng Y, Ye L, Chen C, Shen C, Xu S, Ding Y, Guo Y, Tang Y, Wang S, Ding M. COVID-19 vaccination hesitancy and safety among adult people with epilepsy in eastern China. Epilepsy Behav 2023; 138:108984. [PMID: 36423385 PMCID: PMC9637523 DOI: 10.1016/j.yebeh.2022.108984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 10/28/2022] [Accepted: 10/29/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This study assesses the hesitancy and safety of vaccination administration for the novel 2019 Coronavirus Disease (COVID-19) among adult people with epilepsy (PWE). METHODS We recruited adult PWE who visited the outpatient epilepsy clinic from August 2021 to February 2022. We administered a structured questionnaire and a face-to-face interview regarding demographic factors, epilepsy characteristics, and relevant vaccine issues to all patients. Factors related to receiving a vaccine and epilepsy-related events after vaccination were then analyzed. RESULTS A total of 501 PWE were surveyed; 288 were unvaccinated and 213 were vaccinated. Patients without jobs (OR: 0.59; 95% CI: 0.37-0.95, p = 0.03) were less likely to receive the vaccine compared to students or those with jobs. Other factors associated with vaccination were a higher number of anti-seizure medications (OR: 0.72; 95% CI: 0.55-0.95, p = 0.02) and a lower pre-vaccine seizure frequency (OR: 2.21; 95% CI: 1.06-4.59, p = 0.03). Of the 213 vaccinated patients, 10 (4.70%) reported at least one local and/or systemic side effect. Most patients (92.50%) did not report worse seizures within one month of vaccination. Poor ASM adherence (OR: 15.06; 95% CI: 1.75-129.87, p = 0.01) and fatigue/stimulant drinks such as caffeine (OR: 50.59; 95% CI: 7.57-337.94, p < 0.01) were significantly associated with seizure worsening within one month of receiving the COVID-19 vaccination. CONCLUSION Almost two-fifths of patients with adult PWE have received a COVID-19 vaccine. Attention should be paid to educating epilepsy patients without jobs on the significance and safety of the vaccine. There was a low risk of seizure worsening in the short term after vaccination in PWE.
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Affiliation(s)
- Shan Wang
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jin Lv
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Chenmin He
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yuyu Yang
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yuanyuan Zheng
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lingqi Ye
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Cong Chen
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Chunhong Shen
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Sha Xu
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yao Ding
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yi Guo
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yelei Tang
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shuang Wang
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
| | - Meiping Ding
- Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
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23
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Fang X, Hu S, Han T, Yang T, Hu J, Song Y, Li C, Ma A, Li Y, Kong Q, Tang L, Chen W, Sun W, Fang C, Sun Y, Chen J, Sun W, Yan Y, Gao Y, Geng J, Li N, Li Q, Jiang Z, Lv S, Li W, Lang X, Wang S, Chen Y, Li B, Li L, Liu X, Liu Y, Zhan Y, Gao Z, Qu L, Fu Q, Liu X. Effect of inactivated COVID-19 vaccines on seizure frequency in patients with epilepsy: A multicenter, prospective study. Front Immunol 2022; 13:984789. [PMID: 36569941 PMCID: PMC9769399 DOI: 10.3389/fimmu.2022.984789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
Objectives Several COVID-19 vaccines list "uncontrolled epilepsy" as a contraindication for vaccination. This consequently restricts vaccination against COVID-19 in patients with epilepsy (PWE). However, there is no strong evidence that COVID-19 vaccination can exacerbate conditions in PWE. This study aims to determine the impact of COVID-19 vaccination on PWE. Methods PWE were prospectively recruited from 25 epilepsy centers. We recorded the seizure frequency at three time periods (one month before the first vaccination and one month after the first and second vaccinations). A generalized linear mixed-effects model (GLMM) was used for analysis, and the adjusted incidence rate ratio (AIRR) with 95% CI was presented and interpreted accordingly. Results Overall, 859 PWE were included in the analysis. Thirty-one (3.6%) and 35 (4.1%) patients were found to have increased seizure frequency after the two doses, respectively. Age had an interaction with time. The seizure frequency in adults decreased by 81% after the first dose (AIRR=0.19, 95% CI:0.11-0.34) and 85% after the second dose (AIRR=0.16, 95% CI:0.08-0.30). In juveniles (<18), it was 25% (AIRR=0.75, 95% CI:0.42-1.34) and 51% (AIRR=0.49, 95% CI:0.25-0.95), respectively. Interval between the last seizure before vaccination and the first dose of vaccination (ILSFV) had a significant effect on seizure frequency after vaccination. Seizure frequency in PWE with hereditary epilepsy after vaccination was significantly higher than that in PWE with unknown etiology (AIRR=1.95, 95% CI: 1.17-3.24). Two hundred and seventeen (25.3%) patients experienced non-epileptic but not serious adverse reactions. Discussion The inactivated COVID-19 vaccine does not significantly increase seizure frequency in PWE. The limitations of vaccination in PWE should focus on aspects other than control status. Juvenile PWE should be of greater concern after vaccination because they have lower safety. Finally, PWE should not reduce the dosage of anti-seizure medication during the peri-vaccination period.
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Affiliation(s)
- Xiqin Fang
- Department of Neurology, Qilu Hospital, Shandong University, Jinan, China,Institute of Epilepsy, Shandong University, Jinan, China
| | - Shimin Hu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China,Beijing Key Laboratory of Neuromodulation, Beijing, China,Institute of Sleep and Consciousness Disorders, Center of Epilepsy, Beijing institute for Brain Disorders, Capital Medical University, Beijing, China
| | - Tao Han
- Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China
| | - Tingting Yang
- Department of Neurology, Qilu Hospital, Shandong University, Jinan, China,Institute of Epilepsy, Shandong University, Jinan, China
| | - Junji Hu
- Department of Neurology, Zibo Changguo Hospital, Zibo, China
| | - Yucheng Song
- Department of Neurology, Jining City Dai Zhuang Hospital, Jining, China
| | - Chunxiang Li
- Department of Pediatrics, Yantai Yuhuangding Hospital, Yantai, China
| | - Aihua Ma
- Department of Pediatrics, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China
| | - Yufeng Li
- Department of Pediatrics, Linyi People’s Hospital, Linyi, China
| | - Qingxia Kong
- Department of Neurology, Affiliated Hospital of Jining Medical, Jining, China
| | - Liou Tang
- Department of Neurology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Wei Chen
- Department of Neurosurgery, Liaocheng People’s Hospital, Liaocheng, China
| | - Wenxiu Sun
- Department of Pediatrics, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China
| | - Chunyan Fang
- Department of Neurology, Zhucheng People’s Hospital, Zhucheng, China
| | - Yanping Sun
- Department of Neurology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Juan Chen
- Department of Neurology, Heze Third People’s Hospital, Heze, China
| | - Wenying Sun
- Department of Pediatrics, Liaocheng People’s Hospital, Liaocheng, China
| | - Yibing Yan
- Department of Neurosurgery, The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Yuxing Gao
- Department of Pediatrics, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China
| | - Jianhong Geng
- Department of Neurology, Affiliated Hospital of Weifang Medical College, Weifang, China
| | - Nan Li
- Department of Neurology, Shengli Oilfield Central Hospital, Dongying, China
| | - Qiubo Li
- Department of Pediatrics, Affiliated Hospital of Jining Medical, Jining, China
| | - Zhaolun Jiang
- Department of Pediatrics, Tengzhou Central People’s Hospital, Zaozhuang, China
| | - Shishen Lv
- Department of Pediatrics, Tengzhou Central People’s Hospital, Zaozhuang, China
| | - Wenke Li
- Department of Pediatrics, Tengzhou Central People’s Hospital, Zaozhuang, China
| | - Xiaoling Lang
- Department of Neurology, Laizhou People’s Hospital, Qingdao, China
| | - Suli Wang
- Department of Pediatrics, Weifang Maternal and Child Health Care Hospital, Weifang, China
| | - Yanxiu Chen
- Department of Neurology, Liaocheng People’s Hospital, Liaocheng, China
| | - Baomin Li
- Department of Pediatrics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Ling Li
- Department of Neurology, Qilu Hospital of Shandong University (Qingdao), Qingdao, China
| | - Xinjie Liu
- Department of Pediatrics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yong Liu
- Department of Pediatrics, Qilu Children’s Hospital of Shandong University, Jinan, China
| | - Yan Zhan
- Department of Neurology, Affiliated Hospital of Binzhou Medical College, Yantai, China
| | - Zaifen Gao
- Department of Pediatrics, Qilu Children’s Hospital of Shandong University, Jinan, China
| | - Lixin Qu
- Department of Neurology, Dezhou People’s Hospital, Dezhou, China
| | - Qingxi Fu
- Department of Neurology, Linyi People’s Hospital, Linyi, China
| | - Xuewu Liu
- Department of Neurology, Qilu Hospital, Shandong University, Jinan, China,Institute of Epilepsy, Shandong University, Jinan, China,*Correspondence: Xuewu Liu,
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Huang A, Lu Y, Ji J, Yao Y, Guan S, Chen Z, Yu L. The effect of COVID-19 vaccination on epileptic seizures in patients with epilepsy: A clinical observation in China. Hum Vaccin Immunother 2022; 18:2141519. [PMID: 36412219 PMCID: PMC9746452 DOI: 10.1080/21645515.2022.2141519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This observational retrospective study was conducted on patients with epilepsy (PWE) in China who had at least one dose of COVID-19 vaccine and it investigated the safety of vaccination by analyzing changes in epileptic seizures and their influencing factors. Consecutive PWE who were followed up in the epilepsy clinic between June 2021 and May 2022 were enrolled. Data on vaccine type, demographic information, clinical characteristics of epilepsy, and treatment were collected through a questionnaire survey and retrospectively analyzed. PWE were divided into a stable seizure group and a worsening seizure group based on seizure episodes at least 90 days after the first vaccine dose. A total of 79 PWE were included. After vaccination, 14 patients (17.7%) had worsening seizures, 92.9% of whom had an increased seizure frequency. Compared with patients in the stable seizure group, patients in the worsening seizure group had significant differences in baseline monthly seizure frequency (P = .012), improper antiseizure medication (ASM) administration (P = .003) and a disrupted sleep routine (P = .016). Multivariate logistic regression analysis showed that improper ASM administration (OR 6.186, 95% confidence interval [CI] 1.312-29.170; p = .021) and a disrupted sleep routine (OR 6.326, 95% CI 1.326-30.174; p = .021) were significantly associated with seizure worsening. In short, COVID-19 vaccination is safe for PWE, and only those with poor seizure control have the possibility of seizure exacerbation after COVID-19 vaccination. The vaccination per se does not represent a major influencing factor, but the improper use of ASMs and a disrupted sleep routine may be correlated with seizure aggravation after vaccination.
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Affiliation(s)
- Aizhen Huang
- Department of Neurology, Liuzhou Municipal Liutie Central Hospital, Liuzhou, GX, China
| | - Yanting Lu
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, GX, China
| | - Jingjing Ji
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, GX, China
| | - Yankun Yao
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, GX, China
| | - Shiping Guan
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, GX, China
| | - Zirong Chen
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, GX, China
| | - Lu Yu
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, GX, China
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Observational retrospective analysis of vaccination against SARS-CoV-2 and seizures: VACCI-COVID registry. Epilepsy Behav 2022; 134:108808. [PMID: 35809503 PMCID: PMC9217164 DOI: 10.1016/j.yebeh.2022.108808] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 06/08/2022] [Accepted: 06/19/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND We aimed to assess the risk of developing new-onset seizures or seizure decompensations in people with epilepsy (PWE) associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines. METHODS A retrospective observational study in a tertiary hospital was conducted. Clinical records of all patients attended because of seizures or epilepsy at outpatient clinics, emergency department, or admitted to our hospital from January to December 2021 were reviewed, including patients older than 16 years who received some dose of coronavirus disease 2019 (COVID-19) vaccines. RESULTS A total of 418 vaccinated PWE were analyzed: 6.2% presented an increase in seizure frequency and 1% reported different seizure types during the next month after vaccination. However, 61.5% had another possible cause for this decompensation. Having monthly seizures (1-3/month) was the only associated risk factor (OR 4.9, p < 0.001) while being seizure free > 1 year had a protective role (OR 0.36, p = 0.019). Patients with epileptic encephalopathies or a history of COVID-19 infection were not at increased risk of seizure decompensation. Besides this, 15 patients presented new-onset seizures within the first month post-vaccination, mean time from vaccination 15 ± 8 days, 67% after the second dose. Again, 53.3% had another possible trigger for seizures. Eight debuted with status epilepticus or cluster of seizures. CONCLUSIONS A small proportion of PWE (6.2%) had an increase in seizure frequency after COVID-19 vaccination and 15 patients had new-onset seizures during the first month after vaccination, though another reason for seizure exacerbation was identified in 61.5% and 53.3%, respectively. Severe acute respiratory syndrome COVID-19 vaccines appear to have little impact on the generation or decompensation of seizures.
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Should patients with epilepsy be vaccinated against coronavirus disease 2019? A systematic review and meta-analysis. Epilepsy Behav 2022; 134:108822. [PMID: 35853315 PMCID: PMC9239978 DOI: 10.1016/j.yebeh.2022.108822] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 06/13/2022] [Accepted: 06/23/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The coronavirus disease 2019 (COVID-19) vaccination coverage, willingness, and safety profiles in patients with epilepsy remain poorly understood. We aimed to summarize the available evidence of COVID-19 vaccination coverage, willingness, and safety profiles among patients with epilepsy. METHODS We performed a literature search in the Pubmed, EMBASE, and Cochrane Central Register database between 1 January 2020 and 30 April 2022. We included eligible studies that provided information on the COVID-19 vaccination coverage, willingness, and safety profiles among patients with epilepsy. We investigated the association between baseline characteristics of patients with epilepsy and unvaccination status using a fixed-effect model. We calculated the pooled overall willingness to be vaccinated against COVID-19. We systematically reviewed the safety profiles after COVID-19 vaccination in patients with epilepsy. RESULTS Ten eligible observational studies and two case reports yielded 2589 participants with epilepsy or their caregivers. Among 2145 participants that provided the information of vaccination status, 1508 (70.3%) patients with epilepsy were not administered COVID-19 vaccine, and 58% (95%CI 40-75%) of respondents were willing to be vaccinated against COVID-19. Seizure status (active versus inactive, OR 1.84 95%CI 1.41-2.39, I2 = 0%) rather than seizure type (focal versus non-focal, OR 1.22 95%CI 0.94-1.58, I2 = 0%) was associated with COVID-19 unvaccination status. Vaccines were well-tolerated; epilepsy-related problems such as increase in seizure frequency and status epilepticus after COVID-19 vaccination were uncommon. CONCLUSIONS Our findings suggest a low COVID-19 vaccination coverage and willingness in patients with epilepsy. Vaccination against COVID-19 appears to be well-tolerated and safe in patients with epilepsy, supporting a positive outlook toward vaccination in this population.
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Chan CCH, Choi C, Lui WT, Ip B, Ma K, Ma SH, Fan FSY, Au L, Lau A, Chan A, Ip V, Soo Y, Leung T, Mok V, Leung H. A cross-sectional study of COVID-19 vaccination patterns among patients with epilepsy in Hong Kong. Epilepsia Open 2022; 7:570-577. [PMID: 35867810 PMCID: PMC9349844 DOI: 10.1002/epi4.12629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 06/19/2022] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE As Hong Kong faced the 5th wave of the COVID-19 pandemic, the facilitators and hurdles toward effective vaccination is important for healthcare professionals to understand the vaccination gap among patients with epilepsy. METHODS A cross-sectional, pragmatic study of COVID-19 vaccination was performed at a tertiary epilepsy center with regards to patterns of vaccination and any unusually high rate of adverse events. Patients having recent visits at the epilepsy center (4 months) had their anonymized electronic linkage records examined 12 months after the inception of vaccination program for types of vaccines, seizure demographics, and adverse events following immunization (AEFI). RESULTS A total of 200 patients with epilepsy and their anonymized data were analyzed. The vaccine uptake was approximately 60% of that of the general population. Twice as many patients with epilepsy chose to receive mRNA vaccine as compared with inactivated vaccine. The proportion of patients who kept up-to-date with all available dosing was 7%. Patients with epilepsy with genetic etiology were least likely to receive vaccination (13/38, 34%, P = .02). There was no unreasonably high rate of unacceptable side effects after vaccination among patients with epilepsy. Only 3 patients reported worsening of seizures without meeting the criteria for AEFI. Refractory epilepsy, allergy to antiseizure medications and elder age (≥65) did not confer any significant difference in vaccination patterns or adverse effects. SIGNIFICANCE A vaccination gap exists among epilepsy patients which calls for actionable strategies for improving vaccine uptake, including education and outreach programs.
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Affiliation(s)
- Charlie CH Chan
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Chun‐Ho Choi
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Wai Ting Lui
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Bonaventure Ip
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Karen KY Ma
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Sze Ho Ma
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Florence SY Fan
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Lisa Au
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Alexander Lau
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Anne YY Chan
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Vincent Ip
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Yannie Soo
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Thomas Leung
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Vincent Mok
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
| | - Howan Leung
- Division of Neurology, Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina,Department of Medicine and TherapeuticsPrince of Wales HospitalHong Kong SARChina
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Asadi-Pooya AA, Karimi A, Razavizadegan SMA, Ashjazadeh N, Nemati H. COVID-19 vaccine-related frequently asked questions (FAQs) by people with epilepsy and carers in Iran; educational video is included. Epilepsy Behav 2022; 133:108763. [PMID: 35696935 PMCID: PMC9117255 DOI: 10.1016/j.yebeh.2022.108763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/21/2022] [Accepted: 05/17/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of the current study was to inquire the questions and concerns of people with epilepsy (PWE) about COVID-19 vaccines in order to provide a more realistic list of their frequently asked questions (FAQs). METHODS We surveyed all the consecutive PWE or their care-givers who were referred to our neurology clinics (Shiraz University of Medical Sciences) during January-February 2022. We collected their questions and concerns in relation to COVID vaccines based on a predesigned brief questionnaire. Informed consent to participate in the study was obtained from the participants. RESULTS In total, 452 people participated in the study; 291 people (64.4%) did not have any questions or concerns with regard to the COVID-19 vaccination. Having any questions or concerns about COVID-19 vaccination was significantly associated with not being vaccinated. Questions and concerns about the adverse effects of COVID-19 vaccines [seizure worsening, general adverse effects, long-term effects (e.g., infertility, cognitive dysfunction)] were by far the most common questions by people with epilepsy and their carers. CONCLUSION Our findings may be used by policy-makers to prepare appropriate educational materials to provide the best targeted and tailored information to people with epilepsy and their carers to convince them of the necessity and safety of COVID-19 vaccination. Such an educational material must include enough information on the associated adverse effects of COVID-19 vaccines and should also discuss some other important issues such as indications of these vaccines in special populations and drug-vaccine interactions.
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Affiliation(s)
- Ali A. Asadi-Pooya
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, USA,Corresponding author at: Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Afrooz Karimi
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Nahid Ashjazadeh
- Department of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Nemati
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Zeng M, Zhai X, Chang H, Feng T, Zhu Y, Ma W, Wang X, Ge Y. COVID-19 vaccine counseling and safety assessment in children and teenagers with underlying medical conditions in China: a single center study. Hum Vaccin Immunother 2022; 18:2082207. [PMID: 35759787 PMCID: PMC9621049 DOI: 10.1080/21645515.2022.2082207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Safety concerns about novel vaccines and necessity of COVID-19 vaccination for children, especially with underlying medical conditions, are the obstacle of COVID-19 vaccination program among pediatric population. The study was conducted to investigate the vaccine hesitancy reasons among the parents, and to monitor the adverse events of inactivated COVID-19 vaccines in children and teenagers with underlying medical conditions in China. Children with underlying medical conditions encountered to the Immunization Advisory Clinic for COVID-19 vaccine counseling were enrolled. They were given immunization recommendation and followed up at 72 h and 28 d after immunization to monitor the immunization compliance after consultation and adverse events. A total of 324 children aged 3–17 y were included. The top three primary medical conditions for counseling were allergy (33.6%), neurological diseases (31.2%) and rheumatic diseases (8.3%). COVID-19 vaccination was promptly recommended for 242 (74.7%) children. Seventy-one (65.7%) children who had allergy issues were recommend to take vaccination, which was significantly lower than that of other medical conditions (p < .05). The follow-up record showed that 180 children received 340 doses of inactivated COVID-19 vaccine after consultation. Overall, 39 (21.6%) children reported at least one adverse event within 28 d of either vaccination. No serious adverse reactions were observed. No difference of adverse effects between the first dose and the second dose of vaccination except fever. Parents’ hesitancy in COVID-19 vaccination for children with underling medical conditions are mainly due to the safety concerns. Specialist consultation is helpful to improve the vaccine uptake.
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Affiliation(s)
- Mei Zeng
- Department of Infectious Disease, Children's Hospital of Fudan University, Shanghai, China
| | - Xiaowen Zhai
- Department of Hematology, Children's Hospital of Fudan University, Shanghai, China
| | - Hailing Chang
- Department of Infectious Disease, Children's Hospital of Fudan University, Shanghai, China
| | - Tianxing Feng
- Department of Infectious Disease, Children's Hospital of Fudan University, Shanghai, China.,Department of Pediatrics, Shanghai Rici Children's and Women's Hospital, Shanghai, China
| | - Yanfeng Zhu
- Department of Infectious Disease, Children's Hospital of Fudan University, Shanghai, China
| | - Wenjie Ma
- Department of Infectious Disease, Children's Hospital of Fudan University, Shanghai, China
| | - Xiangshi Wang
- Department of Infectious Disease, Children's Hospital of Fudan University, Shanghai, China
| | - Yanling Ge
- Department of Infectious Disease, Children's Hospital of Fudan University, Shanghai, China
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30
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Epilepsy and COVID 2021. Epilepsy Curr 2022; 22:398-403. [DOI: 10.1177/15357597221101268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Coronavirus 19 (COVID-19) has infected over 400 million people worldwide. Although COVID-19 causes predominantly respiratory symptoms, it can affect other organs including the brain, producing neurological symptoms. People with epilepsy (PWE) have been particularly impacted during the pandemic with decreased access to care, increased stress, and worsening seizures in up to 22% of them probably due to multiple factors. COVID-19 vaccines were produced in a record short time and have yielded outstanding protection with very rare serious side effects. Studies have found that COVID-19 vaccination does not increase seizures in the majority of PWE. COVID-19 does not produce a pathognomonic EEG or seizure phenotype, but rather 1 that can be seen in other types of encephalopathy. COVID-19 infection and its complications can lead to seizures, status epilepticus and post-COVID inflammatory syndrome with potential multi-organ damage in people without pre-existing epilepsy. The lack of access to care during the pandemic has forced patients and doctors to rapidly implement telemedicine. The use of phone videos and smart telemedicine are helping to treat patients during this pandemic and are becoming standard of care. Investment in infrastructure is important to make sure patients can have access to care even during a pandemic.
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Lu Q, Wang YY, Wang QH, Tang LN, Yang XY, Dun S, Zou LP. Safety of inactivated COVID-19 vaccine in tuberous sclerosis complex patients with epilepsy treated with rapamycin. Seizure 2022; 99:71-74. [PMID: 35605444 PMCID: PMC9110005 DOI: 10.1016/j.seizure.2022.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/12/2022] [Accepted: 05/14/2022] [Indexed: 12/24/2022] Open
Abstract
Purpose Methods Results Conclusion
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Affiliation(s)
- Qian Lu
- Senior Department of Pediatrics, Chinese PLA General Hospital, Department of Pediatrics, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Yang-Yang Wang
- Senior Department of Pediatrics, Chinese PLA General Hospital, Department of Pediatrics, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Qiu-Hong Wang
- Senior Department of Pediatrics, Chinese PLA General Hospital, Department of Pediatrics, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Li-Na Tang
- Senior Department of Pediatrics, Chinese PLA General Hospital, Department of Pediatrics, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China; Fosun Health, Beijing, China
| | - Xiao-Yan Yang
- Senior Department of Pediatrics, Chinese PLA General Hospital, Department of Pediatrics, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Shuo Dun
- Senior Department of Pediatrics, Chinese PLA General Hospital, Department of Pediatrics, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Li-Ping Zou
- Senior Department of Pediatrics, Chinese PLA General Hospital, Department of Pediatrics, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China; Center for Brain Disorders Research, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China.
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Rakusa M, Öztürk S, Moro E, Helbok R, Bassetti CL, Beghi E, Bereczki D, Bodini B, Di Liberto G, Jenkins TM, Macerollo A, Maia LF, Martinelli-Boneschi F, Pisani A, Priori A, Sauerbier A, Soffietti R, Taba P, von Oertzen TJ, Zedde M, Crean M, Burlica A, Cavallieri F, Sellner J. COVID-19 vaccination hesitancy among people with chronic neurological disorders: a position paper. Eur J Neurol 2022; 29:2163-2172. [PMID: 35460319 PMCID: PMC9111566 DOI: 10.1111/ene.15368] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 04/15/2022] [Indexed: 11/30/2022]
Abstract
Background and purpose Health risks associated with SARS‐CoV‐2 infection are undisputed. Moreover, the capability of vaccination to prevent symptomatic, severe, and fatal COVID‐19 is recognized. There is also early evidence that vaccination can reduce the chance for long COVID‐19. Nonetheless, the willingness to get vaccinated and receive booster shots remains subpar among people with neurologic disorders. Vaccine scepticism not only jeopardizes collective efforts to end the COVID‐19 pandemic but puts individual lives at risk, as some chronic neurologic diseases are associated with a higher risk for an unfavorable COVID‐19 course. Methods In this position paper, the NeuroCOVID‐19 Task Force of the European Academy of Neurology (EAN) summarizes the current knowledge on the prognosis of COVID‐19 among patients with neurologic disease, elucidates potential barriers to vaccination coverage, and formulates strategies to overcome vaccination hesitancy. A survey among the Task Force members on the phenomenon of vaccination hesitancy among people with neurologic disease supports the lines of argumentation. Results The study revealed that people with multiple sclerosis and other nervous system autoimmune disorders are most skeptical of SARS‐CoV‐2 vaccination. The prevailing concerns included the chance of worsening the pre‐existing neurological condition, vaccination‐related adverse events, and drug interaction. Conclusions The EAN NeuroCOVID‐19 Task Force reinforces the key role of neurologists as advocates of COVID‐19 vaccination. Neurologists need to argue in the interest of their patients about the overwhelming individual and global benefits of COVID‐19 vaccination. Moreover, they need to keep on eye on this vulnerable patient group, its concerns, and the emergence of potential safety signals.
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Affiliation(s)
- Martin Rakusa
- Department of Neurologic Diseases, University Medical Centre Maribor, Maribor, Slovenia
| | - Serefnur Öztürk
- Department of Neurology and Neurointensive Care, Selcuk University, Faculty of Medicine, Konya, Turkey
| | - Elena Moro
- Grenoble Alpes University, Division of Neurology, CHU of Grenoble, Grenoble Institute of Neurosciences, Grenoble, France
| | - Raimund Helbok
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.,Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Claudio L Bassetti
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Ettore Beghi
- Istituto di Ricerche Farmacologiche Mario Negri, IRCCS, Milan, Italy
| | - Daniel Bereczki
- Department of Neurology, Semmelweis University, Budapest, Hungary
| | - Benedetta Bodini
- Department of Neurology, Saint-Antoine Hospital, APHP, Paris, France.,Paris Brain Institute, Sorbonne University, Paris, France
| | - Giovanni Di Liberto
- Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Thomas M Jenkins
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK.,Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Antonella Macerollo
- The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, UK.,Institute of Systems, Molecular and Integrative Biology, University of Liverpool, UK
| | - Luis F Maia
- Department of Neurology, Hospital Santo António, Centro Hospitalar Universitário do Porto, Porto, Portugal.,i3S - Instituto de Investigação e Inovação em Saúde Universidade do Porto, Porto, Portugal
| | - Filippo Martinelli-Boneschi
- Neurology Unit and MS Centre, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation (DEPT), Dino Ferrari Centre, Neuroscience Section, University of Milan, Milan
| | - Antonio Pisani
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,IRCCS Mondino Foundation, Pavia, Italy
| | - Alberto Priori
- Division of Neurology, Department of Neurology, 'Aldo Ravelli' Research Center, University of Milan and ASST Santi Paolo e Carlo, Milan, Italy
| | - Anna Sauerbier
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany
| | - Riccardo Soffietti
- Division of Neuro-Oncology, Department of Neuroscience, University of Turin, Turin, Italy
| | - Pille Taba
- Department of Neurology and Neurosurgery, Institute of Clinical Medicine, Tartu, Estonia.,Tartu University Hospital, Tartu, Estonia
| | - Tim J von Oertzen
- Department of Neurology, Neuromed Campus, Kepler Universitätsklinikum, Linz, Austria.,Medical Faculty, Johannes Kepler University, Linz, Austria
| | - Marialuisa Zedde
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Michael Crean
- European Academy of Neurology (EAN) Head Office, Vienna, Austria
| | - Anja Burlica
- European Academy of Neurology (EAN) Head Office, Vienna, Austria
| | - Francesco Cavallieri
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Johann Sellner
- Department of Neurology, Landesklinikum Mistelbach-Gänserndorf, Mistelbach, Austria
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Dinoto A, Gastaldi M, Iorio R, Marini S, Damato V, Farina A, Zoccarato M, Sechi E, Pinna F, Maniscalco GT, Barnabei R, Zuliani L, Ferrari S, Mariotto S. Safety profile of SARS-CoV-2 vaccination in patients with antibody-mediated CNS disorders. Mult Scler Relat Disord 2022; 63:103827. [PMID: 35508101 PMCID: PMC9035564 DOI: 10.1016/j.msard.2022.103827] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/11/2022] [Accepted: 04/21/2022] [Indexed: 11/19/2022]
Abstract
Objectives: In this retrospective multicenter study, we evaluated the safety of SARS-CoV-2 vaccination in patients harboring autoantibodies targeting neuronal surface and/or synaptic antigens. Methods: From eight Italian Neurology Units, we included patients with: a) serum and/or CSF positivity for specific neuronal autoantibodies; b) a compatible neurological syndrome; and c) available follow-up ≥6 weeks after vaccination with any of the approved SARS-CoV-2 vaccines. Demographics, clinical data, and information regarding previous SARS-CoV-2 infection and vaccination were collected. Disease relapses were considered “post-infectious” or “post-vaccination” when occurring within 6 weeks from infection/vaccination. Results: We included 66 patients; 7/66 (11%) had a previous history of SARS-CoV-2 infection and 1/7 (14%) had post-infection relapses. BNT162b2-Pfizer-BioNTec was administered in 55 cases (83.3%) and mRNA-1273-Moderna in 11 (16.7%). The median number of doses administered per patient was 2 (1–3) and >50% of patients did not experience side effects. Five patients (8%) had post-vaccination relapses (seizure 3/5); 4/5 improved after immunotherapy, while one did not receive immunotherapy and worsened. Patients with post-vaccination relapses had higher disability scores at vaccination (p = 0.025), a trend favoring Leucine-rich glioma-inactivated protein 1 LGI1 glutamic acid decarboxylase 65 (GAD65) antibodies (p = 0.054) and shorter time from last relapse (p = 0.057). Discussion: Our data support the safety of SARS-CoV-2 vaccines in patients with neurological disorders associated with antibodies to neuronal and synaptic antigens.
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Affiliation(s)
- Alessandro Dinoto
- Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Matteo Gastaldi
- Neuroimmunology Laboratory, IRCCS Mondino Foundation, Pavia, Italy
| | - Raffaele Iorio
- UOC Neurologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
| | - Sofia Marini
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Valentina Damato
- Department of Neurosciences, Drug and Child Health, University of Florence, Florence, Italy
| | - Antonio Farina
- Department of Neurosciences, Drug and Child Health, University of Florence, Florence, Italy
| | - Marco Zoccarato
- UOC Neurologia O.S.A. - Azienda Ospedale Università Di Padova, Padua, Italy
| | - Elia Sechi
- Azienda Ospedaliera Universitaria Sassari, Unit of Neurology, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Francesca Pinna
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Giorgia Teresa Maniscalco
- Neurological Clinic and Stroke Unit, Multiple Sclerosis Center, "A. Cardarelli" Hospital, Naples, Italy
| | | | | | - Sergio Ferrari
- Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sara Mariotto
- Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
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Romozzi M, Rollo E, Quintieri P, Dono F, Evangelista G, Consoli S, Veleno L, Anzellotti F, Calvello C, Costa C, Servidei S, Calabresi P, Vollono C. Impact of COVID-19 vaccine on epilepsy in adult subjects: an Italian multicentric experience. Neurol Sci 2022; 43:4627-4634. [PMID: 35501537 PMCID: PMC9059692 DOI: 10.1007/s10072-022-06100-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 04/25/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To investigate the safety and tolerability of COVID-19 vaccines in people with epilepsy (PwE). METHODS In this multicentric observational cohort study, we recruited adult patients (age > 18 years old) with epilepsy who attended the Outpatient Epilepsy Clinic from 1st July to 30th October 2021. We administered to the patients a structured questionnaire and interview on demographic and epilepsy characteristics, current treatment, previous SARS-CoV-2 infection, vaccine characteristics, post-vaccine seizure relapse, other side effect, variation of sleep habits, caffeine, or alcohol intake. Seizure frequency worsening was defined as a ratio between mean monthly frequency post-vaccination and mean monthly frequency pre-vaccination superior to 1. Patients were categorized in two groups: patients with seizure frequency worsening (WORSE) and patients with seizure stability (STABLE). RESULTS A total of 358 people participated with a mean age of 47.46 ± 19.04. Focal seizure (79.1%), generalized epilepsy (20.4%), and unknown types of epilepsy (0.5%) were detected among participants. In total, 31 (8.7%) people expressed that they were not willing to receive a COVID-19 vaccine; 302 patients (92.35%) did not experience an increase in the seizure frequency (STABLE-group) whereas 25 patients (7.65%) had a seizure worsening (WORSE-group). Post-vaccine seizures occurred mainly in the 7 days following the administration of the vaccine. Patients in the WORSE-group were treated with a mean higher number of anti-seizure medication (ASMs) (p = 0.003) and had a higher pre-vaccine seizure frequency (p = 0.009) compared with patients in the STABLE-group. Drug-resistant epilepsy was also associated with seizure worsening (p = 0.01). One-year pre-vaccination seizure frequency pattern demonstrated that patients in the WORSE-group had a higher frequency pattern (p < 0.001). Multivariate analysis of the vaccinated group showed that only the seizure frequency pattern (confidence interval [CI] = 1.257-2.028; p < 0.001) was significantly associated with seizure worsening. CONCLUSION In our cohort of vaccinated PwE, only a little percentage had a transient short-term increase of seizure frequency. The present study demonstrates that COVID-19 vaccines have a good safety and tolerability profile in the short term in PwE.
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Affiliation(s)
- Marina Romozzi
- Dipartimento Universitario Di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurologia, Dipartimento Di Scienze Dell'invecchiamento, Neurologiche, Ortopediche E Della Testa-Collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Eleonora Rollo
- Dipartimento Universitario Di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurologia, Dipartimento Di Scienze Dell'invecchiamento, Neurologiche, Ortopediche E Della Testa-Collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Paolo Quintieri
- Dipartimento Universitario Di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Fedele Dono
- Dipartimento Di Neuroscienze, Imaging E Scienze Cliniche, "G. D'Annunzio, Università Di Chieti-Pescara, Chieti, Italy.
- Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology - CAST, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy.
| | - Giacomo Evangelista
- Dipartimento Di Neuroscienze, Imaging E Scienze Cliniche, "G. D'Annunzio, Università Di Chieti-Pescara, Chieti, Italy
| | - Stefano Consoli
- Dipartimento Di Neuroscienze, Imaging E Scienze Cliniche, "G. D'Annunzio, Università Di Chieti-Pescara, Chieti, Italy
| | - Luigi Veleno
- Dipartimento Di Neuroscienze, Imaging E Scienze Cliniche, "G. D'Annunzio, Università Di Chieti-Pescara, Chieti, Italy
| | - Francesca Anzellotti
- Dipartimento Di Neuroscienze, Imaging E Scienze Cliniche, "G. D'Annunzio, Università Di Chieti-Pescara, Chieti, Italy
| | - Carmen Calvello
- Sezione Di Neurologia, Dipartimento Di Medicina E Chirurgia, Università Di Perugia, Ospedale S. Maria della Misericordia, Perugia, Italy
| | - Cinzia Costa
- Sezione Di Neurologia, Dipartimento Di Medicina E Chirurgia, Università Di Perugia, Ospedale S. Maria della Misericordia, Perugia, Italy
| | - Serenella Servidei
- Dipartimento Universitario Di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurofisiopatologia, Dipartimento Di Scienze Dell'invecchiamento, Neurologiche, Ortopediche E Della Testa-Collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Paolo Calabresi
- Dipartimento Universitario Di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurologia, Dipartimento Di Scienze Dell'invecchiamento, Neurologiche, Ortopediche E Della Testa-Collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Catello Vollono
- Dipartimento Universitario Di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurofisiopatologia, Dipartimento Di Scienze Dell'invecchiamento, Neurologiche, Ortopediche E Della Testa-Collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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