Are COVID-19 vaccines safe for people with epilepsy? A cross-sectional study

Abstract

Background COVID-19 disease was first seen in December 2019 and was declared a pandemic soon after. To fight the pandemic, there is an immense need for effective vaccines. The purposes of our study were to investigate the effect of coronavirus vaccines on seizures in people with epilepsy (PWE) and assess the adverse events of COVID-19 vaccine in PWE. Methods This was a cross-sectional study. We included epilepsy patients who got vaccinated with two or three doses at least 1 month earlier. We gathered the data using a standardized form. The form contained questions about patients' demographic features, clinical features, and information about the vaccination and its adverse events. The questionnaire included questions about epilepsy-related adverse events. ResultsWe included 178 people with epilepsy in our study. The frequency of adverse events was lower than clinical studies of the vaccines. The mean number of seizures in the month before the vaccination was 1.62, between the doses was 1.61, and after vaccination was 1.64. There was no significant difference in the number of monthly seizures before the vaccination, the month between the doses, or the month after the vaccination (p = 0.46). Conclusions The vaccines under consideration in our study were tolerated well by the epilepsy patients. The vaccines did not affect the monthly number of seizures of the PWE. A small number of patients had more seizures than normal after vaccination. We think that benefits of the vaccines outweigh the slightly increased possibility of having a seizure after vaccination.

Should patients with epilepsy be vaccinated against coronavirus disease 2019? A systematic review and meta-analysis

“…After screening 82 duplicates and 152 papers through titles and abstracts, we retrieved the full texts of the remaining 16 studies. Ten observational studies and two case reports studies [17] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] that met the inclusion criteria were included in this systematic review and meta-analysis ( Figure 1 ).

Figure 1 Flow diagram of study

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“…Seven studies [17] , [23] , [24] , [25] , [26] , [29] , [30] provided the information of primary outcome (vaccination status), and six studies [22] , [24] , [25] , [26] , [28] , [29] reported the secondary outcomes of vaccination willingness and unwillingness. Seven studies [17] , [23] , [24] , [25] , [26] , [27] , [30] reported the incidence of adverse effects after COVID-19 vaccination. Supplemental Table 1 summarizes the inclusion, exclusion criteria and definition of seizure free in the included studies.…”

Observational retrospective analysis of vaccination against SARS-CoV-2 and seizures: VACCI-COVID registry

“…Currently, only a few studies addressed the relationship between PWE and SARS-CoV-2 vaccination [17] , [18] , [19] , [20] . These studies aimed to explore the safety and tolerability of vaccination among PWE, as well as the vaccination rates and the reasons for refusing.…”

“…First of all, these studies were based on questionnaires completed by the patients, associating an inevitable selection bias. The first studies [18] , [19] , [20] included small and poorly extrapolable samples. In addition, vaccination rates were relatively low at the time.…”

“…Despite this, vaccination against SARS-CoV-2 may associate a relevant risk of acute symptomatic seizures or an increase in seizure frequency in PWE. So far, a few studies evaluating the adverse effects of the SARS-CoV-2 vaccines in PWE have approached this last question [17] , [18] , [19] , [20] , outlining that worsening of seizure control was infrequent. However, several biases cast doubts on these reports, and further studies to corroborate the results seem necessary [21] .…”