COVID‐19 vaccine take‐up rate and safety in adults with epilepsy: Data from a multicenter study in China

Abstract

SummaryObjectiveThis study was undertaken to investigate the COVID‐19 vaccine uptake rate and possible postvaccination effects in adults with epilepsy.MethodsWe invited adults with epilepsy attending three centers in China from July 24 to August 31, 2021 to participate in this study. We also asked age‐ and sex‐matched controls among people attending for other chronic neuropsychiatric conditions and healthy controls accompanying people with illness attending the hospitals to participate. We excluded people who, under the national guidelines, had evident contradictions to vaccination. Participants were interviewed face‐to‐face using questionnaires. Vaccine uptake and postvaccine adverse events among the people with epilepsy were compared with those with neuropsychiatric conditions and controls. We also compared the willingness and reasons for hesitancy among unvaccinated participants.ResultsWe enrolled 981 people, of whom 491 had epilepsy, 217 had other neuropsychiatric conditions, and 273 were controls. Forty‐two percent of those with epilepsy had had the first dose of a vaccine, compared with 93% of controls and 84% of the people with neuropsychiatric conditions (p < .0001). The majority (93.8%) of those immunized had inactivated vaccines. Among the unvaccinated people with epilepsy, 59.6% were willing to have the vaccine. Their main reasons for hesitation were potential adverse effects (53.3%) and concerns about losing seizure control (47.0%). The incidence of adverse events in the epilepsy group was similar to controls. Nineteen people with epilepsy reported an increase in seizure frequency. No episode of status epilepticus or prolonged seizures was reported. Two controls had their first‐ever seizure, which was unlikely related to the vaccine.SignificanceThe vaccine uptake rate in people with epilepsy was lower than in their same‐age controls. The postvaccination effect was no higher than in controls. We found no evidence suggesting worsening seizures after vaccination. Measurement and education focused on increasing the vaccination rate in epilepsy are warranted.

COVID-19 vaccine-related frequently asked questions (FAQs) by people with epilepsy and carers in Iran; educational video is included

“…In a study of the COVID-19 vaccine take-up rate in 491 adult patients with epilepsy from China (conducted in August 2021), 42% of those with epilepsy had had the first dose of a vaccine, compared with 93% of the controls and 84% of the people with other neuropsychiatric conditions (p < 0.0001). The main reasons for vaccine hesitancy were potential adverse effects of the vaccines and concerns about losing seizure control [9] ; these are similar to our observations. It is important to highlight that the incidence of the COVID-19 vaccine adverse events in the epilepsy group was similar to that in the controls in that Chinese study; they found no evidence suggesting seizure worsening after vaccination [9] .…”

“…The main reasons for vaccine hesitancy were potential adverse effects of the vaccines and concerns about losing seizure control [9] ; these are similar to our observations. It is important to highlight that the incidence of the COVID-19 vaccine adverse events in the epilepsy group was similar to that in the controls in that Chinese study; they found no evidence suggesting seizure worsening after vaccination [9] . In another study of 111 PWE from Kuwait (conducted in April 2021), COVID-19 vaccines showed a good safety profile and a low risk of epilepsy worsening [10] .…”

“…We did not have a control group to compare the COVID-19 vaccine related FAQs in PWE and their carers with those in the general public or other chronic conditions. However, similarity of our observations with those from the USA [6] and China [9] implies that our findings may be generalizable to other populations and therefore, 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 also drug-vaccine interactions (if any).…”

Safety profile of SARS-CoV-2 vaccination in patients with antibody-mediated CNS disorders

“…In this context, seizures were a common manifestation in post-vaccination relapses and always occurred in patients with a known history of epilepsy. Since an increase in seizure frequency after vaccination has also been reported in a minority of patients with non-autoimmune epilepsy, the possibility that systemic/structural rather than autoimmune factors might be the leading cause of this post-vaccine symptom should be considered ( Steriade et al, 2020 , Lu et al, 2022 ). The association between pre-vaccination disease severity, which represents a risk factor for remote symptomatic seizures, and the occurrence of post-vaccination worsening further reinforces this hypothesis.…”

Epilepsy and COVID-19: Recent Findings and Considerations

“…51 최근 중국에서 조사한 연구에서도 뇌전증 환자(42%)는 다른 정신질환 (84%)이나 건강한 대조군(93%)에 비해 백신 접종률이 낮았고, 난 치성 뇌전증 환자들이 조절되는 뇌전증 환자에 비해 유의하게 접 종률이 낮았다. 52 의료진을 대상으로 한 설문에서도 약 74% 정도 만이 뇌전증 환자에게 백신 접종을 추천하겠다고 하였다. 53 그러나 실제 COVID-19 백신 접종을 한 환자를 대상으로 한 연구에서 1차 접종을 한 54명 뇌전증 환자(18세 이상) 중 1명만 이 발작이 악화되었고, 30% 정도에서 두통, 피로, 발열 등 일반 적 인 백 신 부작 용 만 이 있었 다.…”