Safety and Tolerability of COVID-19 Vaccine in Children With Epilepsy: A Prospective, Multicenter Study.

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.

Effect of inactivated COVID-19 vaccines on seizure frequency in patients with epilepsy: A multicenter, prospective study.

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.

[Characterization of injured child psychology-a case-control study].

OBJECTIVE: To study psychologic features of accidentally injured children to provide basis for application of psychologic intervening measures. METHODS: Eysenck personality questionnaire (EPQ) and Achenback child behavior capacity list (CBCL) (list for parents) were used to test accidentally injured children 7 - 11 years of age who were hospitalized (injury group) and healthy children (control group). Each group was composed of 81 cases. RESULTS: (1) Scores of P, E and N branch capacity lists in EPQ of injury group were all higher than those of control group (P < 0.05 or < 0.001). But the score of L branch capacity of control group was higher than that of injury group (P < 0.001). (2) Boys of injury group in seven factors of restlessness, violation of discipline, attack, harmful contact, schizoid anxiety, depression and body complaint and girls of injury group in seven factors of restlessness, cruelty, attack, depression, body complaint, social flinching and violation of discipline had higher scores than those in control group did (P < 0.01). (3) Detectable rate of behavior problems of injury group was 32.09% (26/81), higher than that of control group [11.11% (9/81), P < 0.001]. The odds ratio (OR) was 3.78, 95% CI was 1.66 approximately 8.59 (P < 0.01). The behavior factor had a lower sensitivity (32.1%) and a higher specificity (88.9%) and lower positive result value (74.3%). (4) Average CBCL score of boys in injury group (39.84 +/- 10.99) was higher than that of girl in injury group (34.26 +/- 10.43, P < 0.05). Boys in two factors of violation of discipline and attack, girls in factor of depression factor M had higher score than the opposite sex subjects did (P < 0.05 or 0.01). (5) Average CBCL score (37.62 +/- 11.03) of injury group was higher than that of control group (17.77 +/- 12.12, P < 0.001). Logistic multiple factor analysis showed that boys' accidentally injured factors were attack, restlessness, violation of discipline, and girls' accidentally injured factors were attack, violation of discipline and depression. CONCLUSION: Accidentally injured children have more psychologic problems in character and behavior. Psychologic education should be given to reduce incidence of accidental injury to children.