Effect of vaccinations on seizure risk and disease course in Dravet syndrome

Nienke E. Verbeek; Nicoline A. T. van der Maas; Anja C. M. Sonsma; Elly Ippel; Patricia E. Vermeer-de Bondt; Eveline Hagebeuk; Floor E.  Jansen; Huibert H. Geesink; Kees P. Braun; Anton de Louw; Paul B. Augustijn; Rinze F. Neuteboom; Jolanda H. Schieving; Hans Stroink; R. Jeroen Vermeulen; Joost Nicolai; Oebele F. Brouwer; Marjan Van Kempen; Carolien G F  de Kovel; Jeanet M. Kemmeren; Bobby P. C.  Koeleman; Nine V. Knoers; Dick Lindhout; W. Boudewijn Gunning; Eva H. Brilstra

doi:10.1212/WNL.0000000000001855

Effect of vaccinations on seizure risk and disease course in Dravet syndrome

Nienke E. Verbeek^*, Nicoline A. T. van der Maas, Anja C. M. Sonsma, Elly Ippel, Patricia E. Vermeer-de Bondt, Eveline Hagebeuk, Floor E. Jansen, Huibert H. Geesink, Kees P. Braun, Anton de Louw, Paul B. Augustijn, Rinze F. Neuteboom, Jolanda H. Schieving, Hans Stroink, R. Jeroen Vermeulen, Joost Nicolai, Oebele F. Brouwer, Marjan Van Kempen, Carolien G F de Kovel, Jeanet M. KemmerenBobby P. C. Koeleman, Nine V. Knoers, Dick Lindhout, W. Boudewijn Gunning, Eva H. Brilstra

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Objective:

To study the effect of vaccination-associated seizure onset on disease course and estimate the risk of subsequent seizures after infant pertussis combination and measles, mumps, and rubella (MMR) vaccinations in Dravet syndrome (DS).

Methods:

We retrospectively analyzed data from hospital medical files, child health clinics, and the vaccination register for children with DS and pathogenic SCN1A mutations. Seizures within 24 hours after infant whole-cell, acellular, or nonpertussis combination vaccination or within 5 to 12 days after MMR vaccination were defined as "vaccination-associated." Risks of vaccination-associated seizures for the different vaccines were analyzed in univariable and in multivariable logistic regression for pertussis combination vaccines and by a self-controlled case series analysis using parental seizure registries for MMR vaccines. Disease courses of children with and without vaccination-associated seizure onset were compared.

Results:

Children who had DS (n = 77) with and without vaccination-associated seizure onset (21% and 79%, respectively) differed in age at first seizure (median 3.7 vs 6.1 months, p <0.001) but not in age at first nonvaccination-associated seizure, age at first report of developmental delay, or cognitive outcome. The risk of subsequent vaccination-associated seizures was significantly lower for acellular pertussis (9%; odds ratio 0.18, 95% confidence interval [CI] 0.05-0.71) and nonpertussis (8%; odds ratio 0.11, 95% CI 0.02-0.59) than whole-cell pertussis (37%; reference) vaccines. Self-controlled case series analysis showed an increased incidence rate ratio of seizures of 2.3 (95% CI 1.5-3.4) within the risk period of 5 to 12 days following MMR vaccination.

Conclusions:

Our results suggest that vaccination-associated earlier seizure onset does not alter disease course in DS, while the risk of subsequent vaccination-associated seizures is probably vaccine-specific.

Original language	English
Pages (from-to)	596-603
Number of pages	8
Journal	Neurology
Volume	85
Issue number	7
DOIs	https://doi.org/10.1212/WNL.0000000000001855
Publication status	Published - 18 Aug 2015

Keywords

WHOLE-CELL PERTUSSIS
ACELLULAR PERTUSSIS
FEBRILE SEIZURES
CONTROLLED-TRIAL
VACCINE
EPILEPSY
SCN1A
MEASLES
MUMPS
ENCEPHALOPATHY

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10.1212/WNL.0000000000001855

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Verbeek, N. E., van der Maas, N. A. T., Sonsma, A. C. M., Ippel, E., Bondt, P. E. V., Hagebeuk, E., Jansen, F. E., Geesink, H. H., Braun, K. P., de Louw, A., Augustijn, P. B., Neuteboom, R. F., Schieving, J. H., Stroink, H., Vermeulen, R. J., Nicolai, J., Brouwer, O. F., Van Kempen, M., de Kovel, C. G. F., ... Brilstra, E. H. (2015). Effect of vaccinations on seizure risk and disease course in Dravet syndrome. Neurology, 85(7), 596-603. https://doi.org/10.1212/WNL.0000000000001855

@article{dcbc4e1f9d614eb6bcfa4ab708a89307,

title = "Effect of vaccinations on seizure risk and disease course in Dravet syndrome",

abstract = "Objective:To study the effect of vaccination-associated seizure onset on disease course and estimate the risk of subsequent seizures after infant pertussis combination and measles, mumps, and rubella (MMR) vaccinations in Dravet syndrome (DS).Methods:We retrospectively analyzed data from hospital medical files, child health clinics, and the vaccination register for children with DS and pathogenic SCN1A mutations. Seizures within 24 hours after infant whole-cell, acellular, or nonpertussis combination vaccination or within 5 to 12 days after MMR vaccination were defined as {"}vaccination-associated.{"} Risks of vaccination-associated seizures for the different vaccines were analyzed in univariable and in multivariable logistic regression for pertussis combination vaccines and by a self-controlled case series analysis using parental seizure registries for MMR vaccines. Disease courses of children with and without vaccination-associated seizure onset were compared.Results:Children who had DS (n = 77) with and without vaccination-associated seizure onset (21% and 79%, respectively) differed in age at first seizure (median 3.7 vs 6.1 months, p <0.001) but not in age at first nonvaccination-associated seizure, age at first report of developmental delay, or cognitive outcome. The risk of subsequent vaccination-associated seizures was significantly lower for acellular pertussis (9%; odds ratio 0.18, 95% confidence interval [CI] 0.05-0.71) and nonpertussis (8%; odds ratio 0.11, 95% CI 0.02-0.59) than whole-cell pertussis (37%; reference) vaccines. Self-controlled case series analysis showed an increased incidence rate ratio of seizures of 2.3 (95% CI 1.5-3.4) within the risk period of 5 to 12 days following MMR vaccination.Conclusions:Our results suggest that vaccination-associated earlier seizure onset does not alter disease course in DS, while the risk of subsequent vaccination-associated seizures is probably vaccine-specific.",

keywords = "WHOLE-CELL PERTUSSIS, ACELLULAR PERTUSSIS, FEBRILE SEIZURES, CONTROLLED-TRIAL, VACCINE, EPILEPSY, SCN1A, MEASLES, MUMPS, ENCEPHALOPATHY",

author = "Verbeek, {Nienke E.} and {van der Maas}, {Nicoline A. T.} and Sonsma, {Anja C. M.} and Elly Ippel and Bondt, {Patricia E. Vermeer-de} and Eveline Hagebeuk and Jansen, {Floor E.} and Geesink, {Huibert H.} and Braun, {Kees P.} and {de Louw}, Anton and Augustijn, {Paul B.} and Neuteboom, {Rinze F.} and Schieving, {Jolanda H.} and Hans Stroink and Vermeulen, {R. Jeroen} and Joost Nicolai and Brouwer, {Oebele F.} and {Van Kempen}, Marjan and {de Kovel}, {Carolien G F} and Kemmeren, {Jeanet M.} and Koeleman, {Bobby P. C.} and Knoers, {Nine V.} and Dick Lindhout and Gunning, {W. Boudewijn} and Brilstra, {Eva H.}",

year = "2015",

month = aug,

day = "18",

doi = "10.1212/WNL.0000000000001855",

language = "English",

volume = "85",

pages = "596--603",

journal = "Neurology",

issn = "0028-3878",

publisher = "Lippincott Williams & Wilkins",

number = "7",

}

Verbeek, NE, van der Maas, NAT, Sonsma, ACM, Ippel, E, Bondt, PEV, Hagebeuk, E, Jansen, FE, Geesink, HH, Braun, KP, de Louw, A, Augustijn, PB, Neuteboom, RF, Schieving, JH, Stroink, H, Vermeulen, RJ, Nicolai, J, Brouwer, OF, Van Kempen, M, de Kovel, CGF, Kemmeren, JM, Koeleman, BPC, Knoers, NV, Lindhout, D, Gunning, WB & Brilstra, EH 2015, 'Effect of vaccinations on seizure risk and disease course in Dravet syndrome', Neurology, vol. 85, no. 7, pp. 596-603. https://doi.org/10.1212/WNL.0000000000001855

TY - JOUR

T1 - Effect of vaccinations on seizure risk and disease course in Dravet syndrome

AU - Verbeek, Nienke E.

AU - van der Maas, Nicoline A. T.

AU - Sonsma, Anja C. M.

AU - Ippel, Elly

AU - Bondt, Patricia E. Vermeer-de

AU - Hagebeuk, Eveline

AU - Jansen, Floor E.

AU - Geesink, Huibert H.

AU - Braun, Kees P.

AU - de Louw, Anton

AU - Augustijn, Paul B.

AU - Neuteboom, Rinze F.

AU - Schieving, Jolanda H.

AU - Stroink, Hans

AU - Vermeulen, R. Jeroen

AU - Nicolai, Joost

AU - Brouwer, Oebele F.

AU - Van Kempen, Marjan

AU - de Kovel, Carolien G F

AU - Kemmeren, Jeanet M.

AU - Koeleman, Bobby P. C.

AU - Knoers, Nine V.

AU - Lindhout, Dick

AU - Gunning, W. Boudewijn

AU - Brilstra, Eva H.

PY - 2015/8/18

Y1 - 2015/8/18

N2 - Objective:To study the effect of vaccination-associated seizure onset on disease course and estimate the risk of subsequent seizures after infant pertussis combination and measles, mumps, and rubella (MMR) vaccinations in Dravet syndrome (DS).Methods:We retrospectively analyzed data from hospital medical files, child health clinics, and the vaccination register for children with DS and pathogenic SCN1A mutations. Seizures within 24 hours after infant whole-cell, acellular, or nonpertussis combination vaccination or within 5 to 12 days after MMR vaccination were defined as "vaccination-associated." Risks of vaccination-associated seizures for the different vaccines were analyzed in univariable and in multivariable logistic regression for pertussis combination vaccines and by a self-controlled case series analysis using parental seizure registries for MMR vaccines. Disease courses of children with and without vaccination-associated seizure onset were compared.Results:Children who had DS (n = 77) with and without vaccination-associated seizure onset (21% and 79%, respectively) differed in age at first seizure (median 3.7 vs 6.1 months, p <0.001) but not in age at first nonvaccination-associated seizure, age at first report of developmental delay, or cognitive outcome. The risk of subsequent vaccination-associated seizures was significantly lower for acellular pertussis (9%; odds ratio 0.18, 95% confidence interval [CI] 0.05-0.71) and nonpertussis (8%; odds ratio 0.11, 95% CI 0.02-0.59) than whole-cell pertussis (37%; reference) vaccines. Self-controlled case series analysis showed an increased incidence rate ratio of seizures of 2.3 (95% CI 1.5-3.4) within the risk period of 5 to 12 days following MMR vaccination.Conclusions:Our results suggest that vaccination-associated earlier seizure onset does not alter disease course in DS, while the risk of subsequent vaccination-associated seizures is probably vaccine-specific.

AB - Objective:To study the effect of vaccination-associated seizure onset on disease course and estimate the risk of subsequent seizures after infant pertussis combination and measles, mumps, and rubella (MMR) vaccinations in Dravet syndrome (DS).Methods:We retrospectively analyzed data from hospital medical files, child health clinics, and the vaccination register for children with DS and pathogenic SCN1A mutations. Seizures within 24 hours after infant whole-cell, acellular, or nonpertussis combination vaccination or within 5 to 12 days after MMR vaccination were defined as "vaccination-associated." Risks of vaccination-associated seizures for the different vaccines were analyzed in univariable and in multivariable logistic regression for pertussis combination vaccines and by a self-controlled case series analysis using parental seizure registries for MMR vaccines. Disease courses of children with and without vaccination-associated seizure onset were compared.Results:Children who had DS (n = 77) with and without vaccination-associated seizure onset (21% and 79%, respectively) differed in age at first seizure (median 3.7 vs 6.1 months, p <0.001) but not in age at first nonvaccination-associated seizure, age at first report of developmental delay, or cognitive outcome. The risk of subsequent vaccination-associated seizures was significantly lower for acellular pertussis (9%; odds ratio 0.18, 95% confidence interval [CI] 0.05-0.71) and nonpertussis (8%; odds ratio 0.11, 95% CI 0.02-0.59) than whole-cell pertussis (37%; reference) vaccines. Self-controlled case series analysis showed an increased incidence rate ratio of seizures of 2.3 (95% CI 1.5-3.4) within the risk period of 5 to 12 days following MMR vaccination.Conclusions:Our results suggest that vaccination-associated earlier seizure onset does not alter disease course in DS, while the risk of subsequent vaccination-associated seizures is probably vaccine-specific.

KW - WHOLE-CELL PERTUSSIS

KW - ACELLULAR PERTUSSIS

KW - FEBRILE SEIZURES

KW - CONTROLLED-TRIAL

KW - VACCINE

KW - EPILEPSY

KW - SCN1A

KW - MEASLES

KW - MUMPS

KW - ENCEPHALOPATHY

U2 - 10.1212/WNL.0000000000001855

DO - 10.1212/WNL.0000000000001855

M3 - Article

C2 - 26203087

SN - 0028-3878

VL - 85

SP - 596

EP - 603

JO - Neurology

JF - Neurology

IS - 7

ER -

Effect of vaccinations on seizure risk and disease course in Dravet syndrome

Abstract

Keywords

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