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

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机构： [1]Department of Neurology, Qilu Hospital, Shandong University, Jinan, China. [2]Institute of Epilepsy, Shandong University, Jinan, China. [3]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China. [4]Beijing Key Laboratory of Neuromodulation, Beijing, China. [5]Institute of Sleep and Consciousness Disorders, Center of Epilepsy, Beijing institute for Brain Disorders, Capital Medical University, Beijing, China. [6]Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China. [7]Department of Neurology, Zibo Changguo Hospital, Zibo, China. [8]Department of Neurology, Jining City Dai Zhuang Hospital, Jining, China. [9]Department of Pediatrics, Yantai Yuhuangding Hospital, Yantai, China. [10]Department of Pediatrics, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China. [11]Department of Pediatrics, Linyi People's Hospital, Linyi, China. [12]Department of Neurology, Affiliated Hospital of Jining Medical, Jining, China. [13]Department of Neurology, Affiliated Hospital of Qingdao University, Qingdao, China. [14]Department of Neurosurgery, Liaocheng People's Hospital, Liaocheng, China. [15]Department of Neurology, Zhucheng People's Hospital, Zhucheng, China. [16]Department of Neurology, Heze Third People's Hospital, Heze, China. [17]Department of Pediatrics, Liaocheng People's Hospital, Liaocheng, China. [18]Department of Neurosurgery, The First Affiliated Hospital of Shandong First Medical University, Jinan, China. [19]Department of Neurology, Affiliated Hospital of Weifang Medical College, Weifang, China. [20]Department of Neurology, Shengli Oilfield Central Hospital, Dongying, China. [21]Department of Pediatrics, Affiliated Hospital of Jining Medical, Jining, China. [22]Department of Pediatrics, Tengzhou Central People's Hospital, Zaozhuang, China. [23]Department of Neurology, Laizhou People's Hospital, Qingdao, China. [24]Department of Pediatrics, Weifang Maternal and Child Health Care Hospital, Weifang, China. [25]Department of Neurology, Liaocheng People's Hospital, Liaocheng, China. [26]Department of Pediatrics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China. [27]Department of Neurology, Qilu Hospital of Shandong University (Qingdao), Qingdao, China. [28]Department of Pediatrics, Qilu Children's Hospital of Shandong University, Jinan, China. [29]Department of Neurology, Affiliated Hospital of Binzhou Medical College, Yantai, China. [30]Department of Neurology, Dezhou People's Hospital, Dezhou, China. [31]Department of Neurology, Linyi People's Hospital, Linyi, China.

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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.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.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.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.Copyright © 2022 Fang, Hu, Han, Yang, Hu, Song, Li, Ma, Li, Kong, Tang, Chen, Sun, Fang, Sun, Chen, Sun, Yan, Gao, Geng, Li, Li, Jiang, Lv, Li, Lang, Wang, Chen, Li, Li, Liu, Liu, Zhan, Gao, Qu, Fu and Liu.

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出版当年[2021]版：

大类 | 2 区

医学

小类 | 2 区免疫学

最新[2023]版：

大类 | 2 区医学

小类 | 2 区免疫学

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出版当年[2020]版：

Q1 IMMUNOLOGY

最新[2023]版：

Q1 IMMUNOLOGY

影响因子： 5.7 最新[2023版] 6.8 最新五年平均 7.561 出版当年[2020版] 7.624 出版当年五年平均 5.085 出版前一年[2019版] 8.787 出版后一年[2021版]

第一作者：

第一作者机构： [1]Department of Neurology, Qilu Hospital, Shandong University, Jinan, China. [2]Institute of Epilepsy, Shandong University, Jinan, China.

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通讯作者：

通讯机构： [1]Department of Neurology, Qilu Hospital, Shandong University, Jinan, China. [2]Institute of Epilepsy, Shandong University, Jinan, China.

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