From the Guidelines
Most childhood vaccinations are safe for children with seizure disorders, but caution is warranted with certain vaccines, and the DTaP vaccine is generally recommended even for children with seizure disorders, as long as the seizures are well-controlled and there is no history of severe allergic reaction or encephalopathy after a previous dose of DTP or DTaP 1.
Key Considerations
- The DTaP vaccine is recommended for children with stable seizure disorders, but precautions should be taken for those with progressive or unstable neurologic disorders, including uncontrolled seizures or progressive encephalopathy 1.
- The MMR vaccine can cause fever, which might trigger seizures in susceptible children, but the benefits typically outweigh the risks.
- For children with unstable or poorly controlled seizures, vaccination timing may be adjusted to periods when seizures are better controlled.
- Antipyretic medications like acetaminophen may be recommended before and after vaccination to reduce fever risk.
Contraindications and Precautions
- Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component is a contraindication for DTaP, Tdap, DT, and Td vaccines 1.
- Encephalopathy (e.g., coma, decreased level of consciousness, or prolonged seizures) not attributable to another identifiable cause within 7 days of administration of previous dose of DTP or DTaP is a contraindication for DTaP vaccine 1.
- Progressive or unstable neurologic disorder, including infantile spasms, uncontrolled seizures or progressive encephalopathy, is a precaution for DTaP vaccine, and vaccination should be deferred until neurologic status is clarified and stabilized 1.
From the Research
Childhood Vaccinations and Seizure Disorder
- There are several childhood vaccinations associated with an increased risk of febrile seizures, including:
- Measles-mumps-rubella vaccine 2
- Measles-mumps-rubella-varicella vaccine 2, 3
- Combined diphtheria, tetanus, acellular pertussis, polio, and Haemophilus influenzae type b vaccine 2
- Whole-cell pertussis vaccine 2
- 7-valent pneumococcal conjugate vaccine 2
- Trivalent inactivated influenza vaccine administered with either the 7-valent pneumococcal conjugate vaccine or the diphtheria, tetanus, and acellular pertussis vaccine 2
- The risk of febrile seizure is temporarily increased for a few days after the administration of certain vaccines in children aged six to 23 months 4
- A longitudinal cohort study found that childhood MMR vaccination is associated with an increased risk of seizure episode and seizure disorder, particularly in the 6-11 days post-vaccination period 5
- Some studies suggest that certain vaccinations, such as MMRV, should be avoided in children with genetic epilepsy syndrome or a personal and family history of febrile seizures 6
Vaccination Recommendations for Children with Seizure Disorder
- The decision to recommend a particular vaccine to a child with a seizure disorder should be based on individual factors, such as the child's medical history and the risk of febrile seizures associated with the vaccine 3
- Parents should be informed about the potential risks and benefits of vaccination, particularly for children with a history of febrile seizures or seizure disorder 6
- Choosing vaccines with a lower risk of developing febrile seizures and administering them during a low-risk window in the immunization schedule may help reduce the risk of febrile seizures in children with seizure disorder 6