Top

Published in:

Open Access 02-05-2022 | COVID-19 Vaccination | COVID-19

Impact of COVID-19 vaccine on epilepsy in adult subjects: an Italian multicentric experience

Authors: Marina Romozzi, Eleonora Rollo, Paolo Quintieri, Fedele Dono, Giacomo Evangelista, Stefano Consoli, Luigi Veleno, Francesca Anzellotti, Carmen Calvello, Cinzia Costa, Serenella Servidei, Paolo Calabresi, Catello Vollono

Published in: Neurological Sciences | Issue 8/2022

Abstract

Objectives

To investigate the safety and tolerability of COVID-19 vaccines in people with epilepsy (PwE).

Methods

In this multicentric observational cohort study, we recruited adult patients (age > 18 years old) with epilepsy who attended the Outpatient Epilepsy Clinic from 1st July to 30th October 2021. We administered to the patients a structured questionnaire and interview on demographic and epilepsy characteristics, current treatment, previous SARS-CoV-2 infection, vaccine characteristics, post-vaccine seizure relapse, other side effect, variation of sleep habits, caffeine, or alcohol intake. Seizure frequency worsening was defined as a ratio between mean monthly frequency post-vaccination and mean monthly frequency pre-vaccination superior to 1. Patients were categorized in two groups: patients with seizure frequency worsening (WORSE) and patients with seizure stability (STABLE).

Results

A total of 358 people participated with a mean age of 47.46 ± 19.04. Focal seizure (79.1%), generalized epilepsy (20.4%), and unknown types of epilepsy (0.5%) were detected among participants. In total, 31 (8.7%) people expressed that they were not willing to receive a COVID-19 vaccine; 302 patients (92.35%) did not experience an increase in the seizure frequency (STABLE-group) whereas 25 patients (7.65%) had a seizure worsening (WORSE-group). Post-vaccine seizures occurred mainly in the 7 days following the administration of the vaccine. Patients in the WORSE-group were treated with a mean higher number of anti-seizure medication (ASMs) (p = 0.003) and had a higher pre-vaccine seizure frequency (p = 0.009) compared with patients in the STABLE-group. Drug-resistant epilepsy was also associated with seizure worsening (p = 0.01). One-year pre-vaccination seizure frequency pattern demonstrated that patients in the WORSE-group had a higher frequency pattern (p < 0.001). Multivariate analysis of the vaccinated group showed that only the seizure frequency pattern (confidence interval [CI] = 1.257–2.028; p < 0.001) was significantly associated with seizure worsening.

Conclusion

In our cohort of vaccinated PwE, only a little percentage had a transient short-term increase of seizure frequency. The present study demonstrates that COVID-19 vaccines have a good safety and tolerability profile in the short term in PwE.

Hu B, Guo H, Zhou P, Shi ZL (2021) Characteristics of SARS-CoV-2 and COVID-19. Nat Rev Microbiol 19(3):141–154CrossRef

WHO, Draft landscape of COVID-19 candidate vaccines, World Health Organisation (2020).

Baden LR, El Sahly HM, Essink B, Kotloff K, Frey S, Novak R, Diemert D, Spector SA, Rouphael N, Creech CB, McGettigan J, Khetan S, Segall N, Solis J, Brosz A, Fierro C, Schwartz H, Neuzil K, Corey L, Gilbert P, Janes H, Follmann D, Marovich M, Mascola J, Polakowski L, Ledgerwood J, Graham BS, Bennett H, Pajon R, Knightly C, Leav B, Deng W, Zhou H, Han S, Ivarsson M, Miller J, Zaks T (2021) Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. N Engl J Med 384(5):403–416CrossRef

Polack FP, Thomas SJ, Kitchin N, Absalon J, Gurtman A, Lockhart S, Perez JL, Pérez Marc G, Moreira ED, Zerbini C, Bailey R, Swanson KA, Roychoudhury S, Koury K, Li P, Kalina WV, Cooper D, Frenck RW Jr, Hammitt LL, Türeci Ö, Nell H, Schaefer A, Ünal S, Tresnan DB, Mather S, Dormitzer PR, Şahin U, Jansen KU, Gruber WC (2020) Gruber, Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. N Engl J Med 383(27):2603–2615CrossRef

Ramasamy MN, Minassian AM, Ewer KJ, Flaxman AL, Folegatti PM, Owens DR, Voysey M, Aley PK, Angus B, Babbage G, Belij-Rammerstorfer S, Berry L, Bibi S, Bittaye M, Cathie K, Chappell H, Charlton S, Cicconi P, Clutterbuck EA, Colin-Jones R, Dold C, Emary KRW, Fedosyuk S, Fuskova M, Gbesemete D, Green C, Hallis B, Hou MM, Jenkin D, Joe CCD, Kelly EJ, Kerridge S, Lawrie AM, Lelliott A, Lwin MN, Makinson R, Marchevsky NG, Mujadidi Y, Munro APS, Pacurar M, Plested E, Rand J, Rawlinson T, Rhead S, Robinson H, Ritchie AJ, Ross-Russell AL, Saich S, Singh N, Smith CC, Snape MD, Song R, Tarrant R, Themistocleous Y, Thomas KM, Villafana TL, Warren SC, Watson MEE, Douglas AD, Hill AVS, Lambe T, Gilbert SC, Faust SN, Pollard AJ (2021) Safety and immunogenicity of ChAdOx1 nCoV-19 vaccine administered in a prime-boost regimen in young and old adults (COV002): a single-blind, randomised, controlled, phase 2/3 trial. Lancet 396(10267):1979–1993CrossRef

Barlow WE, Davis RL, Glasser JW, Rhodes PH, Thompson RS, Mullooly JP, Black SB, Shinefield HR, Ward JI, Marcy SM, DeStefano F, Chen RT, Immanuel V, Pearson JA, Vadheim CM, Rebolledo V, Christakis D, Benson PJ, Lewis N (2001) The risk of seizures after receipt of whole-cell pertussis or measles, mumps, and rubella vaccine. N Engl J Med 345(9):656–661CrossRef

Brown NJ, Berkovic SF, Scheffer IE (2007) Vaccination, seizures and ‘vaccine damage.’ Curr Opin Neurol 20(2):181–187CrossRef

Pruna D, Balestri P, Zamponi N, Grosso S, Gobbi G, Romeo A, Franzoni E, Osti M, Capovilla G, Longhi R, Verrotti A (2013) Epilepsy and vaccinations: Italian guidelines. Epilepsia 54(Suppl 7):13–22CrossRef

Cabezudo-García P, Ciano-Petersen NL, Mena-Vázquez N, Pons-Pons G, Castro-Sánchez MV, Serrano-Castro PJ (2020) Incidence and case fatality rate of COVID-19 in patients with active epilepsy. Neurology 95(10):e1417–e1425CrossRef

10.

Reed DL, Sacco WP (2016) Measuring sleep efficiency: what should the denominator be? J Clin Sleep Med 12(2):263–266CrossRef

11.

Richter P, Werner J, Heerlein A, Kraus A, Sauer H (1998) On the validity of the Beck Depression Inventory. Rev Psychopathol 31(3):160–168CrossRef

12.

Fisher RS, Cross JH, French JA, Higurashi N, Hirsch E, Jansen FE, Lagae L, Moshé SL, Peltola J, Roulet Perez E, Scheffer IE, Zuberi SM (2017) Operational classification of seizure types by the International League Against Epilepsy: position paper of the ILAE Commission for Classification and Terminology. Epilepsia 58(4):522–530CrossRef

13.

Bursac Z, Gauss CH, Williams DK, Hosmer DW (2008) Purposeful selection of variables in logistic regression. Sour Code Biol Med 3:17–17CrossRef

14.

L Lu, Q Zhang, J Xiao, Y Zhang, W Peng, X Han, S Chen, D Yang, JW Sander, D Zhou, W Xiong (2021). COVID-19 vaccine take-up rate and safety in adults with epilepsy: dData from a multicenter study in China, Epilepsia

15.

Massoud F, Ahmad SF, Hassan AM, Alexander KJ, Al-Hashel J, Arabi M (2021) Safety and tolerability of the novel 2019 coronavirus disease (COVID-19) vaccines among people with epilepsy (PwE): a cross-sectional study. Seizure 92:2–9CrossRef

16.

von Wrede R, Pukropski J, Moskau-Hartmann S, Surges R, Baumgartner T (2021) COVID-19 vaccination in patients with epilepsy: first experiences in a German tertiary epilepsy center. Epilepsy Behav 122:108160CrossRef

17.

Arnheim-Dahlström L, Hällgren J, Weibull CE, Sparén P (2012) Risk of presentation to hospital with epileptic seizures after vaccination with monovalent AS03 adjuvanted pandemic A/H1N1 2009 influenza vaccine (Pandemrix): self controlled case series study. BMJ 345:e7594CrossRef

18.

Xing K, Tu XY, Liu M, Liang ZW, Chen JN, Li JJ, Jiang LG, Xing FQ, Jiang Y (2021) Efficacy and safety of COVID-19 vaccines: a systematic review. Zhongguo Dang Dai Er Ke Za Zhi 23(3):221–228PubMed

19.

N Li, C Chu, W Lin (2021) A survey of hesitancy and response to the COVID-19 vaccine among patients with epilepsy in Northeast China, Front Neurol 12(2049)

20.

Kow CS, Hasan SS (2021) Potential interactions between COVID-19 vaccines and antiepileptic drugs. Seizure 86:80–81CrossRef

Title: Impact of COVID-19 vaccine on epilepsy in adult subjects: an Italian multicentric experience
Authors: Marina Romozzi
Eleonora Rollo
Paolo Quintieri
Fedele Dono
Giacomo Evangelista
Stefano Consoli
Luigi Veleno
Francesca Anzellotti
Carmen Calvello
Cinzia Costa
Serenella Servidei
Paolo Calabresi
Catello Vollono
Publication date: 02-05-2022
Publisher: Springer International Publishing
Keywords: COVID-19 Vaccination
Vaccination
COVID-19
Epilepsy
Published in: Neurological Sciences / Issue 8/2022
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-022-06100-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Impact of COVID-19 vaccine on epilepsy in adult subjects: an Italian multicentric experience

Abstract

Objectives

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 8/2022

COVID-19-associated severe mono-hemispheric encephalitis in a young infant

Powassan virus infection presenting as acute encephalitis in a patient from the New England area: a case report

Dolichoectasia: a brain arterial disease with an elusive treatment

A man with epilepsy, bradykinesia, and cognitive decline

Qpack—a Python package for QASAT—quantitative scale for grading cerebral blood flow, autonomic testing, and skin biopsies

Longitudinally extensive dorsal column spinal cord lesion with sensory ganglionopathy