Febrile seizures following measles and varicella vaccines in young children in Australia |
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| Affiliation: | 1. National Centre for Immunization Research & Surveillance, Westmead, NSW, Australia;2. Discipline of Paediatrics and Child Health, University of Sydney, Sydney, Australia;3. Children''s Hospital Westmead, Sydney, Australia;4. School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia;5. Australian Paediatric Surveillance Unit, Westmead, Australia;6. Murdoch Children''s Research Institute, Parkville, Australia;7. Royal Children''s Hospital, Melbourne, Australia;8. Women and Children''s Hospital, Adelaide, Australia;9. Robinson Research Institute and School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia;10. Royal Children''s Hospital, Brisbane, Australia;11. Wesfarmer''s Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia;12. University of Western Australia School of Paediatrics and Child health, Princess Margaret Hospital, Perth, Australia;13. Paediatrics Department, The University of Melbourne, Melbourne, Australia;1. Service de dermatologie, Universitair Ziekenhuis Brussel, (UZ Brussel), Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, Bruxelles, Belgique;2. Service d’anatomie pathologique, Universitair Ziekenhuis Brussel, (UZ Brussel), Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, Bruxelles, Belgique;3. Service d’hématologie, Universitair Ziekenhuis Brussel, (UZ Brussel), Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, Bruxelles, Belgique;1. Department of General Medicine, The Royal Children''s Hospital, Melbourne, VIC, Australia;2. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA;3. Vaccine and Immunisation Research Group (VIRGo), Murdoch Childrens Research Institute and Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia;4. Department of Allergy and Immunology, Royal Children''s Hospital, Melbourne, VIC, Australia;5. Department of Pediatrics, The University of Melbourne, Melbourne, VIC, Australia;6. SAEFVIC, Murdoch Children''s Research Institute, Melbourne, VIC, Australia;1. Department of neurosurgery, Montpellier university medical center, Gui de Chauliac hospital, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France;2. Department of pathology, Montpellier university medical center, Gui de Chauliac hospital, Montpellier, France;3. Department of endocrinology, Montpellier university medical center, Lapeyronie hospital, Montpellier, France;4. Department of otorhinolaryngology, Montpellier university medical center, Gui de Chauliac hospital, Montpellier, France;1. Department of Developmental Medical Sciences, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;2. Department of Pediatrics, Fukuoka University, Fukuoka, Japan;3. Division of Neurology, National Center for Child Health and Development, Tokyo, Japan;4. Division of Neurology, Saitama Children''s Medical Center, Saitama, Japan;5. Department of Pediatrics, Tokyo Medical University, Tokyo, Japan;6. Department of Pediatrics, Tokyo Metropolitan Children''s Medical Center, Tokyo, Japan |
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| Abstract: | BackgroundFebrile seizures (FS) are common in childhood with incidence peaking in the second year of life when measles and varicella-containing vaccines are administered. This study aimed to examine the vaccine-attributable risk of FS following separate administration of MMR and monovalent varicella vaccines (VV) prior to a planned change to MMRV as the second dose of measles-containing vaccine at 18 months of age.MethodsAll FS cases in children aged <5 years from 1st January 2012 to 30th April 2013 were identified from emergency department (ED) and inpatient databases at five Australian tertiary paediatric hospitals participating in PAEDS (Paediatric Active Enhanced Disease Surveillance). Immunization records were obtained from the Australian Childhood Immunization Register (ACIR). The relative incidence (RI) of FS following MMR dose 1 (MMR1) and VV in children aged 11–23 months was determined using the self-controlled case series (SCCS) method and used to calculate attributable risk.ResultsThere were 2013 FS episodes in 1761 children. The peak age at FS was 18 months. The risk of FS was significantly increased 5–12 days post receipt of MMR1 at 12 months (RI = 1.9 [95% CI: 1.3–2.9]), but not after VV at 18 months (RI = 0.6 [95% CI: 0.3–1.2]. The estimated excess annual number of FS post MMR1 was 24 per 100,000 vaccinated children aged 11–23 months (95% CI = 7–49 cases per 100,000) or 1 per 4167 doses.ConclusionsOur study detected the expected increased FS risk post MMR1 vaccine at 12 months, but monovalent varicella vaccine at age 18 months was not associated with increased risk of FS. This provides baseline data to assess the risk of FS post MMRV, introduced in Australia as the second dose of measles-containing vaccine at 18 months of age in July 2013. |
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| Keywords: | Vaccine safety Febrile seizures Measles–mumps–rubella vaccine Varicella vaccine Risk |
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