Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases.
Clin Infect Dis. 2014 Jan;58(2):173-7. doi: 10.1093/cid/cit671. Epub 2013 Nov 20.
Rotavirus illness has been linked to childhood seizures. We investigated whether a protective association exists between receipt of rotavirus vaccine and being hospitalized or visiting the emergency department for seizures in the year after vaccination.
We retrospectively analyzed a cohort of children born after 28 February 2006 (when rotavirus vaccine was licensed in the United States) and enrolled in the Vaccine Safety Datalink (VSD) through November 2009. Seizure rates from 4 to 55 weeks following last rotavirus vaccination were compared by vaccine exposure status (fully vaccinated and unvaccinated). A time-to-event analysis using a Cox proportional hazards model was performed, accounting for time-varying covariates. We calculated the relative incidence of seizure compared by vaccine exposure status during the postexposure interval.
Our cohort contained VSD data on 250 601 infants, including 186 502 children fully vaccinated (74.4%) and 64 099 (25.6%) not vaccinated with rotavirus vaccine. Rates of seizures were associated with rotavirus vaccination status. After adjusting for covariates (VSD site, age at last dose, sex, and calendar month of the index date), a statistically significant protective association was observed between a full course of rotavirus vaccination vs no vaccination for both first-ever seizures (risk ratio [RR] = 0.82; 95% confidence interval [CI], .73-.91) and all seizures (RR = 0.79; 95% CI, .71-.88).
A full course of rotavirus vaccination was statistically associated with an 18%-21% reduction in risk of seizure requiring hospitalization or emergency department care in the year following vaccination, compared with unvaccinated children. This reduction in childhood seizures complements the well-documented vaccine-related benefit of preventing US diarrhea hospitalizations.
轮状病毒疾病与儿童癫痫有关。我们调查了在接种疫苗后的一年内，接种轮状病毒疫苗与因癫痫而住院或到急诊就诊之间是否存在保护关联。
我们回顾性分析了 2006 年 2 月 28 日后（美国批准轮状病毒疫苗时）出生并于 2009 年 11 月前加入疫苗安全数据链（VSD）的一组儿童。比较了末次轮状病毒疫苗接种后 4 至 55 周内疫苗暴露状态（完全接种和未接种）的癫痫发作率。使用 Cox 比例风险模型进行时间事件分析，考虑了时变协变量。我们按疫苗暴露状态计算了暴露后间隔期间癫痫发作的相对发病率。
我们的队列包含了 VSD 上的 250601 名婴儿的数据，其中 186502 名儿童完全接种（74.4%），64099 名（25.6%）未接种轮状病毒疫苗。癫痫发作率与轮状病毒疫苗接种状态有关。在调整了协变量（VSD 地点、末次剂量年龄、性别和索引日期的日历月份）后，与未接种轮状病毒疫苗相比，完全接种轮状病毒疫苗与首次癫痫发作（风险比 [RR] = 0.82；95%置信区间 [CI]，0.73-0.91）和所有癫痫发作（RR = 0.79；95%CI，0.71-0.88）之间存在统计学上的保护关联。
与未接种疫苗的儿童相比，完全接种轮状病毒疫苗可使接种后一年内因癫痫而住院或到急诊就诊的风险降低 18%-21%。这种儿童癫痫发作的减少补充了轮状病毒疫苗预防美国腹泻住院的已有充分记录的益处。
