Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
Epilepsia. 2022 Dec;63(12):3100-3110. doi: 10.1111/epi.17436. Epub 2022 Oct 29.
The risk of seizure following BNT162b2 and CoronaVac vaccinations has been sparsely investigated. This study aimed to evaluate this association.
Patients who had their first seizure-related hospitalization between February 23, 2021 and January 31, 2022, were identified in Hong Kong. All seizure episodes happening on the day of vaccination (day 0) were excluded, since clinicians validated that most of the cases on day 0 were syncopal episodes. Within-individual comparison using a modified self-controlled case series analysis was applied to estimate the incidence rate ratio (IRR) with 95% confidence intervals (CIs) of seizure using conditional Poisson regression.
We identified 1656 individuals who had their first seizure-related hospitalization (BNT162b2: 426; CoronaVac: 263; unvaccinated: 967) within the observation period. The incidence of seizure was 1.04 (95% CI .80-1.33) and 1.11 (95% CI .80-1.50) per 100 000 doses of BNT162b2 and CoronaVac administered, respectively. Sixteen and 17 individuals, respectively, received a second dose after having a first seizure within 28 days after the first dose of BNT162b2 and CoronaVac vaccinations. None had recurrent seizures after the second dose. There was no increased risk during day 1-6 after the first (BNT162b2: IRR = 1.39, 95% CI = .75-2.58; CoronaVac: IRR = 1.19, 95% CI = .50-2.83) and second doses (BNT162b2: IRR = 1.36, 95% CI = .72-2.57; CoronaVac: IRR = .71, 95% CI = .22-2.30) of vaccinations. During 7-13, 14-20, and 21-27 days post-vaccination, no association was observed for either vaccine.
The findings demonstrated no increased risk of seizure following BNT162b2 and CoronaVac vaccinations. Future studies will be warranted to evaluate the risk of seizure following COVID-19 vaccinations in different populations, with subsequent doses to ensure the generalizability.
BNT162b2 和科兴疫苗接种后发生癫痫的风险鲜有研究报道。本研究旨在评估这种关联。
在香港，研究人员确定了 2021 年 2 月 23 日至 2022 年 1 月 31 日期间首次因与癫痫相关而住院的患者。所有发生在接种日（第 0 天）的癫痫发作均被排除，因为临床医生证实第 0 天的大多数病例都是晕厥发作。采用改良的个体内对照病例系列分析，应用条件泊松回归估计癫痫的发病率比值（IRR）及其 95%置信区间（CI）。
研究期间，共确定了 1656 名首次因癫痫相关住院的患者（BNT162b2：426 例；科兴疫苗：263 例；未接种疫苗：967 例）。BNT162b2 和科兴疫苗接种后每 100000 剂的癫痫发作发生率分别为 1.04（95%CI：0.80-1.33）和 1.11（95%CI：0.80-1.50）。在接种 BNT162b2 和科兴疫苗后的第 28 天内，分别有 16 名和 17 名患者在第 1 次接种后发生第 1 次癫痫发作后接受了第 2 次接种。在第 2 次接种后，均未出现复发性癫痫发作。第 1 次（BNT162b2：IRR=1.39，95%CI=0.75-2.58；科兴疫苗：IRR=1.19，95%CI=0.50-2.83）和第 2 次（BNT162b2：IRR=1.36，95%CI=0.72-2.57；科兴疫苗：IRR=0.71，95%CI=0.22-2.30）接种疫苗后第 1-6 天、第 7-13 天、第 14-20 天和第 21-27 天，均未观察到与任何疫苗相关的癫痫发作风险增加。
研究结果表明，BNT162b2 和科兴疫苗接种后癫痫发作的风险没有增加。未来的研究将需要评估不同人群中 COVID-19 疫苗接种后癫痫发作的风险，以及后续接种疫苗以确保其普遍性。
