Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157 Xiwu Road, Xincheng District, Xi'an, Shaanxi, 710004, People's Republic of China.
Department of Pediatrics, The First Affiliated Hospital of Air Force Medical University, Xi'an, People's Republic of China.
Eur J Pediatr. 2024 Jun;183(6):2763-2768. doi: 10.1007/s00431-024-05537-z. Epub 2024 Apr 1.
This study explored the coronavirus disease 2019 (COVID-19) vaccination coverage among children with epilepsy (CwE), factors affecting vaccination coverage, and the effect of COVID-19 vaccines on epilepsy after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. A questionnaire was administered to CwE and their parents at the Pediatric Neurology Clinic of the Second Affiliated Hospital of Xi'an Jiaotong University between December 12, 2022, and February 28, 2023. Data were analyzed using the t-tests, chi-square tests, and logistic regression. The analysis included 250 CwE who responded to the survey; of these, 152 (60.8%) had been vaccinated against COVID-19. COVID-19 vaccine hesitancy in parents whose CwE were not vaccinated was mostly due to concerns of vaccine-related exacerbation of seizures and of vaccine-related adverse reactions (44.30% and 41.90% of the respondents, respectively). Univariate analysis showed that vaccination and number of doses of vaccine did not affect seizure incidence within 1 month of SARS-CoV-2 infection. Logistic regression analysis showed that CwE below primary school age, and those taking two or more antiseizure medication (ASMs) were less likely to be vaccinated (p = 0.007). Conclusion: The primary reasons for vaccine hesitancy among parents of unvaccinated CwE were concerns regarding seizure exacerbation and adverse reactions following COVID-19 vaccination. CwE who were below primary school age and those who took two or more ASMs were less likely to be vaccinated. Addressing parents' concerns is necessary to build their confidence in COVID-19 vaccines and ensure that CwE are vaccinated. What is Known: • People with epilepsy have a higher risk of severe and fatal COVID-19 than those without epilepsy but, despite this, COVID-19 vaccination coverage is considerably lower in people with epilepsy than in people without epilepsy. What is New: • In unvaccinated children with epilepsy, the foremost reasons for COVID-19 vaccine hesitancy among parents were concerns about seizure exacerbation and vaccine-related adverse reactions. • Vaccination and number of doses of vaccine did not exacerbate seizures in children with epilepsy, those below primary school level and those taking two or more antiseizure medications were less likely to be vaccinated.
本研究旨在探讨儿童癫痫患者（CwE）中 2019 年冠状病毒病（COVID-19）疫苗接种率、影响疫苗接种率的因素，以及 COVID-19 疫苗对严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染后癫痫的影响。2022 年 12 月 12 日至 2023 年 2 月 28 日，在西安交通大学第二附属医院儿科神经病学诊所向 CwE 及其父母发放问卷。采用 t 检验、卡方检验和 logistic 回归分析数据。分析包括 250 名对调查做出回应的 CwE；其中，152 名（60.8%）已接种 COVID-19 疫苗。父母对 CwE 未接种 COVID-19 疫苗的犹豫主要是因为担心疫苗相关的癫痫发作加重和疫苗相关的不良反应（分别为 44.30%和 41.90%的受访者）。单因素分析显示，SARS-CoV-2 感染后 1 个月内，疫苗接种和疫苗接种剂量均不影响癫痫发作的发生。logistic 回归分析显示，小学以下年龄的 CwE 以及服用两种或两种以上抗癫痫药物（ASMs）的 CwE 接种疫苗的可能性较小（p=0.007）。结论：未接种疫苗的 CwE 父母对疫苗犹豫的主要原因是担心 COVID-19 疫苗接种后癫痫发作加重和不良反应。小学以下年龄的 CwE 以及服用两种或两种以上 ASMs 的 CwE 不太可能接种疫苗。解决家长的担忧是建立他们对 COVID-19 疫苗信心并确保 CwE 接种疫苗的必要条件。已知：• 癫痫患者患严重和致命 COVID-19 的风险高于无癫痫患者，但尽管如此，癫痫患者的 COVID-19 疫苗接种率仍明显低于无癫痫患者。新发现：• 在未接种疫苗的儿童癫痫患者中，父母对 COVID-19 疫苗犹豫不决的首要原因是担心癫痫发作加重和疫苗相关的不良反应。• 疫苗接种和疫苗接种剂量均不会加重癫痫发作，小学以下年龄和服用两种或两种以上抗癫痫药物的儿童不太可能接种疫苗。
