Abstract
Little is known about the risk of febrile seizures (FS) after vaccination with measles-containing vaccines (MCVs) in middle- and low-income countries. This self-controlled case series study aimed to evaluate the risk of FSs in Chinese children using data from the Ningbo Regional Health Information Platform. The observation period was 0–12 and 13–24 months of age for the MR and MMR vaccines, respectively. The relative incidences (RIs) within 0–6 days, 7–13 days, 14–27 days, and 28–42 days after vaccination with MCVs were estimated. The remaining observation period was the control period. The RIs within 0–6 days, 7–13 days, 14–27 days, and 28–42 days after MR vaccination were 1.11 [95% confidence interval (CI) 0.33 to 3.70], 0.80 (95% CI 0.23 to 2.86), 1.67 (95% CI 0.81 to 3.42), and 1.02 (95% CI 0.49 to 2.14), respectively. The corresponding RIs after MMR vaccination were 0.99 (95% CI 0.56 to 1.75), 1.17 (95% CI 0.68 to 2.01), 0.87 (95% CI 0.54 to 1.39), and 0.85 (95% CI 0.54 to 1.34), respectively. This study suggests that China’s vaccination schedule for MCVs, as suggested by the World Health Organization (WHO) for countries with a high risk of measles mortality and ongoing transmission, does not increase the risk of FSs.
Highlights
As the most type of seizure disorder among children, those younger than two years old, febrile seizures (FSs) affect approximately 2–5% of children [1]
According to a recent Cochrane systematic review [3], all cohort or self-controlled case series (SCCS) studies published before 2 May 2019, have observed an increased risk of
The existing studies on the association between measles-containing vaccines (MCVs) and FSs were all from high-income countries in Europe, America, and Australia, and no such studies came from middle- and low-income countries
Summary
As the most type of seizure disorder among children, those younger than two years old, febrile seizures (FSs) affect approximately 2–5% of children [1]. Infections, especially respiratory tract infections, vaccine administration, etc., are causes of FSs [2]. According to a recent Cochrane systematic review [3], all cohort or self-controlled case series (SCCS) studies published before 2 May 2019, have observed an increased risk of FSs within the risk window of 7–14 days after MMR vaccination [4,5,6,7,8], and no evidence supported an increased risk of FSs in 14 or more days after MMR vaccination [5,6]. In terms of the risk of FSs within one week after MMR vaccination, the results from two cohort studies were controversial [4,5]. The existing studies on the association between measles-containing vaccines (MCVs) and FSs were all from high-income countries in Europe, America, and Australia, and no such studies came from middle- and low-income countries. The vaccination schedule of MCVs varied between high-income countries and middle- and low-income countries. China’s Expanded Program on Immunization (EPI) requires that the first dose of an MCV (i.e., the measles-rubella (MR) vaccine before June 2020 and the MMR vaccine after June 2020) be given at eight months of age, and the second dose of an MCV (i.e., the MMR vaccine) be given at
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