Abstract
Seizures and status epilepticus can occur within 14 days following administration of inactivated and live-attenuated vaccines. These vaccine-proximate seizures can undermine parental confidence in vaccine safety and affect further vaccination decisions. Vaccine-proximate status epilepticus (VP-SE) is uncommon but may be the first manifestation of genetic developmental epileptic encephalopathies, including Dravet syndrome. The aim of this article is to review current literature on the risks and outcomes of vaccine-proximate seizures and, using two clinical scenarios, outline management of subsequent revaccination. Vaccine-proximate seizures require careful evaluation of the vaccine(s) involved, seizure type and duration to determine asafe course for revaccination. Vaccine-proximate febrile seizures (VP-FSs) have similar outcomes to other febrile seizures and are not associated with increased developmental or behavioural concerns. Vaccination for children with VP-FSs can occur safely in the community. However, VP-SE cases warrant prompt specialist review, consideration of genetic epilepsy testing and referral to a specialist immunisation clinic for subsequent vaccination under medical supervision.
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