According to a new study, due to the increased risk of seizures being brought on by an influenza infection, children with a severe form of epilepsy should receive the flu vaccine.
The risk of severe neurological symptoms and complications, such as worsening seizures, declining language and motor skills, and even death after contracting the flu, made the research, led by the Murdoch Children’s Research Institute and the University of Melbourne, conclude that the safe administration of the seasonal influenza vaccine should be a priority in people with SCN1A-positive Dravet syndrome.
Paediatric neurologist, Dr. Katherine Howell from the Murdoch Children’s said the decision for parents to vaccinate children with this syndrome was complex because seizures could be triggered by both infection and vaccination. Dr. Howell said despite the syndrome being associated with high rates of prolonged seizures during infections, the impact of influenza had not been previously studied.
Children with SCN1A-positive Dravet syndrome who had a confirmed flu infection at The Royal Children’s and Austin Hospital participated in the study, which was written about in Neurology. Researchers discovered that 21 kids contracted the flu 24 times, with brain problems occurring in 88% of those cases.
Prior to influenza vaccination, vaccine providers should review the child’s regular anti-seizure medications and ensure a seizure management plan is in place. The use of additional anti-seizure medications in the post vaccination period, such as benzodiazepines, is now recommended to reduce the risk of seizures following a vaccine and is becoming routine practice.
Professor Ingrid Scheffer
75 percent of those who were hospitalized upon presentation recovered swiftly, while one in five infections resulted in death or long-term neurological problems. They each received 60 doses of the influenza vaccine, with the majority of them tolerating it well.
“Concerns about giving the flu vaccine and incomplete routine immunisations are common in this patient group due to the risk of seizures after vaccination,” Dr. Howell said. “However, because this syndrome is also associated with a high risk of seizures during infections, it highlights the critical need to protect patients from the complications of vaccine-preventable infections like the flu. Our research highlights that the benefits of flu vaccines for these children far outweighs the risks of seizures being triggered following vaccination.”
SCN1A-postive Dravet syndrome, the most common severe form of genetic epilepsy, occurs in one in 15,000 children.
Melbourne mum Renae Caddy’s son Fraser, 4, was diagnosed with SCN1A-Dravet syndrome after experiencing seizures as a baby.
Renae said her son now received a flu shot every year to prevent prolonged seizures, which are largely triggered by an infection. Fraser needed four days in the hospital for treatment after having a two-hour seizure at the age of 11 months due to the virus.
“The seizures have gone from monthly to weekly, but they are much shorter now, resolving after a few minutes rather than a couple of hours,” she said. “But if he has a viral infection he will seize for as long as his temperature is high and may need a lot of medication and even intubation to get his seizures under control. It can take Fraser up to four days to get back to normal after he experiences a severe seizure so anything we can do to avoid him getting sick we will do.”
Renae said all his influenza vaccines had been well-tolerated with no seizures.
“The research is reassuring for parents that it’s beneficial for children with this condition to have the flu shot to try and avoid an onset of seizures caused by an infection, which are damaging and terrifying to watch,” she said.
University of Melbourne Professor Ingrid Scheffer said the findings would change clinical practice.
“Identifying safe strategies and strongly encouraging influenza vaccination in children and adults with SCN1A-Dravet syndrome is critical,” she said.
“Prior to influenza vaccination, vaccine providers should review the child’s regular anti-seizure medications and ensure a seizure management plan is in place. The use of additional anti-seizure medications in the post vaccination period, such as benzodiazepines, is now recommended to reduce the risk of seizures following a vaccine and is becoming routine practice.”
Researchers from The Royal Children’s Hospital also contributed to the study.
