Study Results Show Influenza Vaccination Is Priority for Children With Severe Epilepsy

The seasonal flu vaccine should be prioritized for those with SCN1A-positive Dravet syndrome, because of the likelihood of severe neurological symptoms and complications.

Children with a severe form of epilepsy should be vaccinated against influenza, because of the high risk of the infection triggering seizures, according to the results of a study led by the Murdoch Children’s Research Institute and the University of Melbourne in Australia.1

Investigators found that the safe administration of the seasonal influenza vaccine should be a priority for those with SCN1A-positive Dravet syndrome.

This is because of the likelihood of severe neurological symptoms and complications, including deteriorating language and motor skills, worsening seizures, and, in some cases, death, after an individual with this condition has an influenza infection, investigators said.1

“Concerns about giving the flu vaccine and incomplete routine immunizations are common in this patient group, due to the risk of seizures after vaccination,” Katherine Howell, MD, pediatric neurologist at the Murdoch Children’s Research Institute, said in a statement.1

“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,” Howell said.1

The decision for parents to vaccinate their children could be difficult, because of the syndrome’s seizures being triggered by both infection and vaccination, she said.

Despite the syndrome being associated with high rates of prolonged seizures related to infections, the impact of influenza has not been studied before.1

The study, which was published in Neurology, included children with SCN1A-positive Dravet syndrome who had a confirmed influenza infection. The children were also from the Royal Children’s and Austin Hospital in Australia.1 The medical records were searched, and investigators asked the families questions to identify which individuals had influenza infections. The infections were confirmed by pathology reports, and baseline clinical characteristics and clinical details of the infection were also recorded.2

Investigators found that 21 children had influenza 24 times, with brain complications reported in about 88% of the cases. Of all individuals brought to the hospital, 75% recovered quickly. However, death or long-term brain complications occurred in 1 of 5 infections.1

Among all the children, they received 60 influenza vaccinations, with most of them tolerating it well.1

“Identifying safe strategies and strongly encouraging influenza vaccination in children and adults with SCN1A-[positive] Dravet syndrome is critical,” Ingrid Scheffer, PhD, from the University of Melbourne said in the statement.1

“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,” Scheffer said.1

Investigators said that these new findings would change clinical practice.1

Reference

1. Children with severe form of epilepsy should receive flu vaccine due to high seizure risk after influenza infection. News release. EurekAlert. November 15, 2022. Accessed November 15, 2022. https://www.eurekalert.org/news-releases/971194

2. Howell KB, Butcher S, Schneider AL, Russ-Hall S, et al. Complications of influenza A or B virus infection in individuals with SCN1A-positive Dravet syndrome. Neurology. 2022;10.1212/WNL.0000000000201438. doi:10.1212/WNL.0000000000201438