Child with epilepsy gets COVID-19 vaccine

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COVID-19 is a worldwide pandemic that as of February 2021, has killed more than 450,000 Americans. While anyone can develop severe disease due to COVID, the elderly and those with underlying medical conditions are at greatest risk.

There are currently two COVID-19 vaccines authorized for Emergency Use by the U.S. Food and Drug Administration (Moderna and Johnson & Johnson), and one with full FDA approval (Pfizer’s ComirnatyTM) for the prevention of COVID-19. Information about the COVID-19 vaccines can be found on the CDC's website.

What is Emergency Use Authorization?

Emergency Use Authorization (EUA) is a way to facilitate the availability of medical countermeasures like vaccines, during a public health emergency. Since COVID-19 is a public health emergency, the Moderna, Pfizer and Johnson & Johnson vaccines received an EUA. While it is fully approved for adults 16 and older, the Pfizer vaccine was also authorized by the FDA for emergency use in adolescents 12-16.

How is the vaccine being given out?

All three vaccines are now more widely available in the U.S. Everyone 12 years of age and older is eligible to get a COVID-19 vaccination.

Both the Pfizer and Moderna vaccines require two doses to be effective. The Johnson & Johnson vaccine only requires one dose.

  • Pfizer doses are 21 days apart
  • Moderna doses are 28 days apart

Who should get the COVID-19 vaccination?

It is important that every individual talk to their health care provider about their concerns regarding the vaccine. This can’t be emphasized enough. Individual risk varies from person to person.

The CDC recommends COVID-19 vaccination for all people aged 12 years and older. The Pfizer vaccine has been authorized for people age 12 and over. The Moderna and J&J vaccines have been authorized for people age 18 and older.

I am otherwise healthy. Should I get the vaccine?

Persons who are otherwise healthy can still develop severe disease due to COVID, so it is recommended that they are vaccinated. Vaccination will also prevent you from spreading COVID to those around you, who may be more vulnerable to severe disease.

I have already had COVID-19 and recovered. Do I still need to get the vaccine?

We do not yet know if, or for how long, after infection someone is protected from getting COVID-19 again. Some data suggests that natural immunity after COVID-19 may not last very long. The CDC recommends that persons who previously had COVID should still get the vaccination. If you were treated for COVID-19 with monoclonal antibodies or convalescent plasma, you should wait 90 days before getting a COVID-19 vaccine.

Can pregnant women or breastfeeding mothers get the vaccine?

The CDC recommends COVID-19 vaccination for all people aged 12 years and older, including people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future. More information can be found on the CDC’s pregnancy and breastfeeding COVID-19 page.

Should children ages 12-15 with epilepsy get the vaccine?

As with adults with epilepsy, at this time there is no evidence that children with seizures alone (no other compromising risk factors) are at higher risk for vaccination adverse events than anyone else in this age group. Therefore, we encourage that children with epilepsy in this age range who are otherwise eligible should also get vaccinated against COVID-19.

What is known about the covid vaccine booster and epilepsy?

The CDC has concluded that an additional dose (“booster”) of the COVID vaccine may be necessary for some people, in order to maintain immunity. Over time, boosters may be needed for all the currently available covid vaccines, and recommendations for who should receive them will be changing over time. For current CDC recommendations, please see the CDC's page on booster shot eligibility.

There are no special concerns or warnings related to people with epilepsy and seizures, and we therefore suggest you follow CDC recommendations.

Isn’t masking, social distancing and self-quarantining a good alternative to COVID vaccination?

Given the extent of COVID-19 spread in the U.S., it is critically important to develop large-scale immunity through vaccination in order to stop the pandemic. COVID often spreads in the community from people who do not have symptoms. People can be contagious for as long as 14 days without symptoms, and those with symptoms can infect others two days before their symptoms begin. 

According to most recent guidance from the CDC, for now, fully vaccinated people can gather indoors without physical distancing or wearing masks with other people who are fully vaccinated; and unvaccinated people from one other household, unless any of those people or anyone they live with has an increased risk for severe illness from COVID-19. Until more information is known, fully vaccinated people should continue masking and distancing from other people in other settings, such as when they are in public or visiting with unvaccinated people from multiple households.

Is the COVID-19 vaccine safe?

To date, the data suggests the vaccines are very safe.

The FDA has evaluated the data from clinical trials prior to approving each vaccine. In the clinical trials, more than 30,000-40,000 persons received the vaccine. In order to receive Emergency Use Authorization by the FDA, the company who manufactured the vaccine must have followed at least half of study participants for two months or longer, after receiving both doses of vaccine, and the vaccine must be proven safe and effective.

In addition to the safety review by the FDA, the Advisory Council on Immunization Practices (ACIP) also convened a panel of vaccine safety experts who independently evaluated all safety data. This means two panels of experts have carefully reviewed the data for each vaccine.

In addition, the Centers for Disease Control and Prevention (CDC) continue to carefully monitor the vaccine safety and will regularly share clear and accurate information with healthcare providers and the public.

Is the J&J vaccine safe?

The FDA and CDC have confidence that the J&J vaccine is safe and effective in preventing COVID-19. The FDA has determined that the available data shows that the vaccine’s known and potential benefits outweigh its known and potential risks in individuals 18 years of age and older. At this time, the available data suggests that the chance of blood clots with low platelets occurring is very low. However, according to the CDC, women younger than 50 years of age should be aware of this rare risk of blood clots with low platelets following vaccination, as well as the availability of other COVID-19 vaccines where this risk has not been observed.

The COVID vaccine was developed very quickly. Did they cut any corners on safety?

The COVID vaccines are going through the same rigorous safety assessments as have other vaccines, and corners are not being cut. The COVID vaccine uses a new technology where messenger RNA is injected, as opposed to a piece of the virus. Messenger RNA contains the instructions for your body to make a protein related to the virus, but not the actual virus. Your immune system will then make antibodies to that protein. If you are then exposed to COVID infection, your body will rapidly recognize the protein, and will be primed to fight off infection very early, preventing you from developing severe illness.

This vaccine has been developed more quickly than previous vaccines, leading some people to worry that this was rushed. Advances in genetics allowed scientists to determine the genetic code of the COVID-19 virus very early, which was critical to making the messenger RNA for the vaccine. These vaccines have been carefully studied, and large numbers of volunteers who received the vaccines have been closely followed for side effects. The data suggests these vaccines are very safe.

Does the J&J vaccine cause seizures?

The CDC’s ACIP, an independent panel of medical experts who reviewed data following concerns with the J&J vaccine, confirmed that seizures may be seen in persons who develop blood clots to the brain, which are very rarely associated with the J&J vaccine. On April 23, 2021, ACIP voted to reinstate the original emergency use authorization of J&J’s vaccine given that the benefits outweigh the risks. There is currently no evidence that persons with epilepsy are at higher risk of side effects after vaccination.

When people have a blood clot that disrupts blood flow to the brain, this can lead to seizures; however, these seizures are not equivalent to epilepsy. As with any vaccine, some people may develop a fever that could lower their seizure threshold for the short term, but rarely could result in a break-through seizure. There is currently no evidence that the J&J vaccine (or any of the other vaccines currently available under EUA) results in worsening of the epilepsy, or brain injury.

What side effects have been reported in the clinical trials of COVID vaccines?

Approximately 15% of persons developed local pain or swelling at the vaccine site that resolved. Approximately 50% of persons develop headache, chills, fatigue, muscle aches or fever that is also transient (lasts for a short time), and is a sign that your immune system is responding to the vaccine.

A small number of people have reported allergic reactions. It is recommended that persons with severe allergic reactions to prior vaccinations discuss with their physician how to balance the unknown risk of allergic reaction with the benefit of vaccination. However, those with severe reactions can still get the COVID vaccine but should be monitored carefully for 30 minutes after the vaccine is given. It is recommended that persons with other types of allergies such as food, latex, pollen, or other substances get the vaccine.

There were reports of six cases of a rare and severe type of blood clot in individuals following administration of the J&J COVID-19 Vaccine. ACIP reviewed available data to assess the risks of blood clots and low platelet counts. The FDA has determined that the vaccine’s known and potential benefits outweigh its known and potential risks in individuals 18 years of age and older. At this time, the available data suggest that the chance of blood clots with low platelets occurring is very low. However, according to the CDC, women younger than 50 years should be aware of this rare risk of blood blots with low platelets following vaccination and the availability of other COVID-19 vaccines where this risk has not been observed.

There are many safety monitoring systems in place  to track adverse events (side effects) including V-safe, a smartphone-based, after-vaccination health checker for people who receive COVID-19 vaccines and the Vaccine Adverse Event Reporting System (VAERS), a national adverse event reporting system for healthcare providers, vaccine manufacturers and the public.

Are those with epilepsy at higher risk of side effects?

There is no evidence that persons with epilepsy are at higher risk of side effects after vaccination. As with any vaccine, some persons may develop a fever which could lower their seizure threshold for the short term, and rarely could result in a break-through seizure. There is no evidence that this vaccination results in worsening of the epilepsy, or brain injury.

Should those with seizures triggered by fever avoid getting the COVID vaccine?

Elevated temperature (fever) is a common side effect after getting a vaccine. Fevers have been reported as a side effect after getting the COVID vaccine because the immune system is reacting to create immunity in the body. Some people with epilepsy have seizures that are triggered by fever. However, the available data about the risks of COVID and the safety of the COVID vaccines still support vaccination. If you or your loved one have seizures triggered by fever, please talk to your health care provider about:

  1. Ways to reduce the likelihood of fever from a vaccine causing a seizure
  2. Recommendations about where you or your loved one receive the vaccine, such as a location where medical staff are available
  3. A Seizure Action Plan that includes consideration of rescue therapies

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How effective is the COVID vaccine?

The experimental data so far suggest that vaccines are at least 90% effective after two doses in preventing symptomatic COVID infection and in developing severe disease. It is not known if the vaccine completely prevents any infection with COVID or just prevents development of disease.

Do I need to continue to mask and social distance even after I get the vaccine?

According to most recent guidance from the CDC, for now, fully vaccinated people can gather indoors without physical distancing or wearing masks with other people who are fully vaccinated; and unvaccinated people from one other household, unless any of those people or anyone they live with has an increased risk for severe illness from COVID-19. Until more information is known, fully vaccinated people should continue masking and distancing from other people in other settings, such as when they are in public or visiting with unvaccinated people from multiple households.

Where can I get the vaccine?

All three vaccines are now more widely available in the U.S. Everyone 12 years of age and older is eligible to get a COVID-19 vaccination. Operation Warp Speed and the CDC are working to ensure that all people can access a vaccination and that cost will not be a barrier. It is likely that there are several centers in each community where one could be vaccinated. To find a vaccination center near you, visit Vaccines.gov, text your ZIP code to 438829, or call 1-800-232-0233 to find locations near you.

The Disability Information and Access Line (DIAL) connects callers to information about how to access the COVID-19 vaccine and related supports for people with disabilities. DIAL connects callers to vaccine sites and provides information related to barriers to vaccination by referring callers to local and national disability resources. For assistance, visit acl.gov/dial, call 888-677-1199 from 9 a.m. ET to 8 p.m. ET, or email dial@n4a.org.

Who is paying for the COVID vaccine?

Vaccination doses purchased with U.S. taxpayer dollars will be given to the American people at no charge. However, vaccine providers will be able to charge an administration fee to give the shot to someone, and would be able to have this fee reimbursed by the patient’s public or private insurance company. For uninsured patients, this fee can be covered by the Health Resources and Services Administration’s Provider Relief Fund.

Can I get a vaccine medical exemption if I have epilepsy?

The American Epilepsy Society does not recommend medical exemption from COVID-19 vaccination in patients with epilepsy in the absence of complicating medical factors.

 

Authored By: 
Elaine Wirrell MD
Authored Date: 
12/2020
Reviewed By: 
Jacqueline French MD
Elaine Wirrell
Epilepsy Foundation Advocacy
on: 
Friday, October 22, 2021