Abstracts

Rationale: To prevent the spread of COVID-19, it is imperative that as many individuals as possible get vaccinated. However, compliance with vaccination recommendations has been limited due to concerns over the safety of the COVID-19 vaccinations. Some people with epilepsy (PWE) have concerns over vaccine safety and associated seizure risk. Examining the incidence of seizure after vaccination in PWE will aid providers in addressing these concerns and hopefully reduce vaccine hesitancy in this population.

Methods: To gain a better understanding of the safety of the different Covid-19 vaccinations in PWE, patients at an outpatient neurology clinic in Northern Virginia were asked to report whether they experienced a seizure within the first 48 hours after vaccine administration in surveys administered at follow up visits. Patients also reported demographic information and information characterizing the seizure. Patients were surveyed at clinic follow up visits that occurred from February 2021 to September 2021. A total of 257 patients participated in the survey. Of these, 222 patients had a diagnosis of epilepsy and were included in the end analysis. Data were managed and analyzed using the SAS platform.

Results: Of the 222 patients, 189 had received a COVID-19 vaccine and 33 were unvaccinated at the time of the survey. The majority of vaccinated patients received Pfizer-BioNTech mRNA vaccine (BNT162b2) (n = 128), with the next largest group being Moderna mRNA vaccine (mRNA-1273) (n = 46), followed by the Johnson and Johnson vaccine (JNJ−78436735) (n=15). Of the 189 vaccinated, 178 provided information regarding the occurrence of seizure within 48 hours of vaccine administration. Of those 178, 13 (7%) reported a seizure within 48 hours of vaccine administration, with Figure 1 showing the breakdown by the vaccine administered. Of the 13 patients with seizures, 6 (46%) of these patients had an underlying diagnosis of intractable epilepsy. Additionally, of the 13 that reported a seizure, 10 (76%) of these patients reported another possible contributing factor for  their seizure such as fever, missed medication, or lack of sleep.

Conclusions:  The results from this survey shows a low incidence of seizure within 48 hours of receiving a COVID-19 vaccination in this cohort. From this survey it appears that a majority of the patients who reported seizures had a suspected trigger which may have contributed by lowering the seizure threshold. Additionally, some of the reported seizures occurred in patients with intractable epilepsy, individuals more predisposed to having a seizure. Three of the 13 reported seizures had no associated trigger. Overall, the data collected from this survey appear to show a very low incidence of seizures experienced by PWE after vaccination and a majority of the reported seizures had a possible associated provocation.

Funding: Please list any funding that was received in support of this abstract.: This is an unfunded project.