Risk of Febrile Seizures and Epilepsy After Vaccination With Diphtheria, Tetanus,Acellular Pertussis, Inactivated Poliovirus,and Haemophilus Influenzae Type b

摘要

STUDIES HAVE REPORTED IN-creased risks of febrile seizures shortly after administration ofwhole-cell pertussis vaccine,1.2 as would be expected since the whole-cell pertussis vaccine often causes fever.Whole-cell pertussis vaccine has also been associated with serious neurological illnesses characterized by seizures and intellectual impairment,3'4 but recent studies indicate that the vaccination only triggers an earlier onset of severe epileptic encephalopathy in children with sodium channel gene mutations.5-7 The cellular pertussis vaccine has replaced the whole-cell pertussis vaccine in most countries because the efficacy of the acellular vaccine is comparable with the whole-cell vaccine and it has substantially fewer adverse effects, including fever.8-12 Previous randomized controlled trials did not reveal differences in the risk of seizures after acellular pertussis vaccination compared with whole-cell pertussis vaccination, but the trials were not powered to detect rare adverse effects.