Should patients with epilepsy be vaccinated against coronavirus disease 2019? A systematic review and meta-analysis

Kan Lin; Huayao Huang; Shuangfang Fang; Guanyi Zheng; Kailong Fu; Nan Liu; Houwei Du

doi:10.1016/j.yebeh.2022.108822

Should patients with epilepsy be vaccinated against coronavirus disease 2019? A systematic review and meta-analysis

Epilepsy Behav. 2022 Sep:134:108822. doi: 10.1016/j.yebeh.2022.108822. Epub 2022 Jun 29.

Authors

Kan Lin¹, Huayao Huang², Shuangfang Fang³, Guanyi Zheng¹, Kailong Fu¹, Nan Liu⁴, Houwei Du⁵

Affiliations

¹ Department of Traditional Chinese Medicine, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
² Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
³ Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
⁴ Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, Fujian, China; Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
⁵ Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China; Institute of Clinical Neurology, Fujian Medical University, Fuzhou, Fujian, China. Electronic address: houweidu@fjmu.edu.cn.

Abstract

Objective: The coronavirus disease 2019 (COVID-19) vaccination coverage, willingness, and safety profiles in patients with epilepsy remain poorly understood. We aimed to summarize the available evidence of COVID-19 vaccination coverage, willingness, and safety profiles among patients with epilepsy.

Methods: We performed a literature search in the Pubmed, EMBASE, and Cochrane Central Register database between 1 January 2020 and 30 April 2022. We included eligible studies that provided information on the COVID-19 vaccination coverage, willingness, and safety profiles among patients with epilepsy. We investigated the association between baseline characteristics of patients with epilepsy and unvaccination status using a fixed-effect model. We calculated the pooled overall willingness to be vaccinated against COVID-19. We systematically reviewed the safety profiles after COVID-19 vaccination in patients with epilepsy.

Results: Ten eligible observational studies and two case reports yielded 2589 participants with epilepsy or their caregivers. Among 2145 participants that provided the information of vaccination status, 1508 (70.3%) patients with epilepsy were not administered COVID-19 vaccine, and 58% (95%CI 40-75%) of respondents were willing to be vaccinated against COVID-19. Seizure status (active versus inactive, OR 1.84 95%CI 1.41-2.39, I² = 0%) rather than seizure type (focal versus non-focal, OR 1.22 95%CI 0.94-1.58, I² = 0%) was associated with COVID-19 unvaccination status. Vaccines were well-tolerated; epilepsy-related problems such as increase in seizure frequency and status epilepticus after COVID-19 vaccination were uncommon.

Conclusions: Our findings suggest a low COVID-19 vaccination coverage and willingness in patients with epilepsy. Vaccination against COVID-19 appears to be well-tolerated and safe in patients with epilepsy, supporting a positive outlook toward vaccination in this population.

Keywords: Adverse effect; COVID-19; Epilepsy; Seizure; Vaccines.

Publication types

Case Reports
Meta-Analysis
Review
Systematic Review

MeSH terms

Anticonvulsants
COVID-19 Vaccines
COVID-19*
Epilepsies, Partial*
Epilepsy*
Humans
Seizures

Substances

Anticonvulsants
COVID-19 Vaccines