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COVID-19 vaccination uptake in children with epilepsy and vaccine hesitancy among their parents: a survey

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Abstract

This study explored the coronavirus disease 2019 (COVID-19) vaccination coverage among children with epilepsy (CwE), factors affecting vaccination coverage, and the effect of COVID-19 vaccines on epilepsy after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. A questionnaire was administered to CwE and their parents at the Pediatric Neurology Clinic of the Second Affiliated Hospital of Xi’an Jiaotong University between December 12, 2022, and February 28, 2023. Data were analyzed using the t-tests, chi-square tests, and logistic regression. The analysis included 250 CwE who responded to the survey; of these, 152 (60.8%) had been vaccinated against COVID-19. COVID-19 vaccine hesitancy in parents whose CwE were not vaccinated was mostly due to concerns of vaccine-related exacerbation of seizures and of vaccine-related adverse reactions (44.30% and 41.90% of the respondents, respectively). Univariate analysis showed that vaccination and number of doses of vaccine did not affect seizure incidence within 1 month of SARS-CoV-2 infection. Logistic regression analysis showed that CwE below primary school age, and those taking two or more antiseizure medication (ASMs) were less likely to be vaccinated (p = 0.007).

  Conclusion: The primary reasons for vaccine hesitancy among parents of unvaccinated CwE were concerns regarding seizure exacerbation and adverse reactions following COVID-19 vaccination. CwE who were below primary school age and those who took two or more ASMs were less likely to be vaccinated. Addressing parents’ concerns is necessary to build their confidence in COVID-19 vaccines and ensure that CwE are vaccinated.

What is Known:

• People with epilepsy have a higher risk of severe and fatal COVID-19 than those without epilepsy but, despite this, COVID-19 vaccination coverage is considerably lower in people with epilepsy than in people without epilepsy.

What is New:

• In unvaccinated children with epilepsy, the foremost reasons for COVID-19 vaccine hesitancy among parents were concerns about seizure exacerbation and vaccine-related adverse reactions.

• Vaccination and number of doses of vaccine did not exacerbate seizures in children with epilepsy, those below primary school level and those taking two or more antiseizure medications were less likely to be vaccinated.

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Data availability

No datasets were generated or analysed during the current study.

Abbreviations

ASM:

Antiseizure medication

CI:

Confidence interval

COVID-19:

Coronavirus disease 2019

CWE:

Children with epilepsy

OR:

Odds ratio

PWE:

Patients with epilepsy

SARS-CoV-2:

Severe acute respiratory syndrome coronavirus 2

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Acknowledgements

We thank the patients and their family members for their cooperation. We also thank Editage (www.editage.com) for the English language editing.

Funding

This work was supported by the Shaanxi Provincial Key R&D Programs (Grant Number 2023-YBSF-640). This foundation had no role in the study design; data collection, analysis, or interpretation; writing of the manuscript; or in the decision to submit the article for publication.

Author information

Author notes

  1. Dandan Lou and Ye Song contributed equally to this work.

Authors and Affiliations

  1. Department of Pediatrics, The Second Affiliated Hospital of Xi’an Jiaotong University, No. 157 Xiwu Road, Xincheng District, Xi’an, Shaanxi, 710004, People’s Republic of China

    Dandan Lou, Dan Li, Yongjin Shi & Lin Yang

  2. Department of Pediatrics, The First Affiliated Hospital of Air Force Medical University, Xi’an, People’s Republic of China

    Ye Song

  3. Department of Pediatrics, Xi’an Gaoxin Hospital, Xi’an, People’s Republic of China

    Bo Wang

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  1. Dandan Lou
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Contributions

DDL: Conceptualization; Data curation; Formal analysis; Investigation; Resources; Roles/Writing - original draft; Writing - review & editing. YS: Roles/Writing - original draft; Writing - review & editing. DL: Methodology; Data curation; Investigation; YJS: Methodology; Data curation; Investigation; BW: Data curation; Investigation; LY: Conceptualization; Writing - review & editing. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Lin Yang.

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Ethics approval

This study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of the Second Affiliated Hospital of Xi’an Jiaotong University.

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Written informed consent was obtained from the parents.

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Not applicable

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The authors declare no competing interests.

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Communicated by Tobias Tenenbaum

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Lou, D., Song, Y., Li, D. et al. COVID-19 vaccination uptake in children with epilepsy and vaccine hesitancy among their parents: a survey. Eur J Pediatr (2024). https://doi.org/10.1007/s00431-024-05537-z

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