Parents don’t need another reason to worry about vaccinating their children. That was the general view during a discussion of febrile seizures at the June meeting of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices.
ACIP’s general recommendations working group has a subgroup dedicated to febrile seizures. One job of this subgroup is to review data on what is known about the incidence of febrile seizures associated with various childhood vaccines alone or in combination. The bottom line: the working group decided to recommend that ACIP NOT make a recommendation about vaccination and febrile seizures.
Several presentations included data showing that febrile seizures are neither unusual nor significantly associated with vaccinations. Dr. Andrew Kroger of the CDC acknowledged that data are limited, especially data on the risk/benefit ratios of simultaneous vaccinations and febrile seizures.
“How much risk of influenza and invasive pneumococcal disease are we willing to take with delayed vaccination, in order to prevent the occurrence of febrile seizures?” Dr. Kroger asked.
Ultimately, the working group decided that, for now at least, the issue was “best addressed through messaging,” rather than voting. A majority of the working group recommended that providers should simply inform parents of the increased risk of febrile seizures with concomitant vaccinations but not recommend any delay of vaccination because of it.
This option seemed to go over well during the discussion period.
“The worst thing we could do is send a message that delaying vaccinations is preferable to preventing febrile seizures,” Dr. Michael Brady, representing the American Academy of Pediatrics, said during the discussion period.
Dr. Doug Campos-Outcalt, representing the American Academy of Family Physicians, agreed. “It’s important to consider febrile seizure numbers in the context of the disease,” he said.
ACIP member Dr. Janet Englund noted that “for ACIP to mandate discussion of febrile seizures during a visit would be harmful to the [vaccination] process.”
In fact, some data suggest that vaccination has a protective effect on febrile seizures, and such data could be useful when collected over the long term, said Dr. Jeff Duchin, chair of the general recommendations working group.
Hmm. Something else to encourage childhood vaccination. That sounds like a good message.
–Heidi Splete (on twitter @hsplete)