The approval of COVID-19 vaccines provides great hope that we can return to some form of normality in 2021.
There are currently a number of vaccines approved for use in Ireland – the Pzifer/BioNtech Vaccine, Moderna Vaccine, AstraZeneca & Janssen.
Since the vaccine programme has begun, we have had a number of questions from people with epilepsy about advice regarding this and possible side-effects.
We have outlined these below:
How will people with epilepsy be prioritised under the COVID Vaccination Plan?
Vaccination is being rolled out now based on age and has moved away from the cohorts-based approach which was employed earlier in the rollout programme. Vaccination is now open to everyone aged 18 and over – either via the HSE portal or through participating pharmacies. You can read more on this HERE.
We would encourage you to please register and get vaccinated as the more people who get vaccinated, the better a chance we have of returning to normal – something we are all now longing for.
Am I at higher risk of contracting COVID-19 due to having epilepsy?
After over a year of living with the virus, there is no data to suggest that people with epilepsy are more at a higher risk of contracting the virus compared to the general public.
If I do catch the virus, will I be more adversely affected due to having epilepsy?
Again, there is no data to suggest that you will be more adversely affected by the virus due to having epilepsy. That being said, we have all heard now of personal testimonies of those who have contracted the virus and the varying ways they have been affected. Much like epilepsy, the virus’ presentation from person to person – and the impact it has on them – varies, so we must continue to do everything we can to ensure we are all following public health guidelines.
It is also important to note that the virus could cause a fever which in turn could lead to seizures for some people so again, it is important that we do all we can to ensure that we do not contract the virus.
I have concerns about the vaccines and how quickly they were developed. Should I take them?
It is important to note that all vaccines currently approved for use in Ireland have been approved by the European Medicines Agency. This is the same body which approves all other medications that come into the country – including anti-epileptic drugs.
Vaccines for COVID-19 have gone through rigorous testing and peer review before they were approved. There were no short cuts taken compared to the normal clinical trial and regulatory process. Instead, the regulatory process was made more efficient in several ways, for example by running trials in parallel rather than sequentially; and by analysing data during the trials rather than waiting to the end. In addition, governments have provided huge levels of funding for Covid-19 vaccine development, minimising the risks for pharmaceutical companies, and enabling the process to proceed much faster than is normally the case.
As we are all widely aware, rare instances of blood clotting have been identified with the AstraZeneca vaccine and Janssen vaccine.
Post-marketing surveillance is a critical part of the process of ensuring that all new treatments are safe once they are in use in the general population. It is not unusual that potential safety markers, including exceptionally rare events are identified as part of this process. Ultimately, regulators such as the EMA and HPRA will take evidence-based decisions on concerns that may arise, taking into the account the risks and benefits associated with the vaccines and associated with contracting Covid-19.
Therefore we would strongly encourage people with epilepsy and others to get the vaccine considering the current circumstances – mass vaccination is the pathway to get back to normal; something we are all now longing for.
We would also encourage everyone to please get your information about the vaccines from reliable sources such as the HSE, HPRA, European Medicines Agency or international equivalents such as the UK’s MHRA or US FDA.
You can also see very useful information on the vaccines and vaccines in general on the European Commission website HERE.
Will the vaccines interact with my existing Anti-Epileptic Drugs or CBD treatments?
There is no evidence to suggest that the vaccines will interfere with your current treatments or reduce their effectiveness.
Are there general side effects that I should be aware of when it comes to receiving the vaccine and are there also specific side effects I should be aware of as a person with epilepsy?
The most common side effects are usually mild or moderate and improve quickly. These can include pain and swelling at the injection site, tiredness, headache, muscle and joint pain, chills and fever. These side effects are consistent with what would normally be observed following vaccination because of the immune system’s response to the vaccine. There have been some reports that side effects are more common following the second dose.
The Health Product Regulatory Authority – the body responsible for medicines regulation in Ireland will routinely issue safety reports on the vaccines which you can find HERE.
While there are no side-effects being reported specific to people with epilepsy, it is important to note that fever is a potential side effect that could trigger a seizure for some people with epilepsy. Antipyretics, i.e. medicines that help regulate temperature; for example, paracetamol, taken regularly for 48 hours after the vaccination (or for the duration of fever) will help minimise this risk.
If I have well-controlled epilepsy and have a seizure after being vaccinated, would the seizure be classed a 'provoked' seizure?
A provoked seizure is a seizure which has a known cause and is unlikely to be repeated. Should the advice given below (rest, fluids & paracetamol) be followed it is unlikely that a person with controlled epilepsy will have a seizure. In the unlikely event that a seizure does occur, an argument could be made that the seizure was provoked. However, you will need to consult with your neurologist on this. The decision on whether a seizure can be classified as provoked is individualised and at the discretion of your treating clinician.
With a number of vaccines now available, is there a preferred option for people with epilepsy?
There is no evidence to suggest that one vaccine over another is preferred for people with epilepsy.
When the time comes to being vaccinated, is there any specific advice for people with epilepsy?
The advice would be the same as with any other vaccine. Have plenty of rest before and after the vaccine and plan your day around your vaccine so you’re not rushing and overly stressed.
It is also important to stay hydrated both before and after the vaccine. Finally, as noted the vaccine can cause a fever in some people. For some people with epilepsy, this could trigger a seizure so it is recommended that a person with epilepsy take 2 paracetamol after vaccination and every 6 hours (while awake) for up to 48 hours after vaccination unless contra indicated for any other health reason - if you have any concerns in relation to this you should talk to your GP.
Before you receive a COVID-19 vaccine, make sure to let your vaccination provider know that you have epilepsy and your particular seizure type(s), as well as any other important medical information, such as:
- Allergies, especially an allergy to any ingredient in the vaccine
- Allergic reactions to prior vaccines (e.g. flu vaccine)
- Current or recent fever or infection
- All medications you are taking, especially medications that suppress the immune system (e.g. immunomodulatory or immunosuppressive medicines) or anticoagulants. It may be beneficial to take a list of these with you
- If you are pregnant or nursing, or plan to become pregnant
As with any vaccine, you should not receive the COVID-19 vaccine if you are allergic to any of its ingredients. You should not receive a second dose if you had an allergic reaction to the first dose.
When fully vaccinated, does that mean I can get back to normal?
If you have already received the COVID-19 vaccine, it is important to continue wearing a mask, employ regular hand washing and to social distance. The current vaccines reduce your risk of getting a severe form of COVID-19 by up to 90%, depending on the vaccine, but vaccinated people may still be able to spread COVID-19 to others without knowing they are carrying it.
What should I do in the meantime while awaiting being called for the vaccine?
While awaiting a vaccine, we all still have to continue practising good hand hygiene & social distancing while wearing a mask in public places. This has been a difficult time for so many but we must hold firm to ensure that the most vulnerable in our society are protected. Better days are ahead and we all know what we must do to get there.
Watch our video with Prof. Norman Delanty....
Many of the questions outlined above were discussed with Professor Norman Delanty of Beaumont Hospital and FutureNeuro. As the vaccines began to become available, we discussed many of the questions with Prof. Delanty to provide his expertise to people with epilepsy and their families. You can watch our discussion with Prof. Delanty below but please note this was recorded in early February at a time when the age-based system was not currently in place.