Child with epilepsy gets COVID-19 vaccine

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COVID-19 is a worldwide pandemic that as of February 2021, has killed more than 450,000 Americans. While anyone can develop severe disease due to COVID, the elderly and those with underlying medical conditions are at greatest risk.

There are currently two COVID-19 vaccines authorized for Emergency Use by the U.S. Food and Drug Administration, with other in the pipeline. Information about the COVID-19 vaccines can be found on the CDC's website.

What is Emergency Use Authorization?

Emergency Use Authorization (EUA) is a way to facilitate the availability of medical countermeasures like vaccines, during a public health emergency. Since COVID-19 is a public health emergency, both the Moderna and Pfizer vaccines have received a EUA.

How is the vaccine being given out?

There are limited number of doses of both the Pfizer and Moderna vaccine at present. Federal and state authorities are working on prioritizing delivery based on risk of acquiring infection, risk of developing severe disease, risk of negative societal impact, and the risk of transmitting the infection to others. The following prioritization has been voted on by the CDC Advisory Committee on Immunization Practices as of December 20, 2020:

  • Phase 1a: Health care workers and residents and staff of long-term care facilities
  • Phase 1b: Adults age 75 years and older and frontline essential workers like first responders, teachers and other school/daycare staff, and critical workers (like bus/public transit drivers, postal workers, grocery store workers, etc.). Frontline essential workers are in sectors that critical to the functioning of society and have a higher risk of exposure to the virus.
  • Phase 1c: People (16-64 years of age) with high-risk conditions (this does not include epilepsy), adults age 65 and over, and essential workers not included in phase 1b (those in food service, construction, finance, public safety, etc.).
  • Phase 2: All people 16 years of age and older who were not included in Phase 1.

Find a full list of who is considered frontline essential workers from the CDC.

These federal phases are only recommendations. Actual allocation will be determined by your state. The CDC COVID-19 vaccine webpage can connect you to your state's health department for more information. 

The Pfizer vaccine was shipped out and vaccination started as early as December 14, 2020. The Moderna vaccine shipped out Monday, December 21, 2020.

Both vaccines require two doses to be effective.

  • Pfizer doses are 21 days apart
  • Moderna doses are 28 days apart

Who should get the COVID-19 vaccination?

It is important that every individual talk to their health care provider about their concerns regarding the vaccine. This can’t be emphasized enough. Individual risk varies from person to person.

The Pfizer vaccine has been authorized for people age 16 and over. The Moderna vaccine has been authorized for people age 18 and older.

I Am Otherwise Healthy: Should I Get The Vaccine?

Persons who are otherwise healthy can still develop severe disease due to COVID, so it is recommended that they are vaccinated. Vaccination will also prevent you from spreading COVID to those around you, who may be more vulnerable to severe disease.

I Have Already Had COVID-19 And Recovered. Do I Still Need To Get The Vaccine?

We do not yet know if, or for how long, after infection someone is protected from getting COVID-19 again. Some data suggests that natural immunity after COVID-19 may not last very long. Presently, the CDC has not provided guidance on this question but many experts are suggesting the safest bet is to get the vaccination.

Can pregnant women or breastfeeding mothers get the vaccine?

There currently isn’t any data on the safety and effectiveness of any COVID-19 vaccine for women who are pregnant or breastfeeding. If you are pregnant or lactating, speak to your health care provider about if you should get the vaccine, especially if you are in a high-priority group to receive the vaccine.

Isn’t masking, social distancing and self-quarantining a good alternative to COVID vaccination?

Given the extent of COVID-19 spread in the U.S., it is critically important to develop large-scale immunity through vaccination in order to stop the pandemic. COVID often spreads in the community from people who do not have symptoms. People can be contagious for as long as 14 days without symptoms, and those with symptoms can infect others two days before their symptoms begin. This means that while masking, distancing and self-quarantining is important to continue doing, it is not enough to contain the pandemic.

Is the COVID-19 vaccine safe?

The data to date suggests the vaccines are very safe.

The FDA will evaluate the data from clinical trials prior to approving each vaccine. In the clinical trials, over 30,000-40,000 persons received the vaccine. In order to receive Emergency Use Authorization by the FDA, the company who manufactured the vaccine must have followed at least half of study participants for two months or longer, after receiving both doses of vaccine, and the vaccine must be proven safe and effective.

In addition to the safety review by the FDA, the Advisory Council on Immunization Practices also has convened a panel of vaccine safety experts who will independently evaluate all safety data. This means two panels of experts will carefully review the data for each vaccine.

In addition, the Centers for Disease Control and Prevention will continue to carefully monitor the vaccine safety and will regularly share clear and accurate information with healthcare providers and the public.

The COVID Vaccine Was Developed Very Quickly. Did They Cut Any Corners On Safety?

The COVID vaccines are going through the same rigorous safety assessments as have other vaccines, and corners are not being cut. The COVID vaccine uses a new technology where messenger RNA is injected, as opposed to a piece of the virus. Messenger RNA contains the instructions for your body to make a protein related to the virus, but not the actual virus. Your immune system will then make antibodies to that protein. If you are then exposed to COVID infection, your body will rapidly recognize the protein, and will be primed to fight off infection very early, preventing you from developing severe illness.

This vaccine has been developed more quickly than previous vaccines, leading some people to worry that this was rushed. Advances in genetics allowed scientists to determine the genetic code of the COVID-19 virus very early, which was critical to making the messenger RNA for the vaccine. These vaccines have been carefully studied, and large numbers of volunteers who received the vaccines have been closely followed for side effects. The data suggests these vaccines are very safe.

What side effects have been reported in the clinical trials of COVID vaccines?

Approximately 15% of persons developed local pain or swelling at the vaccine site that resolved. Approximately 50% of persons develop headache, chills, fatigue, muscle aches or fever that is also transient (lasts for a short time), and is a sign that your immune system is responding to the vaccine.

A small number of people have reported allergic reactions. It is recommended that persons with severe allergic reactions to prior vaccinations discuss with their physician how to balance the unknown risk of allergic reaction with the benefit of vaccination. However, those with severe reactions can still get the COVID vaccine but should be monitored carefully for 30 minutes after the vaccine is given. It is recommended that persons with other types of allergies such as food, latex, pollen, or other substances get the vaccine.

There are many safety monitoring systems in place  to track adverse events (side effects) including V-safe, a smartphone-based, after-vaccination health checker for people who receive COVID-19 vaccines and the Vaccine Adverse Event Reporting System (VAERS), a national adverse event reporting system for healthcare providers, vaccine manufacturers and the public.

Are Those With Epilepsy At Higher Risk Of Side Effects?

There is no evidence that persons with epilepsy are at higher risk of side effects after vaccination. As with any vaccine, some persons may develop a fever which could lower their seizure threshold for the short term, and rarely could result in a break-through seizure. There is no evidence that this vaccination results in worsening of the epilepsy, or brain injury.

Should Those With Seizures Triggered By Fever Avoid Getting The COVID Vaccine?

Elevated temperature (fever) is a common side effect after getting a vaccine. Fevers have been reported as a side effect after getting the COVID vaccine, because the immune system is reacting to create immunity in the body. Some people with epilepsy have seizures that are triggered by fever. However, the available data about the risks of COVID and the safety of the COVID vaccines still support vaccination. If you or your loved one have seizures triggered by fever, please talk to your health care provider about:

  1. The specific benefits and risks of the COVID vaccine for you or your loved one
  2. Recommendations about where you or your loved one receive the vaccine, such as a location where medical staff are available
  3. A Seizure Action Plan that includes consideration of rescue therapies

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How effective is the COVID vaccine?

The experimental data so far suggest that vaccines are at least 90% effective after two doses in preventing symptomatic COVID infection and in developing severe disease. It is not known if the vaccine completely prevents any infection with COVID or just prevents development of disease.

How Long Will The Effect Of The COVID Vaccination Last?

We do not yet know for how long this vaccine will be protective. It is possible that people may need periodic boosters, similar to the flu shot.

Do I Need To Continue To Mask And Social Distance Even After I Get The Vaccine?

It is important to continue to use all tools to stop this pandemic, such as masking, hand washing, and social distancing even after vaccination. Experts need time to learn more about the protection of the COVID vaccination in real-life conditions, and how long that protection will last. In addition, persons who have been vaccinated may still develop infection with the virus but not get sick, so they may still be able to infect others. Wearing a mask and social distancing will help to prevent that spread.

Where can I get the vaccine?

Operation Warp Speed and the CDC are working on plans to ensure that all people can access a vaccination and that cost will not be a barrier. It is likely that there will be several centers in each community where one could be vaccinated.

Who is paying for the COVID vaccine?

Vaccination doses purchased with U.S. taxpayer dollars will be given to the American people at no charge. However, vaccine providers will be able to charge an administration fee to give the shot to someone, and would be able to have this fee reimbursed by the patient’s public or private insurance company. For uninsured patients, this fee can be covered by the Health Resources and Services Administration’s Provider Relief Fund.

Authored By: 
Elaine Wirrell MD
Authored Date: 
Reviewed By: 
Jacqueline French MD
Elaine Wirrell
Epilepsy Foundation Advocacy
Sunday, February 21, 2021