Diseases of the nervous system are the most common reason for permanent or temporary deferral of vaccinations. There is particular concern about pertussis vaccination, which can trigger seizures or worsen neurological status in some central nervous system diseases.
Vaccinations in children - Symptoms and course
To prevent post-vaccination complications and, on the other hand, to prevent unjustified mass exemptions from vaccination, the World Health Organisation (WHO) and national Scientific Societies have developed specific rules for the vaccination of children with CNS diseases. Permanent contraindications to vaccination include all progressive neurological diseases and congenital metabolic diseases with damage to the central nervous system. Vaccination should also be postponed in children undergoing neurodevelopmental diagnosis, especially in those suspected of having progressive diseases or epileptic encephalopathy. It is up to the doctor's discretion whether to defer all vaccination at that time or only the pertussis vaccination.
If a diagnosis of epilepsy has already been made and the disease is not an encephalopathy or a progressive disorder, virtually all the vaccinations scheduled in the vaccination calendar can be carried out. In children with epilepsy, it is only recommended that at least 12 months of seizure-free treatment should have elapsed before the planned vaccination against pertussis. If the child has not been diagnosed with epilepsy, but only with a history of intractable seizures (e.g. febrile seizures), it is recommended that pertussis vaccination be carried out under the protection of antipyretics, with possible short-term administration of anticonvulsants. In all the cases described above, it is recommended to use the acellular vaccine, which gives fewer side effects with similar immunogenicity.
When to go to the doctor and treat
Your child's doctor at the outpatient clinic should be notified of any history of convulsive incidents or other neurological disorders. On this basis, the doctor will make a decision on the method of vaccination.
Vaccinations in children - Treatment
The basic home antipyretic to prevent vaccination reactions is paracetamol (Panadol, Paracetamol, Apap) in a single dose of 15-20 mg per kilogram of body weight (can be repeated a maximum of 4x a day). Diazepam preparations for rectal infusions are also available (by prescription), which parents of children with epilepsy can administer themselves at home in the event of unexpected convulsions (preparation names: Relsed or Diazepam RecTubes). The prescription and method of use will be issued by the attending physician.
