A recent analysis of reports of reactions following measles immunization has revealed that children who had seizures following measles vaccine were more likely to have a personal history of seizures or a history of seizures in siblings or parents than vaccinees who had nonneurologic reactions associated with immunization.1 These seizures usually are associated with fever and occur five to 11 days postimmunization when febrile reactions to live measles virus are most common; approximately 5% to 15% of vaccinees have elevated temperatures during this time. The seizures resemble typical febrile seizures which are common at this age and are rarely associated with any sequelae. In one study, the vast majority of children who had seizures following live measles vaccination had temperature elevations and about half were associated with intercurrent infections.2
The Committee strongly recommends that children who have a personal or family history of seizures should receive live measles vaccination. Seizures are unpleasant experiences but the risk of measles to unimmunized children is far more significant. Outbreaks in schools with as few as 5% of the children seronegative have been reported.3 Thus, live measles vaccine should not be denied these children.
The parents of children who have either a personal or a family history of seizures should be advised of the risk and told in advance of immunization what they should do if the child does indeed have a seizure. Because the period of risk is approximately 1 week, it is difficult to recommend an effective method of decreasing the chances of seizure occurring.
- Copyright © 1987 by the American Academy of Pediatrics