Many People With Epilepsy Still Hesitate On COVID Vaccines

What was studied

This study combined results from 14 research studies about COVID-19 vaccine hesitancy in adults with epilepsy. In total, 4,230 participants were included. The authors searched several medical databases and grey literature up to February 6, 2026, and used standard systematic review methods to identify and combine relevant studies.

They examined how willing adults with epilepsy were to get a COVID-19 vaccine, which factors were associated with vaccination, and common reasons for hesitancy. They also assessed the methodological quality of the included studies and the overall certainty of the evidence.

What they found

Across the included studies, 51.7% of adults with epilepsy were willing to be vaccinated against COVID-19, although results varied substantially between studies. Among people who had not yet been vaccinated, 44.2% said they were willing to get the vaccine.

Well-controlled epilepsy was associated with higher vaccination rates, while frequent seizures (daily or weekly) were associated with lower likelihood of vaccination. The most commonly reported reasons for hesitancy were fear that vaccination might worsen seizures and concerns about side effects.

Limits of the evidence

The evidence was rated as very low certainty, which means the results are very uncertain. Most of the included studies were methodologically weak, and only one was rated as satisfactory quality.

The review found associations, but it cannot show that seizure control directly causes differences in vaccine uptake. Results also differed greatly across studies, suggesting findings may vary across settings or groups. Because the review only included adults with epilepsy, the findings may not apply to children or adolescents.

For families and caregivers

This review suggests that COVID-19 vaccine hesitancy remains present among adults with epilepsy, with concerns about seizure worsening and side effects commonly reported. For families, this suggests it may be helpful to ask about seizure-related concerns directly rather than assuming hesitancy is the same as in the general public.

At the same time, the evidence is too uncertain to give firm conclusions about how common hesitancy is in every epilepsy group. Families may want to discuss individual seizure patterns, side effect concerns, and available vaccine safety information with a clinician who knows the person’s epilepsy history.

What to watch next

Higher-quality prospective studies using validated instruments are recommended, with clearer information about seizure control and vaccine-related outcomes.

Terms in this summary

systematic review

A study that collects and summarizes all relevant research on a question using a planned method.

meta-analysis

A statistical method that combines results from multiple studies to estimate an overall result.

hesitancy

Delay, uncertainty, or reluctance about getting a vaccine.

odds ratio

A number used to compare how likely something is in one group versus another; above 1 means more likely, below 1 means less likely.

heterogeneity

How different the study results are from each other.

GRADE

A system used to judge how certain or trustworthy the overall evidence is.

risk of bias

Problems in study design or methods that can make results less reliable.