Influenza Vaccination in Children with Neurologic or Neurodevelopmental Disorders

Doctor talking to a mom and a little girl holding a teddy bear.

The journal Vaccination published a study looking at the influenza (flu) vaccination practices of parents and healthcare providers who provide care for children with Neurologic or Neurodevelopmental Disorders (NNDDs). The study evaluated children with NNDDs, generally, and evaluated the three most commonly reported NNDDs (cerebral palsy, epilepsy, and intellectual disability) separately.

The study finds that among its participants, only half of children with NNDDs were vaccinated for flu or scheduled to receive a flu vaccination during the 2011-12 flu season. This is alarming as children with NNDDs are at greater risk for having medical complications if they get the flu, such as needing to be hospitalized or dying. It’s also important to note that some children with NNDDs have increased complications from the flu regardless of whether or not they have a respiratory condition (such as asthma).

Children with NNDDs were more likely to be vaccinated if their parents knew their child was at increased risk for medical complications from the flu. This is important information for healthcare providers. The study demonstrates that although the current flu vaccination rate is low, healthcare providers might increase the rate by educating parents of children with NNDDs about the risk of flu complications and the benefits of influenza vaccination. The more children with NNDDs who receive flu vaccinations, the fewer dangerous complications from flu will be experienced by this high-risk group of children.

This work was a joint effort of disability researchers from CDC, American Academy of Pediatrics (AAP), Family Voices, and Oak Ridge Institute for Science and Education (ORISE).

Read the abstract of the article, Influenza vaccination in children with neurologic or neurodevelopmental disorders.external icon.

Main Findings

  • Despite being at an increased risk for medical complications related to flu, only about 5 in 10 children with NNDDs receive the flu vaccination, which was not different from the rate of flu vaccination in children overall.
  • About two-thirds of children with NNDDs who were identified by their parents as being at high risk for influenza were vaccinated; in contrast, only about one-third of children with NNDDs whose parents did not identify them as high risk were vaccinated.
  • Among children with intellectual disability, those who also had a respiratory condition were nearly twice as likely to be vaccinated, compared to those without a respiratory condition.
  • Half of parents of children with NNDDs participating in the study reported they did not intend to have their child vaccinated for flu. Among those who reported a reason for not vaccinating their child, the following reasons were given for the decision*:
    • About 4 in 10 said, “Concerns about how the vaccine would affect my child”
    • About 3 in 10 gave, “Concerns about the safety of the vaccine”
    • About 2 in 10 “Don’t believe the vaccine protects against the flu”
    • About 1 in 10 said their “Healthcare provider did not recommend the vaccine”
  • Most parents of children with NNDDs said they prefer to receive information from healthcare providers, especially related to vaccines and influenza; other trusted sources of information included the internet and family support or disability advocacy groups.

What is known about vaccination practices and children with NNDDs, and what does the study add?

  • This study provides additional information on factors associated with parents’ decisions about having their child vaccinated for flu.
    • Most parents of children with NNDDs did not consider their children as having a high risk for flu complications.
    • Children with a respiratory condition were generally identified as high risk for medical complications from the flu by their parents and healthcare providers; these children had higher rates of vaccination.
    • Children whose parents recognized NNDDs as high-risk conditions were more likely to be vaccinated.
  • Although pediatricians recognized that children with cerebral palsy were at increased risk for flu complications, only about half knew that children with other NNDDs, specifically intellectual disability and epilepsy, were also at increased risk.
  • Read a related CDC report on vaccination practices in children with NNDDs and its key findings.

What Can Be Done?

  • Healthcare Providers Can:
    • Learn more about potential flu complications among children with NNDDs to be better prepared to educate parents about these risks and the benefits of flu vaccinations for these children.
  • Parents of Children with NNDDs Can:
    • Make informed decisions about the benefits of flu vaccination by learning more about potential flu complications and talking to their child’s healthcare provider about the benefits of the flu vaccination for their child.

About this Study

  • Two on-line surveys were used to gather information about vaccination practices for children with NNDDs:
    • Parents of children with high-risk conditions received and completed one survey regarding their knowledge, attitudes, and practices related to flu vaccination. 2,138 surveys were submitted, which included 1,143 submissions from parents of children with at least 1 NNDD. This is the largest group of parents of children with NNDDs ever surveyed about this topic.
    • 412 pediatricians completed a different survey in an effort to gather information on practice setting and specialty, as well as flu vaccination practices for various patient populations.

Key Findings Reference

Smith M, Peacock G, Uyeki TM, Moore C. Influenza vaccination in children with neurologic or neurodevelopmental disordersexternal icon. Vaccine. 2015;33:2322-2327.

* note the reasons are not mutually exclusive