Table 2.
Summary of articles.
| Study and Year | Country | Study design/Data collection method | Research aim | Participants and disability type | Relevant results |
|---|---|---|---|---|---|
| Bazzano et al. (2012) | USA | Cross sectional telephone survey | To determine if parents change or discontinue their child’s vaccination schedule after ASD diagnosis | 197 parents of children under 18 years with ASD | 50% changed or discontinued vaccination schedule after diagnosis |
| Cerutti et al. (2015) | France | Retrospective audit – Immunization record of children Questionnaire for parents | To evaluate vaccination rates of children with inborn errors of metabolism (IEM) and attitudes of their parents. | 128 children with inborn errors of metabolism and 128 age and gender matched controls | Lower rates in children with IEM overall, with lowest in those with highest risk of decompensating and for live vaccines Most common reason for being hesitant – concerns about adverse reactions |
| Cody & Lerand (2013) | USA | Questionnaire for parent/carers Internet-based survey of health professionals | To describe acceptability of HPV immunization amongst parents of children with special health care needs Parent and provider barriers to HPV vaccine | 17 parents of girls with special health care needs 9–16 yrs 130 providers (of 600) completed online survey | 17% vaccinated against HPV 90% providers said they vaccinated against HPV, main reason why they didn’t was parent refusal. |
| Cooney (2009) | Ireland | Qualitative grounded theory Semi-structured interviews (clients and managers) Questionnaires (care staff) | To identify factors that influenced client satisfaction with a vaccination program for Hep B | 6 clients with ID who had completed 3 course Hep B dose and had follow up blood test, 41 care staff and 3 managers of disability services | High satisfaction with respect shown to clients and program delivery, mixed response to adequate information and lack of policies around restraint Adverse effects more likely to be reported by clients than staff |
| Cummings et al. (2016) | USA | Data linkage | To compare health services use among youth with ASD as compared with those without ASD. | 8325 youth with ASD and 83,195 youth without ASD across the age range 3 yrs to 17 yrs | Youth with ASD are significantly less likely to receive immunizations. |
| Fisher, Audrey, Mytton Hickman & Trotter (2014) | UK | Retrospective audit | To investigate factors associated with HPV initiation and completion in South West England | 14, 282 female students, 196 of these are in non-mainstream schooling | Relevant finding – girls attending non-mainstream schools HPV initiation only 55.7% compared with 88.6% overall |
| Greenwood, Crawford, Walstab & Reddihough (2013) | Australia | Retrospective audit using data linkage, ACIR and CP register | To compare immunization coverage of children with CP with the general population coverage | 449 children with cerebral palsy under 7 years | 19.2% of children with CP were not up to date with immunizations compared to 6.4–8% of general population |
| Groce, Ayora & Kaplan (2007) | Ecuador | Retrospective audit and parent interview | To compare immunization coverage of children with disabilities in remote parts of Ecuador with their non-disabled peers | 32 children with disabilities and their siblings | 31/32 children with disabilities were up to date with immunizations, as were their peers. |
| Haynes & Stone (2004) | Australia | Probabilistic data linkage | To determine the predictors of incomplete immunization status of Victoria children at 12 and 24 months. | 60,491 Victorian children born in 1998 | Congenital malformations not a significant predictor of incomplete immunization at 12 and 24 months. |
| Lin, Lin & Lin. (2010) | Taiwan | Cross-sectional questionnaire | To examine the Hep B coverage rate and its determinants of children with ID in Taiwan | 495 primary caregivers of children with ID who attend 3 special education schools in Taiwan | 74% had received the full Hep B immunization. Incomplete Hep B vaccination was twice the general population Main determinants were lower household income and older age of child |
| McRee, Maslow, G. and Reiter (2017). | USA | Cross sectional study. Secondary analysis of data from the Child Health Assessment and Monitoring Program | To compare adolescent vaccine coverage in youth with special health care needs as compared to youth without special health care needs. | 2156 young people 11–17 years, 604 (28%) with special health care needs. | Similar rates of tetanus immunization (91% uptake) as general population lower uptake of meningococcal immunization (28% vs 72% in general population) and HPV immunization (32% one dose vs 40–60% in general population). Strongest correlate of immunization in the special health care needs group was a health care check in the last year. |
| O’Connor and Bramlett (2008) | USA | Data linkage – National Immunization Survey and National Survey of Children with Special Health Care Needs. 2000–2002 data | To compare vaccination coverage of children 19 to 35 months with and without special health care needs | 17 994 children between 19 and 36 months, 1283 (7%) with special health care needs | Generally no difference between the immunization rates of children with special health care needs and those without. Under-immunization more likely in white affluent household |
| Okoro, Ojinnaka, N., Ikefuna & Onyenwe, (2015) | Nigeria | Cross sectional study, parent carer questionnaire and immunization records | To determine the influence of sociodemographic factors and type of neurological disability on the immunization status of children with chronic neurological conditions | 168 families of children with chronic neurological conditions aged 6 months to 5 years | Mother’s higher education and father’s higher income were the factors that significantly increase the immunization coverage of children with neurological disorders. Those children with visually obvious were less likely to be fully immunized |
| O’Neill, Elia & Perrett (2017) | Australia | Retrospective audit | To determine the uptake of HPV in a cohort of adolescents with developmental disabilities as compared to the general population | 72 adolescents aged 14 years who attended a pediatric outpatient clinic for developmental disabilities in the last year | 44.1% of females and 39.5% of males in this population were fully vaccinated for HPV compared to 77.4% females and 66.4% males of 15 year olds in general population More likely to miss HPV vaccination if they had intellectual impairment irrespective of motor function |
| O’Neill, Newall, Antolovich, Lima & Danchin (2019) | Australia | Prospective cohort study | To determine the uptake of dTPa and HPV in young people with disabilities in specialist schools in Victoria | 374 students aged 12–13 yrs in 28 specialist schools for young people with disability | DTPa was received by 63% of students in specialist schools compared to 89% in mainstream schools, and first dose of HPV was received by 66% of females and 67% of males compared with 75% for mainstream schools Main reasons for non-immunization was absence from school, lack of consent and inability to immunize due to anxiety/behavior |
| Pandolfi et al. (2012)1 | Italy | Prospective survey | To examine the effect of physician recommendation regarding the influenza immunization to families of children with chronic illness and measure the frequency of immunization in this population | 275 families with of children 6m-18y with chronic diseases | 57.5% overall influenza coverage, only 25% in those with neurological diseases Higher (87–94%) who had physician recommendation for flu vaccine |
| Pandolfi et al. (2012)1 | Italy | Cross-sectional study Audit of immunization record and parent interview | To measure immunization coverage and timeliness for children with Type 1 diabetes, HIV, Down syndrome, cystic fibrosis and neurological diseases | 275 children 6m to 18y from 3 Italian regions with chronic illness/disability | Low rates of immunization at 12 months, increased by 24 months but below 90% for all immunizations MMR most likely to be delayed for children with neurological diseases. Most common reasons for delay was acute illness |
| Raddish, Goldmann, Lawrence, Kaplan & Perrin (1993) | USA | Cross sectional survey Parent questionnaire, chart review, immunization record review | To determine immunization levels for among children with spina bifida compared to general population at 24 months and 7 yrs of age, and describe influencing factors | 120 children seen in myelodysplasia clinic of Children’s Hospital in Boston 4 months – 18 yrs | Children with spina bifida had lower uptake immunizations than general population – 24months 58% vs 79% 7 yrs 81% vs 97% |
| Remes et al. (2014) | Canada | Retrospective cohort study Used data linkage – 4 databases | To identify individual and regional level determinants of HPV vaccine refusal in Ontario’s Grade 8 HPV Immunization program | 144,047 girls in Grade 8 in Ontario 2007–2011, | 49.3% refused HPV vaccination Associations with refusal – Down’s syndrome, ASD, few physician visits, previous refusal of scheduled vaccinations, living in areas of high deprivation. |
| Rosenberg et al. (2012) | USA | Online questionnaire | To examine immunization beliefs and practices of families with a child with ASD | 486 families with a child with ASD. | More likely to delay or omit vaccinations if believed they played a role in ASD development. Higher maternal education more likely to delay or omit vaccinations for younger sibling of child with autism irrespective of belief of autism-vaccination link. |
| Rowe, Pritt, Stratton & Yoost (2017) | USA | Retrospective audit and cross sectional survey Immunization record and phone survey with sample of parents | To evaluate if HPV vaccination rates are different between female adolescents with mental and physical limitations and those without. | 1673 females presenting to pediatric or gynecology clinics in 2012, 72 (4%) with mental or physical limitations. 44 parents of control group and 21 parents of affected group | Of those with mental or physical limitation 43% initiated HPV schedule, compared with 57% of control group. The most common reasons for non-vaccination in the affected group was a belief the immunization was not needed and lack of recommendation by medical provider. The most common reasons for non-vaccination in the control group was safety concerns and lack of recommendation by medical provider. |
| Samuels, Liu, Sofis & Palfrey (2008) | USA | Audit of immunization rates before and after intervention and questionnaires to providers | To assess whether a medical model of care for children with special needs improves immunization rates | Six general pediatric practices and 150 children with special needs and 30 pediatricians | Immunization rates were already high, overall 83% and didn’t change after intervention. Severity of illness, technologically dependent, non-English speaking background had no effect on immunization rates |
| Smith, Peacock, Uyeki & Moore (2015) | USA | Prospective survey | To document parental report of influenza vaccination or intent to vaccinate in families of children with neurodevelopmental disorders Provider survey – to document physician recognition of high risk influenza conditions | 2138 parents of children with high-risk conditions, including 1143 with neurodevelopmental disorders | 50% of parents of children with neurodevelopmental disorders vaccinated or were intending to vaccinate their child against flu Similar to general population Providers recognized CP as high risk condition (74%), less so epilepsy (51%) and ID (46%) |
| Tanabe et al. (2011) | Japan | Questionnaire sent to pediatricians | To determine factors influencing the advice from pediatricians about immunization for children with severe handicaps and/or epilepsy | 359 (of 680) pediatricians Asked specifically whether they would vaccinate in cases for febrile seizure, epilepsy or severe handicap | Majority answered “occasionally refuse” to vaccinate in all 3 scenarios. Most common reason duration since last seizure, majority would advocate waiting 3 months since last seizure. For handicap group main reason for refusal was daily epileptic seizures |
| Tillmann,Tillman, Heininger, Lutschg & Weber (2005) | Switzerland | Retrospective case-control study | To examine the uptake and age of vaccination of children with chronic neurological deficits as compared to healthy children | 100 children 1 to 16 yrs with neurological deficits and 200 age-matched controls | Children with chronic neurological deficits receive less childhood vaccinations than healthy controls and at a later age. Those who had congenital neurological deficits or a diagnosis in first 6 months of life were particularly at risk of missing or delayed vaccinations. Pertussis the most likely to be missed or delayed compared to controls |
| Tuffrey & Finlay (2001). | UK | Cross sectional survey of computer database of immunization records | To compare immunization status of children attending three special schools in Bath with age and sex matched controls | 136 children attending 3 special schools from 4.5 to 16.5 years, with severe physical difficulties, severe or profound learning difficulties or both. 272 controls. | 59% of children from special schools fully immunized vs 83% of controls. Significant difference found for pertussis, measles and rubella. No sex or age differences |
| Yen, Chen et al. (2011) | Taiwan | Cross-sectional survey, part of larger study | To identify factors influencing HPV vaccine acceptability among women with physical disabilities in Taiwan | 438 women with physical disabilities aged 18–69 yrs | 54% heard of HPV vaccine Only 3.2% would have if they have to pay 60% would have if subsidized |
| Yen et al. (2012). | Taiwan | Cross sectional survey, validated previously by authors, using parents/carers as proxies | To describe influenza vaccine uptake and determinants for children with ID living in the community. | Parents/carers of 1055 adolescents with ID 12–18yrs | 23% had flu vaccine in last 3 years. Those with mod-severe disability with regular health exams more likely to be vaccinated. |
| Yen & Lin (2011). | Taiwan | Cross sectional survey, part of larger survey into health of people with ID, parent report as proxy | To determine Hep B vaccination coverage rates among community dwelling teenagers with an ID in Taiwan. | 1111 teenagers 12–18 with ID | 72.9% study participants immunized. Rate of non-immunization twice that of general population. Hep B immunization correlated with higher household income, previously oral health exams |