Peer-reviewed article
Immunization Patterns of Children with Chronic Neurological and Neurodevelopmental Disorders: A Cross-Sectional Study from Istanbul.
Emek Uyur, Merve İşeri Nepesov, Nilüfer Eldeş Hacıfazlıoğlu, Nihan Uygur Külcü, Rabia Gönül Sezer Yamanel ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined immunization patterns in 545 children with chronic neurological and neurodevelopmental disorders in Istanbul. Overall, 72% were fully vaccinated, 25% partially vaccinated, and 3% never vaccinated. Vaccination rates varied by diagnosis, with lower rates in autism spectrum disorder and cerebral palsy, but higher rates in Down syndrome. The study found that incomplete vaccination was typically due to partial interruption rather than complete refusal, most commonly after age 4 years.
Key points
- 72.1% of children with chronic neurological and neurodevelopmental disorders were fully vaccinated according to the Turkish National Immunization Program
- Partial vaccination (25.0%) was more common than complete vaccine refusal (2.9%)
- Immunization status differed significantly across diagnostic groups, with autism spectrum disorder and cerebral palsy showing lower coverage
- Down syndrome had higher vaccination coverage compared to other diagnostic categories
- Maternal age was the only factor significantly associated with incomplete or no vaccination in multivariable analysis
Limitations
This is a cross-sectional study from a single tertiary pediatric neurology center in Istanbul, so findings may not be generalizable to other settings, populations, or countries. The study does not explain the reasons parents chose partial vaccination or identify specific barriers to immunization beyond maternal age.
Abstract
Background/Objectives: Children with chronic neurological and neurodevelopmental disorders (CNDD) constitute a medically vulnerable population in whom routine childhood immunization may be interrupted because of clinical complexity and parental concerns. This study aimed to evaluate immunization patterns, timing of vaccination interruption, and associated clinical and sociodemographic factors in children with CNDDs followed at a tertiary pediatric neurology center. Methods: This prospective cross-sectional study included 545 children aged 1-18 years with chronic neurological and neurodevelopmental disorders evaluated between September and November 2025. Immunization status according to the Turkish National Immunization Program was classified as fully vaccinated, partially vaccinated, or not vaccinated. Information regarding non-NIP vaccines, timing of vaccination interruption, parental characteristics, and motor impairment severity assessed using the Gross Motor Function Classification System (GMFCS) was collected. Associations between vaccination status and clinical variables were evaluated using chi-square tests and logistic regression analysis. Results: Overall, 72.1% of children were fully vaccinated, 25.0% were partially vaccinated, and 2.9% had never received routine childhood vaccines. Immunization status differed significantly across diagnostic groups (p < 0.001). Partial vaccination was more common than complete vaccine refusal across most diagnostic categories. Lower full vaccination rates were observed in autism spectrum disorder and cerebral palsy, whereas higher coverage was observed in Down syndrome. Among partially vaccinated children, interruption of routine immunization after 48 months was the most frequent pattern. In multivariable analysis, only maternal age remained significantly associated with incomplete or no vaccination. Conclusions: Incomplete immunization in children with CNDDs was more commonly characterized by partial vaccination than complete vaccine refusal and followed diagnosis-specific patterns. Evaluating vaccination continuity during pediatric neurology follow-up may help support diagnosis-sensitive immunization counseling.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Routine childhood immunization according to the Turkish National Immunization Program
- Population
- 545 children aged 1-18 years with chronic neurological and neurodevelopmental disorders (cerebral palsy, autism spectrum disorder, Down syndrome, and others) followed at a tertiary pediatric neurology center in Istanbul
Key finding
72.1% achieved full vaccination according to Turkish National Immunization Program
Uyur et al. · PubMed (US National Library of Medicine) · 2 Jul 2026