Peer-reviewed article
Vaccine Coverage among Children with and without Intellectual Disabilities in the UK: Cross Sectional Study
Eric Emerson, Janet Robertson, Susannah Baines, Chris Hatton ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study compared vaccination coverage rates between children with and without intellectual disabilities in the UK using data from the Millennium Cohort Study collected at ages 9 months, 3 years, 5 years, and 14 years. Children with intellectual disabilities had lower vaccination coverage rates across nearly all vaccines and ages examined. The differences remained significant at ages 9 months and 3 years even after adjusting for family socio-economic factors. The study concludes that children with intellectual disabilities face increased risk of vaccine-preventable diseases.
Key points
- Vaccination coverage was lower for children with intellectual disabilities at nearly all ages and for nearly all vaccines, with the exception of MMR at age 5
- Significantly lower complete vaccination coverage for children with intellectual disabilities at 9 months (PRR 2.03) and 3 years (PRR 2.16)
- Differences in socio-economic position and other family factors accounted for some but not all of the vaccination gap
- Parents of children with and without intellectual disabilities reported similar reasons for non-vaccination
- The vaccination gap puts children with intellectual disabilities at risk and may compromise herd immunity
Limitations
This study relies on parental reports of vaccination rather than verified medical records, and the cross-sectional design at each timepoint does not allow examination of causal factors. The study cannot identify the specific mechanisms or barriers leading to lower vaccination rates in this population.
Abstract
BACKGROUND: Universal childhood vaccination programmes form a core component of child health policies in most countries, including the UK. Achieving high coverage rates of vaccines is critical for establishing 'herd immunity' and preventing disease outbreaks. Evidence from the UK has identified several groups of children who are at risk of not being fully immunised. Our aim was to determine whether children with intellectual disabilities constitute one such group. METHODS: Secondary analysis of parental report data on child vaccination collected in the UK's Millennium Cohort Study when the children were 9 months, 3 years, 5 years and 14 years old. RESULTS: With one exception (MMR coverage at age 5) vaccination coverage rates were lower for children with intellectual disabilities (when compared to children without intellectual disability) for all vaccinations at all ages. Complete coverage rates were significantly lower for children with intellectual disabilities at ages 9 months (unadjusted PRR non-vaccination = 2.03 (1.14-3.60), p < 0.05) and 3 years (unadjusted PRR = 2.16 (1.06-4.43), p < 0.05), but not at age 5 years (unadjusted PRR = 1.91 (0.67-5.49)). HPV vaccination was lower (but not significantly so) at age 14 (PRR = 1.83 (0.99-3.37), p = 0.054). Adjusting PRRs for between group differences in family socio-economic position and other factors associated with coverage reduced the strength of association between intellectual disability and coverage at all ages. However, incomplete vaccination remained significantly elevated for children with intellectual disabilities at ages 9 months and 3 years. There were no statistically significant differences between parents of children with/without intellectual disability regarding the reasons given for non-vaccination. CONCLUSIONS: Children with intellectual disabilities in the UK are at increased risk of vaccine preventable diseases. This may jeopardise their own health, the health of younger siblings and may also compromise herd immunity.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Universal childhood vaccination programmes (comparison of coverage rates between children with and without intellectual disabilities)
- Population
- UK children from the Millennium Cohort Study, with and without intellectual disabilities, assessed at ages 9 months, 3 years, 5 years, and 14 years
Key finding
Complete vaccination coverage was significantly lower for children with intellectual disabilities at 9 months (unadjusted PRR 2.03, 95% CI 1.14-3.60)