Clinical Summary
Clinical Summary: Vaccination Behavior Among Children With Developmental Delay and Their Siblings: A Cross-Sectional Study From India
Children with developmental delay and their siblings can be left vulnerable to vaccine-preventable illness when family vaccination behavior changes after a developmental diagnosis. This study addresses a clinically important question beyond autism spectrum disorder: whether lower vaccine uptake extends across families of children with developmental disabilities seen in child development centers.
Design
This cross-sectional study was conducted from December 2017 to February 2018.
N
The study included 189 families with children with developmental disabilities.
Population
The families of children with developmental disabilities were recruited into the study from 3 child development centers in the districts of Kozhikode and Kannur in Kerala, India.
Duration
from December 2017 to February 2018
Key Findings
- Overall complete vaccination was significantly lower in children with developmental disabilities (70%) and younger siblings (64%) than in older siblings (85%, Pearson χ2, P < .01).
- MMR vaccination was significantly lower in children with developmental disabilities (60%) and younger siblings (59%) than in older siblings (86%, Pearson χ2, P < .001).
- There was no significant difference in the proportion of overall vaccination status between index cases and younger siblings.
- There was no significant difference in the proportion of MMR vaccination status between index cases and younger siblings.
- The most common diagnosis among children with developmental delay was global developmental delay/intellectual development disorder (43.4%), followed by ASD (15.9%), language disorder (13.8%), and cerebral palsy (13.8%).
Clinical Bottom Line
In families attending child development centers, lower vaccination uptake was seen not only in children with developmental delay but also in their younger siblings, with the clearest gap in MMR vaccination. Clinicians should treat vaccine review as a family-level issue when caring for children with developmental disabilities.
Practice Implications
- Review vaccine completion for all children in the household, not only the child with developmental delay, because overall complete vaccination was 70% in probands and 64% in younger siblings versus 85% in older siblings.
- Address MMR-specific concerns directly during counseling, since MMR uptake was 60% in children with developmental disabilities and 59% in younger siblings versus 86% in older siblings.
- Do not assume vaccine underuse is confined to autism spectrum disorder; the largest diagnostic group was global developmental delay/intellectual development disorder (43.4%), while ASD accounted for 15.9%.
- Do not rely on parental education, paternal occupation, or religious beliefs to identify which families need counseling, because no association was found between vaccination status and these sociodemographic variables.
