Children with cerebral palsy, epilepsy need flu vaccine but don’t always get it

Children who have neurological disorders such as cerebral palsy or epilepsy are no more likely to be vaccinated against influenza than children without these conditions, despite the increased risk for complications from flu these children experience, according to a study published online April 9 in Vaccine. Moreover, healthcare providers may not be familiar with the increased risk among these patients to effectively recommend influenza vaccine.

Researchers from the University of Louisville and the Centers for Disease Control and Prevention conducted 2 separate on-line surveys (1 for parents, 1 for healthcare providers) to ask questions about influenza vaccination beliefs and practices.

Overall, 2,138 surveys were completed by parents of children with at least 1 high-risk condition of any kind. Of these, 1,143 were completed by parents of children with at least 1 neurologic and neurodevelopmental disorder [NNDD] and 516 by parents of children with more than one NNDD. In the survey of providers, 412 physicians participated. The researchers worked with Family Voices, a national advocacy group for children with special healthcare needs, and the American Academy of Pediatrics to recruit survey participants in all 50 states and the District of Columbia.

Overall, 47% of parents reported that their children had received or were scheduled to receive seasonal flu vaccine; among the group of NNDD parents, the rate was only slightly higher at 50%.

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The major driver to have a child vaccinated was not the presence of an NNDD, however, but the presence of a chronic respiratory condition, although several studies show that children with NNDDs are at increased risk of complications from flu. According to a 2013 study in Pediatrics, one-third of reported pediatric influenza-related deaths between 2004 and 2012 in the United States occurred in children with NNDDs.

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Parents who did not vaccinate their children were asked why. More than one-third of the 1,140 respondents – 38% – said they had concerns about how the vaccine would affect their child. Another 32% expressed concerns about the safety of the vaccine.

Dr SmithAmong the 412 physicians who participated, 74% recognized that children with another NNDD, cerebral palsy, were at higher risk from flu but other NNDDs were not so highly recognized as posing risk: epilepsy at 51% and intellectual disability at 46%.

“Prior studies have shown that children with NNDDs are at increased risk of complications and death after influenza infection,” said Michael J. Smith, MD, is an associate professor in the University of Louisville Department of Pediatrics and a pediatric infectious disease specialist with University of Louisville Physicians. “Our study showed that, despite this increased risk, children with NNDDs are not more likely to be vaccinated than other children.

“Parents and healthcare providers do not appear to be aware of the increased risk of complications after influenza incurred by children with NNDDs,” Dr Smith said. “Further education in this area is needed.”

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