Understanding Vaccine Hesitancy Among Parents of Children With Autism Spectrum Disorder and Parents of Children With Non-Autism Developmental Delays

Abstract

Parents of children with autism spectrum disorder (ASD) may be at greater risk for developing antivaccine beliefs that lead to vaccine delays and/or refusals for their children. We investigated current parental vaccine hesitancy, parents’ beliefs about causes of children’s developmental delays, and children’s vaccination histories among parents of children with ASD or non-ASD developmental delays. Data were analyzed from 89/511 parents (17.4%) who completed the Parent Attitudes About Childhood Vaccines questionnaire and the Revised Illness Perception Questionnaire; 46.1% had childhood vaccination records available. Overall, 21/89 (23.6%, 95% confidence interval [CI]: 15.0-34.0) of parents were vaccine hesitant (ASD n = 19/21 [90.5%], non-ASD n = 2/21 [9.5%]). Parents of children with ASD were significantly more likely to agree with “toxins in vaccines” as a cause of their child’s developmental delays (28.4% vs 5.0%, P = .034). The odds of being vaccine hesitant were 11.9 times (95% CI 2.9-48.0) greater among parents who agreed versus disagreed that toxins in vaccines caused their children’s developmental delays. Rates of prior vaccine receipt did not differ between hesitant and nonhesitant groups.

Keywords

autism ASD developmental delay vaccines immunizations parent perception

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References

Centers for Disease Control. Great public health achievements—United States, 2011-2010. Morb Mortal Wkly Rep. 2011;60(19):619–623.

Olive

Hotez

Damania

Nolan

. The state of the antivaccine movement in the United States: a focused examination of nonmedical exemptions in states and counties. PLoS Med. 2018;15(6):e1002578.

Centers for Disease Control and Prevention. Increase in measles cases—United States, January 1–April 26, 2019. Morb Mortal Wkly Rep. 2019;68(17):402–404.

Gust

Brown

Sheedy

Hibbs

Weaver

Nowak

. Immunization attitudes and beliefs among parents: beyond a dichotomous perspective. Am J Health Behav. 2005;29(1):81–92.

Gust

Woodruff

Kennedy

Brown

Sheedy

Hibbs

. Parental perceptions surrounding risks and benefits of immunization. Semin Pediatr Infect Dis. 2003;14(3):207–212.

Gust

Darling

Kennedy

Schwartz

. Parents with doubts about vaccines: which vaccines and reasons why. Pediatrics. 2008;122(4):718–725.

Opel

Taylor

Zhou

Catz

Myaing

Mangione-Smith

. The relationship between parent attitudes about childhood vaccines survey scores and future child immunization status: a validation study. JAMA Pediatr. 2013;167(11):1065.

Henrikson

Opel

Grothaus

, et al. Physician communication training and parental vaccine hesitancy: a randomized trial. Pediatrics. 2015;136(1):70–79.

Schaefer GB, Mendelsohn NJ; Professional Practice and Guidelines Committee. Clinical genetics evaluation in identifying the etiology of autism spectrum disorders: 2013 guideline revisions. Genet Med. 2013;15(5):399–407.

10.

Edwards KM, Hackell JM; The Committee on Infectious Diseases, The Committee on Practice and Ambulatory Medicine. Countering vaccine hesitancy. Pediatrics. 2016;138(3):e20162146–e20162146.

11.

Offit

. Autism’s False Prophets: Bad Science, Risky Medicine, and the Search for a Cure. New York: Columbia University Press; 2008.

12.

Goin-Kochel

Mire

Dempsey

. Emergence of autism spectrum disorder in children from simplex families: relations to parental perceptions of etiology. J Autism Dev Disord. 2015;45(5):1451–1463.

13.

Kuwaik

Roberts

Zwaigenbaum

, et al. Immunization uptake in younger siblings of children with autism spectrum disorder. Autism. 2014;18(2):148–155.

14.

Bazzano

Zeldin

Schuster

Barrett

Lehrer

. Vaccine-related beliefs and practices of parents of children with autism spectrum disorders. Am J Intellect Dev Disabil. 2012;117(3):233–242.

15.

Glickman

Harrison

Dobkins

. Vaccination rates among younger siblings of children with autism. N Engl J Med. 2017;377(11):1099–1101.

16.

Rosenberg

Law

Anderson

Samango-Sprouse

Law

. Survey of vaccine beliefs and practices among families affected by autism spectrum disorders. Clin Pediatr (Phila). 2013;52(9):871–874.

17.

Zerbo

Modaressi

Goddard

, et al. Vaccination patterns in children after autism spectrum disorder diagnosis and in their younger siblings. JAMA Pediatr. 2018;172(5):469.

18.

Opel

Mangione-Smith

Taylor

, et al. Development of a survey to identify vaccine-hesitant parents: the Parent Attitudes About Childhood Vaccines survey. Human Vaccines. 2011;7(4):419–425.

19.

Moss-Morris

Weinman

Petrie

Horne

Cameron

Buick

. The Revised Illness Perception Questionnaire (IPQ-R). Psychol Health. 2002;17(1):1–16.

20.

Opel

Taylor

Mangione-Smith

, et al. Validity and reliability of a survey to identify vaccine-hesitant parents. Vaccine. 2011;29(38):6598–6605.

21.

Centers for Disease Control and Prevention. Resource library: vaccine schedule-related resources. https://www.cdc.gov/vaccines/schedules/hcp/schedule-related-resources.html . Published February 16, 2018. Accessed June 15, 2018.

22.

Goin-Kochel

Mire

Dempsey

, et al.

Parental report of vaccine receipt in children with autism spectrum disorder: do rates differ by pattern of ASD onset?

Vaccine. 2016;34(11):1335–1342.

23.

Cunningham

Minard

Guffey

Swaim

Opel

Boom

. Prevalence of vaccine hesitancy among expectant mothers in Houston, Texas. Acad Pediatr. 2018;18(2):154–160.

24.

Taylor

Swerdfeger

Eslick

. Vaccines are not associated with autism: an evidence-based meta-analysis of case-control and cohort studies. Vaccine. 2014;32(29):3623–3629.

25.

Christensen

Baio

Braun

KVN

, et al. Prevalence and characteristics of autism spectrum disorder among children aged 8 years—autism and developmental disabilities monitoring network, 11 sites, United States, 2012. MMWR Surveill Summ. 2016;65(3):1–23.