title: Influenza vaccination in children with neurologic or neurodevelopmental disorders.
abstract: BACKGROUND
  Children with neurologic or neurodevelopmental disorders (NNDDs) are at increased risk of complications from influenza. Although the Advisory Committee on Immunization Practices (ACIP) has recognized NNDDs as high-risk conditions for influenza complications since 2005, little is known about influenza vaccination practices in this population.
  
  
  METHODS
  CDC collaborated with Family Voices, a national advocacy group for children with special healthcare needs, to recruit parents of children with chronic medical conditions. Parents were surveyed about their knowledge, attitudes, and practices surrounding influenza vaccination. The primary outcome of interest was parental report of vaccination, or intent to vaccinate, at the time of survey participation. CDC also collaborated with the American Academy of Pediatrics to recruit primary care and specialty physicians who provide care for high-risk children, specifically those with neurologic conditions. The primary outcome was physician recognition of ACIP high-risk influenza conditions.
  
  
  RESULTS
  2138 surveys were completed by parents of children with high-risk conditions, including 1143 with at least one NNDD. Overall, 50% of children with an NNDD were vaccinated, or their parents planned to have them vaccinated against influenza. Among all 2138 children, in multivariable analysis, the presence of a respiratory condition and prior seasonal influenza vaccination was significantly associated with receipt or planned current season influenza vaccination, but the presence of an NNDD was not. 412 pediatricians completed the provider survey. Cerebral palsy was recognized as a high-risk influenza condition by 74% of physician respondents, but epilepsy (51%) and intellectual disability (46%) were less commonly identified.
  
  
  CONCLUSIONS
  Our estimates of influenza vaccination in children with NNDDs are comparable to published reports of vaccination in healthy children, which continue to be suboptimal. Education of parents of children with NNDDs and healthcare providers about influenza and the benefit of annual influenza vaccination is needed.
authors.affiliation: Department of Pediatrics, University of Louisville School of Medicine, United States. Electronic address: mjsmit22@louisville.edu.
authors.forename: Michael
authors.initials: M
authors.lastname: Smith
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, United States.
authors.forename: Georgina
authors.initials: G
authors.lastname: Peacock
authors.affiliation: Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, United States.
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Uyeki
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, United States.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Moore
mesh_terms: D000328:Adult; D002487:Centers for Disease Control and Prevention, U.S.; D002547:Cerebral Palsy; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education; D006801:Humans; D007251:Influenza, Human / Q000150:complications / Q000517:prevention & control*; D008607:Intellectual Disability; D008297:Male; D065886:Neurodevelopmental Disorders; D010290:Parents / Q000193:education / Q000523:psychology; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States; D014611:Vaccination / Q000523:psychology / Q000706:statistics & numerical data*
keywords: Disability; High-risk; Immunization; Influenza; Neurologic
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