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Association between vaccination status and neurodevelopmental outcomes in children with cerebral palsy
Hong Zhao1, Mingbo Hu1, Fei Xie1
1Cerebral Palsy Center in Neurosurgery, Second Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
Insights
Routine vaccination is safe and beneficial for children with cerebral palsy, improving motor and communication functions. This supports enhanced immunization strategies for better neurological development outcomes.
Area of Science:
- Pediatrics
- Neurology
- Immunology
Background:
- Concerns regarding vaccine safety and functional outcomes in children with cerebral palsy (CP) hinder routine immunization.
- Limited implementation of vaccination schedules affects this specific pediatric population.
Purpose of the Study:
- To investigate the association between vaccination status and functional development in children with CP.
- To inform targeted vaccination strategies for children with CP.
Main Methods:
- A bidirectional cohort study of 484 children with CP was conducted.
- Participants were classified by vaccination status and assessed using the Gross Motor Function Classification System (GMFCS) and Communication Function Classification System (CFCS).
- Statistical analyses included Mann-Whitney U test and Spearman correlation.
Main Results:
- Vaccinated children with CP showed significantly better motor function (lower GMFCS) and communication function (higher CFCS) compared to unvaccinated children.
- Higher vaccination completion rates correlated with better GMFCS and CFCS scores.
- No significant differences were found in manual or eating abilities.
Conclusions:
- Routine vaccination is safe and potentially beneficial for neurological development in children with CP.
- Reinforcing routine immunization and optimizing strategies through follow-up is recommended for this population.
Background:
The safety of vaccines and their impact on functional outcomes in children with cerebral palsy remain significant concerns for both parents and healthcare providers. These concerns have limited the full implementation of routine immunization schedules in this specific population.
Objective:
This study aimed to investigate the association between vaccination status and the development of motor and communication functions in children with cerebral palsy. The findings are intended to inform the development of targeted vaccination strategies.
Methods:
We conducted a bidirectional cohort study involving 484 children diagnosed with cerebral palsy at the Second Affiliated Hospital of Xinjiang Medical University between January 2018 and December 2024. Participants were divided into a retrospective cohort (diagnosed 2018-2020, n = 277) and a prospective cohort (diagnosed 2021-2022, n = 207). Based on vaccination status, they were further classified into a vaccinated group (received at least one dose) and an unvaccinated group. Functional abilities were assessed using established classification systems, including the Gross Motor Function Classification System (GMFCS) and the Communication Function Classification System (CFCS). Vaccination completion rates were calculated according to the 2021 Chinese National Immunization Program Schedule. Statistical analyses included the Mann-Whitney U test and Spearman correlation to compare groups and examine relationships between vaccination completion rates and functional scores.
Results:
Children in the vaccinated group demonstrated significantly better motor function, reflected by lower GMFCS levels (z = 3.26, p = 0.001), and significantly better communication function, reflected by higher CFCS levels (z = 2.89, p = 0.004), compared to the unvaccinated group. A higher vaccination completion rate was negatively correlated with GMFCS levels (r = -0.24, p < 0.01) and positively correlated with CFCS levels (r = 0.22, p < 0.01). No significant differences were observed between the two groups in manual ability (MACS) or eating and drinking ability (EDACS). In the prospective cohort, the vaccinated group demonstrated significantly greater improvement in GMFCS and CFCS classifications during follow-up (p < 0.05).
Conclusion:
For children with cerebral palsy, routine vaccination is not only safe but may also exert a positive regulatory effect on neurological development. We recommend reinforcing routine immunization in this population and optimizing vaccination strategies through ongoing dynamic follow-up.
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