Medical outcomes of children with neurodevelopmental disorders after SARS-CoV-2 vaccination: A six-month follow-up study

Introduction: The BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) vaccines have been approved for children and adolescents for protecting against SARS-CoV-2 infection. This longitudinal study aimed to compare adverse outcomes after SARS-CoV-2 vaccination in children with neurodevelopmental disor-ders (ND) (e.g., attention-deficit/hyperactivity disorder [ADHD], autism spectrum disorder [ASD], com-munication disorders, intellectual disability, and tic disorders) and healthy control children.Methods: A total of 1335 children who received the SARS-CoV-2 vaccination (762 children with ND and 573 healthy controls) were recruited. All subjects were followed-up for 180 days, and outcome events were defined as outpatient department (OPD) or emergency department (ER) visits during follow-up. Multivariate Cox proportional hazards regression models were used to identify the potential differences in outcomes between the propensity score-matched ND group (n = 311) and the control group (n = 311), and to explore the factors associated with outcomes among all children with ND (n = 762).Results: Compared with the control group, children with ND exhibited a higher likelihood of subsequent OPD or ER visits and paediatric neurology OPD visits after the first dose of vaccination. However, we found that only a small proportion of the children visited the OPD or ER because of adverse vaccination-related effects. Among all children with ND, those with communication disorders showed a higher likelihood of any OPD or ER visit. Paediatric neurology OPD visits were associated with commu-nication disorders, intellectual disability, and methylphenidate and aripiprazole prescriptions. ADHD and ASD were not associated with adverse outcomes.Conclusions: No specific ND diagnosis or medication use clearly increased the risk of adverse effects of SARS-CoV-2 vaccination. Children with ND can be reassured that the SARS-CoV-2 vaccination is a safe regimen to protect themselves. & COPY; 2023 Elsevier Ltd. All rights reserved.

Automated summary

This longitudinal study compared adverse outcomes after SARS-CoV-2 vaccination in children with neurodevelopmental disorders (ND) and healthy control children. The results showed that children with ND had a higher likelihood of subsequent outpatient department or emergency department visits, especially pediatric neurology visits, after the first dose of vaccination compared to the control group. However, only a small proportion of children visited the outpatient department or emergency department due to adverse vaccination-related effects. Overall, the study concluded that specific ND diagnosis or medication use did not significantly increase the risk of adverse effects of SARS-CoV-2 vaccination, and children with ND can be reassured that the vaccination is safe.