Katharine Harlan-Owens is familiar with the challenges associated with vaccinating neurodivergent children. Her son is autistic and has attention-deficit/hyperactivity disorder, which made getting a flu shot at a walk-in clinic difficult.
“He is very needle phobic, so when the nurse entered the examination room holding a syringe in her hand, he jumped off the table and ran straight into a glass door,” she wrote in an article published in Pediatrics.
The article summarizes the success of the Promoting Accessibility to Healthcare (PATH) seasonal vaccine clinic at the UC Davis MIND Institute, a research center that aims to develop more personalized, equitable, and scientifically validated support systems for neurodivergent individuals.
The clinic resulted from a desire to increase vaccination among neurodivergent individuals while helping them build lifelong skills needed to successfully complete medical procedures.
Forging a partnership
In 2021, staff at the MIND Institute’s Center for Excellence in Developmental Disabilities asked caregivers, self-advocates, and community groups about their health care experiences. Their feedback guided the development of the PATH vaccine clinic for people of all ages with developmental disabilities, who are more likely to have lower rates of vaccination.
To increase vaccination rates, the team created an individualized care plan for each patient. A team member spoke with families before their appointments and asked about developmental needs, successful coping strategies, and preferred items like toys or food. They also shared resources to help families prepare for the visit.
“If a family told us their child liked SunChips and PAW Patrol during the intake, when they arrived, we had PAW Patrol playing on a tablet and SunChips on the table, and they also happened to get a vaccine,” wrote developmental-behavioral pediatricians Dr. Van Ma and Dr. Scott Akins in the paper.
Erin Roseborough, another of the article’s co-authors and a child life specialist, said longer appointment times help patients become familiar with the environment and reduce anxiety. “This approach allows staff to use strategies to develop trust, understand communication styles, and build positive interactions with a patient and caregiver prior to the procedure,” she said.
Keys to success include:
- Training providers about neurodiversity and how to support patients.
- Meeting with families before appointments to help them prepare and create an individualized care plan.
- Avoiding the use of restraints.
- Providing visual and sensory support for patients.
- Longer appointments.
- Dedicated parking and a separate entrance.
- A calm post-vaccination waiting room with incentives such as a small toy or snack.
Remarkable success
In the first two years of the COVID-19 vaccine clinic, the team vaccinated 354 people with neurodevelopmental disabilities ranging from age 3 to 75. The success rate — measured by people receiving the vaccine without restraint — was 99.3%.
The clinic operates during the fall and winter months. In 2023, the clinic offered both COVID and flu shots and vaccinated 91 people with a 100% success rate.
“The success rates were much higher than we anticipated,” wrote Ma and Akins. “This initiative taught us the value of creating long-term partnerships that are truly patient and family-led and rooted in the expertise of those with lived experience.”
While the numbers are remarkable, the proof lies within Harlan-Owens’ son’s experience. She was nervous to bring him to the PATH clinic, given his previous negative experience.
At first, he hid behind a table, crying. But with the help of the child life specialist, sensory support, and a nurse who made sure he never saw a needle, her son was successfully vaccinated.
“Our experience shows the power one positive vaccination experience can have,” she wrote. “He is now able to tolerate vaccinations in his pediatrician’s office and even in busy, loud pharmacies.”
The original version of this article was published by UC Davis Health.
