Vaccination far lower for people with intellectual disability: Study

People with intellectual disability are up to three times more likely than the NSW population to be hospitalised for a vaccine-preventable condition, a new study published by UNSW medical researchers has found.
 
The finding was part of a wider report that revealed potentially preventable hospitalisation (PPH) rates are also 3.5–4.5 times higher for people with intellectual disability compared to the general population.
 
‘It is critical that we look into why people with intellectual disability are being hospitalised for vaccine-preventable conditions, as we know that failure to vaccinate is also a factor associated with preventable deaths in people with intellectual disability,’ lead author Dr Janelle Weise said.
 
‘Particularly in light of the COVID-19 vaccine rollout, we need to address the barriers faced by people with intellectual disability to be vaccinated.’
 
Associate Professor Bob Davis, Chair of RACGP Specific Interests Disability, previously told newsGP a disconnect between disability and health is one of the main issues affecting COVID vaccination rates among people with an intellectual disability.
 
‘There needs to be a much more proactive approach to the health issues of people with disability and the problems are magnified when you have a crisis like this,’ he said.
 
GP Dr Lara Roeske also said there are ‘extraordinary barriers’ preventing people with an intellectual disability from accessing the vaccine.
 
‘Some of the challenges are particularly unique to this group, and that really emphasises the need for us to look at the way we’re doing this and really reprioritise,’ she said.
 
‘Often people [with an intellectual disability] cannot understand consent, nor the risks or benefits of vaccination.
 
‘They rely on the disability support workers, staff, and family carers to really interpret information as best as possible, and some will still simply not be able to understand the information or the risks or benefits for themselves.
 
‘GPs do have a very important role.’
 
The researchers, led by Professor Julian Trollor, say the high overall rates of PPHs are a symptom of the systemic neglect experienced by people with intellectual disability within Australian healthcare.
 
‘We already know from international research that people with intellectual disability experience higher rates of PPH, and that they generally face stark health inequalities and barriers to accessing healthcare,’ Professor Trollor said.
 
‘But before our study, there hasn’t been any research into rates of PPH for Australians with intellectual disability.’
 
To address this evidence gap, the researchers analysed data collected over 15 years related to 92,542 people with intellectual disability, and compared it to a cohort of the NSW general population.
 
They also used the PPH definition contained in the National Healthcare agreement, wherein the hospitalisation may have been prevented through the provision of ‘appropriate individualised preventive health interventions and early disease management’, to inform their research.
 
The largest inequality uncovered in the study is that people with intellectual disability are up to 25.7 times more likely than the broader NSW population to be hospitalised for convulsions and epilepsy.
 
The solution, according to researchers, is improved access to primary and community-based healthcare.
 
‘But we simply don’t have enough research into what actually drives PPH in the general population, and even less so in people with intellectual disability,’ Professor Trollor said.
 
‘That’s why we now need to find out why exactly that’s happening, and then do something about it – governments, policy-makers, services and professional groups have much work to do to improve healthcare for people with intellectual disability.’
 
Recommendations also include a national population health strategy for people with intellectual disability and mandating reasonable adjustments in Australian healthcare to meet their needs.
 
‘We also need to equip the healthcare workforce in the area of intellectual disability health,’ Professor Trollor said. ‘And we need to make sure people with intellectual disability and their support networks have the tools to improve their health literacy.’
 
The researchers say preventable hospitalisations, higher multimorbidity and over-representation of premature and potentially avoidable deaths are just the tip of the iceberg which underly a major gap in healthcare.
 
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