Children of mentally ill mothers much less likely to be vaccinated

Children of mothers with mental illness are significantly less likely to receive preventative health vaccinations during the first five years of life, according to a University of Manchester study

The research, from the University's Centre for Women's Mental Health, has important implications for the uptake of a vaccine for COVID-19, which may become available in 18 months' time.

Last year, in The Lancet Public Health, the Manchester team estimated that one in four children in the UK has a mother with a mental illness meaning that a quarter of UK children could be affected.

The findings also come at a time of increasing global concern about the general uptake of vaccinations—especially measles, mumps and rubella or MMR.

Though vaccines are provided for free in most countries, 15% of children remain unvaccinated globally, according to the WHO, often leading to serious illness, disability and even death.

Recent outbreaks of measles in Europe and the US indicate a significant decline in herd or collective immunity as a result of reduced vaccination uptake in infants.

The trends have been attributed to skepticism about the safety of vaccination, particularly following the discredited report by Andrew Wakefield in 1998 linking the MMR vaccine to childhood autism.

The Centre for Women's Mental Health study, published in the European Journal of Epidemiology used data from around 480,000 mothers and children followed up to the age of five.

It revealed that the children of mothers with depression and psychotic illnesses were 14% less likely to receive necessary vaccinations at two years, compared to children of unaffected women.

And children of mothers with alcohol and substance misuse disorders were 50% less likely to receive necessary vaccinations at two years, compared to children of unaffected women.

It is the largest study ever to look at the association between maternal mental illness and childhood vaccination uptake.

The data were sourced from the Clinical Practice Research Datalink between 1993 and 2015 and examined vaccinations for Diphtheria, Tetanus, Whooping cough, Haemophilus influenza (A), Polio, as well as the MMR vaccine.

Lead author Cemre Su Osam, senior doctoral researcher from The University's Centre for Women's Mental Health said: "We know that people with mental illness are less likely to benefit from public health information, preventive health and public health campaigns.

"And as mothers take a central role in their children's health, the extent to which their children access preventative healthcare is of public health concern.

"As people with mental illness are more at risk from COVID-19, these findings will be particularly important when or if a COVID-19 vaccination becomes available."

Professor Kathryn Abel, is Director of the Centre for Women's Mental Health as well as an honorary psychiatrist at Greater Manchester Mental Health Trust.

She said: "Public health policies and practice should be targeted specifically at groups less likely to access them and our work suggests that mothers with mental illness need support to access key preventive health measures like vaccinations for their children in the first five years of life.

"And as children exposed to maternal alcohol and substance misuse are at the greatest risk of not receiving necessary vaccinations, focusing preventive programs on these mothers is important."

Dr. Matthias Pierce, Centre for Women's Mental Health Research Fellow said: "For the first time, our study provides us with robust evidence that is needed to tailor a public health campaign about vaccinations to this key vulnerable group in order to reduce the risks of what are, after all, preventable diseases.

"These children represent an easily identifiable group at risk of not receiving preschool vaccination; while screening of women for mental illness antenatally and postnatally is now part of routine antenatal and postnatal primary care."