Assessment & Research

Vaccine Hesitancy and Attributions for Autism among Racially and Ethnically Diverse Groups of Parents of Children with Autism Spectrum Disorder: A Pilot Study.

Chang et al. (2020) · Autism research : official journal of the International Society for Autism Research 2020
★ The Verdict

Nearly half of parents of color in SPARK report vaccine hesitancy—be ready to discuss vaccine safety concerns empathetically and provide culturally informed education.

✓ Read this if BCBAs running parent training or intake meetings in clinics serving racially diverse families.
✗ Skip if Clinicians who only see adult clients or work in settings with no vaccine requirements.

01Research in Context

01

What this study did

Katz et al. (2020) sent an online survey to parents in the SPARK autism research registry. They asked about childhood vaccine views and what parents think caused their child’s autism. Parents could check several causes, including vaccines, genes, or parenting style.

The team compared answers across racial groups to see if hesitancy differed.

02

What they found

About 1 in 3 parents were vaccine hesitant. Among parents of color, nearly half were hesitant. Among White parents, about 1 in 4 were hesitant.

Hesitant parents were more likely to blame vaccines or other non-biological causes for autism.

03

How this fits with other research

Spriggs et al. (2016) also found racial gaps in autism care. Their study showed White families got earlier diagnoses when they had steady medical care. Black families did not get the same benefit. Both papers point to systemic barriers, not just personal choice.

Woo et al. (2007) warned that vaccine-side-effect reports over-represent autism cases with regression. That bias can fuel parent fears. Katz et al. (2020) now show those fears are strongest among families already facing healthcare inequities.

Howard et al. (2023) surveyed disability support staff about COVID-19 shots. Younger staff of color were more hesitant. The pattern matches the new parent data: hesitancy clusters where trust is low and past harm is high.

04

Why it matters

You can’t assume all families hear vaccine science the same way. Start by asking, “What worries you about shots?” Then share plain facts and invite questions. Offer handouts in the family’s language and time to talk. When you show respect, you help repair trust in the whole care team.

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Add one open-ended vaccine question to your caregiver intake form and keep a short, evidence-based handout ready in Spanish and English.

02At a glance

Intervention
not applicable
Design
survey
Sample size
225
Population
autism spectrum disorder
Finding
not reported

03Original abstract

Little is known about how racial/ethnic differences may influence attributions for autism spectrum disorder (ASD) and subsequent vaccine hesitancy, the latter of which refers to a continuum of concerns about vaccine safety that may lead to vaccine delays and/or refusals. Two hundred and twenty-five parents of children with ASD who were enrolled in the SPARK cohort (Simons Foundation Powering Autism Research for Knowledge) completed the Parent Attitudes about Childhood Vaccines survey and the Revised Illness Perception Questionnaire. 28.9% of respondents (n = 65) were vaccine hesitant (PACV score ≥ 50). Significant differences were observed between proportions of vaccine-hesitant parents (VHP) in the White sample and combined samples of color (Asian, Black, Latinx, Multiracial, and Other): 22.8% of the White sample (n = 39) versus 48.1% of the samples of color (n = 26). White, non-hesitant parents more often agreed with the child's brain structure as a cause of their child's ASD, while White, VHP more often agreed with the deterioration of the child's immunity as a cause. All VHP (regardless of race) agreed more often with diet, their own decisions, and vaccines as causes. VHP of color more often agreed with accident or injury, environmental pollution, their own general stress, and their own emotional state as causes. Future work should examine this phenomenon in larger, diverse samples to further understand differences across specific racial/ethnic groups. LAY SUMMARY: Some parents of children with autism spectrum disorder (ASD) are vaccine hesitant, meaning they have concerns about vaccine safety and may delay/refuse vaccines. We examined possible racial/ethnic differences related to how common vaccine hesitancy is and which causes of ASD were typically endorsed among a sample of caregivers in the SPARK cohort (Simons Foundation Powering Autism Research for Knowledge). Higher proportions of parents of color were vaccine hesitant, and all vaccine-hesitant parents agreed that "toxins in vaccines" were a cause of their child's ASD. Autism Res 2020, 13: 1790-1796. © 2020 International Society for Autism Research and Wiley Periodicals LLC.

Autism research : official journal of the International Society for Autism Research, 2020 · doi:10.1002/aur.2339