Researchers from the A.J. Drexel Autism Institute found more autistic adults had received the first dose of the COVID-19 vaccine compared to the general population in Pennsylvania, as of April 21, 2021. CREDIT Policy Impact Project at the A.J. Drexel Autism Institute

As reported in 2021, autistic adults, adults with intellectual disability and adults with mental health diagnoses have multiple risk factors for COVID-19 infection, and more severe disease if contracted. Public health messaging has strongly urged everyone eligible to get vaccinated for COVID-19, as it reduces the risk of contracting, decreases the severity and limits the spread of the virus. Researchers from Drexel University’s A.J. Drexel Autism Institute recently published a study identifying the differences between autistic adults who reported COVID-19 vaccination acceptance and those who were vaccination hesitant.

Identifying health promotion strategies based on self-reported, lived experiences with COVID-19 among vulnerable groups, including autistic individuals, is important for public health, as it can inform strategies to increase vaccination rates — which, in turn, supports public health by decreasing the potential for disease transmission.

The report, published in Vaccine, described COVID-19 vaccination status, self-reported preferences among autistic adults and additional to related factors.

“Vaccine accepters were more likely to report increased loneliness during COVID-19, live in more populated counties and in counties won by President Biden in the 2020 U.S. presidential election,” said Kaitlin Koffer Miller, director of Policy Impact at the Policy and Analytics Center (PAC) at the Autism Institute and co-author of the report. “Positive relationships were found between wanting to protect others from COVID-19, concern about getting COVID-19 and trusting the safety of the vaccines.”

The report also found concern about vaccine safety was common among the vaccine hesitant, but a lack of concern of COVID-19 overall was not commonly reported among this group.

Autistic adults, who had previously participated in the 2018 Pennsylvania Autism Needs Assessment and agreed to be contacted for future research, were asked to respond to a survey which aimed to learn about community participation experiences of autistic adults in Pennsylvania. The survey included 17 questions specifically related to COVID-19 experiences, including vaccination acceptance, hesitancy and status of vaccination. It was distributed to 431 autistic adults via an online survey platform, with data being collected between March-August 2021.

Researchers found 78.3% of survey respondents reported that they had received or intended to get a COVID-19 vaccine, with 55.4% reporting that they had received at least one dose. In comparison, 42% of overall adults in Pennsylvania received at least one dose of a COVID-19 vaccine as of April 2, 2021, which was the median response date for the survey sample.

“Reaching this group effectively in public health messaging about vaccination is critical,” said Koffer Miller. “By understanding reasons for vaccine hesitancy — for example, concerns about vaccine safety — or vaccine acceptance, such as feelings of increased loneliness, amongst autistic adult respondents can help drive more effective public health messaging and vaccine outreach to this population.”

The report provides concrete suggestions and examples for how public health professionals can most effectively reach autistic adults in their outreach, such as using visual tools like social stories, which are a powerful tool for conveying information and have been shown to be an effective means of communicating with autistic individuals.

The authors noted the importance of using this tailored and accessible messaging will become increasingly paramount as fourth doses become more widely available and recommended, and regular vaccination against COVID-19 becomes part of the public health dialogue.

“It was very important to be able to highlight practical, usable resources from organizations like the Autism, Services, Education, Resources, and Training Collaborative (ASERT) alongside the research findings to provide a direct translation and link to actionable ways to address what was identified as needed action in the study,” said Koffer Miller, who is also regional manager of the ASERT Collaborative Eastern Region.