Association between vaccination status and neurodevelopmental outcomes in children with cerebral palsy

Background The safety of vaccines and their impact on functional outcomes in children with cerebral palsy remain significant concerns for both parents and healthcare providers. These concerns have limited the full implementation of routine immunization schedules in this specific population. Objective This study aimed to investigate the association between vaccination status and the development of motor and communication functions in children with cerebral palsy. The findings are intended to inform the development of targeted vaccination strategies. Methods We conducted a bidirectional cohort study involving 484 children diagnosed with cerebral palsy at the Second Affiliated Hospital of Xinjiang Medical University between January 2018 and December 2024. Participants were divided into a retrospective cohort (diagnosed 2018–2020, n = 277) and a prospective cohort (diagnosed 2021–2022, n = 207). Based on vaccination status, they were further classified into a vaccinated group (received at least one dose) and an unvaccinated group. Functional abilities were assessed using established classification systems, including the Gross Motor Function Classification System (GMFCS) and the Communication Function Classification System (CFCS). Vaccination completion rates were calculated according to the 2021 Chinese National Immunization Program Schedule. Statistical analyses included the Mann–Whitney U test and Spearman correlation to compare groups and examine relationships between vaccination completion rates and functional scores. Results Children in the vaccinated group demonstrated significantly better motor function, reflected by lower GMFCS levels ( z = 3.26, p = 0.001), and significantly better communication function, reflected by higher CFCS levels ( z = 2.89, p = 0.004), compared to the unvaccinated group. A higher vaccination completion rate was negatively correlated with GMFCS levels ( r = −0.24, p < 0.01) and positively correlated with CFCS levels ( r = 0.22, p < 0.01). No significant differences were observed between the two groups in manual ability (MACS) or eating and drinking ability (EDACS). In the prospective cohort, the vaccinated group demonstrated significantly greater improvement in GMFCS and CFCS classifications during follow-up ( p < 0.05). Conclusion For children with cerebral palsy, routine vaccination is not only safe but may also exert a positive regulatory effect on neurological development. We recommend reinforcing routine immunization in this population and optimizing vaccination strategies through ongoing dynamic follow-up.