It can be difficult to recognize COVID-19 vaccine reactions in people who don’t communicate using words. Learning common signs helps protect people with intellectual and developmental disabilities who don’t verbally communicate that something’s wrong. 


(Clearwater, FL) February 17, 2021According to the latest information, almost 52 million Americans, or 11.5% of the total U.S. population, have already received the COVID-19 vaccine.(1) That’s great news for a country that’s struggled to contain the virus—but millions of people in high-risk groups still aren’t protected. People with intellectual and developmental disabilities (IDD) are three times more likely to die from COVID-19 compared to the general population (2) because of several factors, such as a greater likelihood of living in a group home or long-term care facility, higher incidences of comorbid conditions or intolerance to wearing a mask. And even if these individuals receive the vaccine, they may be one of the small number of people who have a negative vaccine reaction. 


Most people tolerate vaccination with no difficultly; if side effects do occur, they’re usually rare and include problems like mild fever, swelling at the injection site, and fatigue. (3) But recognizing reactions to vaccination among people with IDDs can be difficult. Dr. Craig Escudé, President of Health Risk Screening, Inc., says, “Many people with IDD communicate without using words, which can make it challenging to understand how they feel and what’s going on with them. It’s important to learn what signs to watch out for so they can be treated quickly if necessary.”  


It’s relatively common for individuals with IDD to use different strategies to communicate without the use of written or oral language. But this tendency makes it difficult for them to let others know when something is wrong. Family members, healthcare providers, and other people who support those with IDD may have difficulty recognizing common signs of discomfort or illness among people who don’t use words to communicate.  


In the case of vaccine reactions, a person with IDD may show that something is wrong through their actions and attitudes toward others. These signs may include: (5, 6)  

  • Abnormal facial expressions, like grimacing 
  • Changes in attitude, including increased irritability 
  • Eating problems, such as refusal to eat 
  • Picking, scratching, or otherwise touching the injection site 
  • Positioning the body to protect the vaccinated arm 
  • Sleep disturbances such as restlessness or insomnia 
  • Withdrawal from normal daily activities 


If these changes occur, it’s important to let the person’s healthcare team know what’s going on—that way, they can make sure there are no other medical issues affecting the person with IDD.  


In an extremely small number of cases, severe, life-threatening allergic reactions occur when a person is vaccinated. A person with this type of reaction, called anaphylaxis, may have serious symptoms including: (7) 

  • Difficulty breathing 
  • Fast or irregular heartbeat 
  • Low blood pressure 
  • Nausea and vomiting 
  • Skin discoloration 
  • Swelling of the throat 


If symptoms like these occur, 911 should be called or the person should be taken to an emergency room immediately. However, a trip to the hospital should only be considered for true emergencies, since individuals with IDD may be more likely to becominfected with COVID-19 in large healthcare facilities. 


“Just like the rest of us, people with IDD are at risk for reactions to the COVID-19 vaccine, but they may not communicate any problems using words. Learning to recognize the ways they may demonstrate something is wrong is key to preserving their health and wellbeing,” says Dr. Escudé. 


A free reference document can be downloaded at to help people know what to look for after someone they support is vaccinated. 


Introducing IntellectAbility 

In March 2021, Health Risk Screening, Inc. will rebrand as IntellectAbility. IntellectAbility offers the Health Risk Screening Tool, e-Learning courses, and PersonCentered Services to help healthcare providers better support people with IDD. The company’s mission remains the same: to provide tools and training to those who support people with vulnerabilities helping them replace risk with health and wellness.   


About IntellectAbility 

IntellectAbility’s roots began in 1992 and they are the industry leader in training courses, webinars, and materials to help at-risk populations live life to the fullest. Their focus is on developing tools and training for the person-centered support of these vulnerable populations. Through the education of government agencies and service providers, IntellectAbility aims to improve lives. One such tool is the Health Risk Screening Tool (HRST), of which they are the sole developer, producer, and distributor. The web based HRST is the most widely used and validated health risk screening instrument for people with intellectual and developmental disabilities. With unrelenting focus, IntellectAbility works to fulfill its mission of improving the health and quality of life for people faced with these types of vulnerabilities. For more information, visit  


  1. Huang, Pien and Carlsen, Audrey; “How is the COVID-19 Vaccination Campaign Going in Your State?; FEB 16, 2021; National Public Radio; 
  1. Rabin, Roni Caryn. “Developmental Disabilities Heighten Risk of Covid Death.” The New York Times, The New York Times, 10 Nov. 2020,  
  1. “Vaccine Side Effects.”, 2021,  
  1. “Allergic Reactions Including Anaphylaxis After Receipt of the First Dose of Moderna COVID-19 Vaccine – United States, December 21, 2020–January 10, 2021.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 28 Jan. 2021,  
  1. Escude, Craig MD. “How to Help Loved Ones with Intellectual Disabilities with ‘Behaviors.’” Intellectual & Developmental Disabilities, Neurodevelopmental Disorders, 5 Jan. 2021,  
  1. Kripke, Clarissa. “Adults with Developmental Disabilities: A Comprehensive Approach to Medical Care.” American Family Physician, 15 May 2018,  
  1. “Drug Allergies: Anaphylactic Reactions (Anaphylaxis).” [Internet]., U.S. National Library of Medicine, 7 May 2020,  




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