Neurologists should ‘speak up’ about Covid vaccines for people with Parkinson’s, says study

Many people with Parkinson’s disease remain unsure of whether healthcare providers recommend vaccinations for COVID and other respiratory illnesses, according to a US study – leading to calls for neurologists “to advocate for preventive care and improve vaccine trust”

US academics found that in a survey of 143 patients, more than 30% did not know whether their physicians recommended vaccines – with 13% believing that their providers recommended against them.

In the study, published in the ‘Journal of Parkinson’s Disease’, homebound participants reported “difficulty traveling to a clinic” as a major vaccination barrier. Half the participants did not know whether household members had been fully vaccinated, and nearly 15% were certain they had not. Compared to outpatients, the researchers noted that being homebound does not mean a lower risk of communicable disease.

“Family caregivers can be the vectors by which influenza or pneumococcal pneumonia enters the home, and many such household members may similarly be missing routine vaccinations,” said report co-author Dr Jori Fleisher, from the Section of Movement Disorders, Department of Neurological Sciences, Rush University Medical Center, Chicago.

Given these concerns – combined with evidence suggesting people with Parkinson’s disease have a 30% greater chance of dying from coronavirus than those without the condition – the researchers urged neurologists to be more active in encouraging vaccinations.

“Encouraging caregivers to protect their loved ones by seeking their own vaccinations is a simple, quick, and powerful step towards improved patient outcomes,” added Dr Fleisher.

“Now is the time to advocate”

With vaccine hesitancy and refusal a recurring problem in many US regions, large organisations such as the Parkinson’s Foundation and the Michael J. Fox Foundation have been promoting the take-up of Pfizer and Moderna COVID-19 vaccines to protect Parkinson’s community.

Addressing vaccine hesitancy in general, the study – whose cohort was a group of New York-based patients over the age of 65 – adds that “prior work has demonstrated increased vaccination uptake through home visits to older adults, suggesting that such models for individuals with [Parkinson’s disease] may provide an opportunity to advocate for vaccination. The study also suggests that “targeted education and interventions may be necessary to address and overcome concerns about COVID-19 vaccines and logistical barriers for individuals with [Parkinson’s disease]”.

It concludes that: “Effective communication strategies between the neurologist, the person with [Parkinson’s disease], and their household members may reduce vaccine hesitancy and increase uptake, lowering morbidity and mortality.”

Dr Fleisher added that, beyond COVID-19, “knowing how often pneumonia or influenza can cause serious or life-threatening illness in our patients living with [Parkinson’s disease], it should go without saying that neurologists recommend routine vaccinations for people with [Parkinson’s disease]. But that’s precisely the problem: it has gone without saying.”

Addressing neurologists, she urged them to: “Speak up! Ask your patients and their care partners if they are up to date with routine vaccinations. With the rollout of COVID-19 vaccines, now is the time to advocate for preventive care and improve vaccine trust and uptake in our patients and their care partners.”

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