COVID-19 vaccine should be recommended to patients with Parkinson’s disease, experts say

Patients with Parkinson's disease (PD) and healthcare professionals caring for them have expressed concerns about the COVID-19 vaccine's efficacy and safety in the specific context of PD and its symptomatic treatment. In a commentary just published in the Journal of Parkinson's Disease, a set of experts addresses these concerns from an evidence-based perspective. Their conclusion is that COVID-19 vaccination with approved vaccines should be recommended to persons with PD, unless there is a specific contraindication.

"The arrival of these vaccines has created hope for people with PD, as this can help to mitigate their risk of becoming infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which can lead to serious, life-threatening disease, at least among those with more advanced PD," explains lead author Bastiaan R. Bloem, MD, PhD, Radboud University Nijmegen Medical Center; Donders Institute for Brain, Cognition and Behavior; Department of Neurology, Nijmegen, the Netherlands, and co-Editor-in-Chief of the Journal of Parkinson's Disease.

Based on the authors' interpretation of the scientific literature, the unfolding experience with widespread vaccination in the population at large, and input from the International Parkinson and Movement Disorder Society Scientific Issues Committee (IPMDS-SIC), the take home messages with respect to COIVID-19 vaccination for persons with PD are:

• Compared to the general population, the risk of SARS-CoV-2 infection causing serious, life-threatening disease seems higher for people living with PD, at least among those with more advanced disease.

• The approved mRNA-based vaccines and viral vector vaccines under development are not known or expected to interact with the neurodegenerative process in PD.
• The types or incidence of side effects of these vaccines in persons with PD seem no different than in the general population.
• The vaccines also seem safe for older adults, but caution is needed for the specific subgroup of very frail and terminally ill elderly persons with PD living in long-term care facilities.
• COVID-19 vaccination is not known to interfere with the current therapies of PD.
• Vaccinated persons with PD must continue to comply with the public health guidelines to reduce exposure and transmission of COVID-19.
• Insights may change, and we must consciously monitor newly emerging data from both trials and real-life vaccination programs.

The authors strongly encourage visiting the website of the International Parkinson and Movement Disorder Society where recommendations will be updated as new data are published based on further experience, clinical trials and real-life clinical practice: https://www.movementdisorders.org/MDS-Files1/COVID-19vaccination01042021.pdf (for medical professionals) and https://www.movementdisorders.org/COVID-19-Pandemic-MDS/MDS-COVID-19-Vaccine-Statement-for-Patients.htm (for persons with PD).

Taking all current evidence into consideration, perhaps this is the light at the end of the tunnel. We encourage our community of movement disorder specialists to recommend COVID-19 vaccination with approved vaccines to their patients with PD or their responsible caregivers, unless there is a specific contraindication. Finally, even after vaccination, it is important that persons with PD continue complying with the public health guidelines to reduce exposure and transmission of COVID-19 as recommended by the World Health Organization and the Centers for Disease Control and Prevention."

Prof. Bastiaan R. Bloem, MD, PhD, Radboud University Nijmegen Medical Center