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Journal of Parkinson's disease
2021;11 (3): 1057-1065.

Barriers to Vaccination Among People with Parkinson's Disease and Implications for COVID-19.

Tiffany Phanhdone, Patrick Drummond, Talia Meisel, Naomi Friede, Alessandro Di Rocco, Joshua Chodosh, Jori Fleisher
Author Information
  1. Tiffany Phanhdone: Section of Movement Disorders, Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA.
  2. Patrick Drummond: Marlene and Paolo Fresco Institute for Parkinson's and Movement Disorders, Department of Neurology, New York University School of Medicine, New York, NY, USA.
  3. Talia Meisel: College of Medicine, SUNY Downstate Health Sciences University, , Brooklyn, NY, USA.
  4. Naomi Friede: Yale School of Nursing, New Haven, CT, USA.
  5. Alessandro Di Rocco: Zucker School of Medicine at Hofstra Northwell, Long Island, NY, USA.
  6. Joshua Chodosh: Division of Geriatric Medicine and Palliative Care, Department of Medicine, New York University School of Medicine, New York, NY, USA.
  7. Jori Fleisher: Section of Movement Disorders, Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA.
PMID: 33935103 DOI: 10.3233/JPD-202497

Abstract

BACKGROUND: Patients with Parkinson's disease (PD) are at higher risk of vaccine-preventable respiratory infections. However, advanced, homebound individuals may have less access to vaccinations. In light of COVID-19, understanding barriers to vaccination in PD may inform strategies to increase vaccine uptake.
OBJECTIVE: To identify influenza and pneumococcal vaccination rates, including barriers and facilitators to vaccination, among homebound and ambulatory individuals with PD and related disorders.
METHODS: Cross-sectional US-based study among individuals with PD, aged���>���65 years, stratified as homebound or ambulatory. Participants completed semi-structured interviews on vaccination rates and barriers, and healthcare utilization.
RESULTS: Among 143 participants, 9.8% had missed all influenza vaccinations in the past 5 years, and 32.2% lacked any pneumococcal vaccination, with no between-group differences. Homebound participants (n���=���41) reported difficulty traveling to clinic (p���<���0.01) as a vaccination barrier, and despite similar outpatient visit frequencies, had more frequent emergency department visits (31.7% vs. 9.8%, p���<���0.01) and hospitalizations (14.6% vs. 2.9%, p���=���0.03). Vaccine hesitancy was reported in 35% of participants, vaccine refusal in 19%, and 13.3% reported unvaccinated household members, with no between-group differences. Nearly 13% thought providers recommended against vaccines for PD patients, and 31.5% were unsure of vaccine recommendations in PD.
CONCLUSION: Among a sample of homebound and ambulatory people with PD, many lack age-appropriate immunizations despite ample healthcare utilization. Many participants were unsure whether healthcare providers recommend vaccinations for people with PD. In light of COVID-19, neurologist reinforcement that vaccinations are indicated, safe, and recommended may be beneficial.

Keywords

COVID-19 Parkinson���s disease Vaccine hesitancy health services homebound influenza pneumonia vaccination

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Grants

  1. U01 NS100610/NINDS NIH HHS
  2. P30 AG066512/NIA NIH HHS
  3. R24 AG063725/NIA NIH HHS
  4. K23 NS097615/NINDS NIH HHS
  5. U54 AG063546/NIA NIH HHS
  6. R33 AG057291/NIA NIH HHS
  7. UG3 AT009844/NCCIH NIH HHS
  8. R01 NR016461/NINR NIH HHS
  9. R01 AG054574/NIA NIH HHS

MeSH Term

Aged
Aged, 80 and over
COVID-19
Cross-Sectional Studies
Facilities and Services Utilization
Female
Health Knowledge, Attitudes, Practice
Health Services Accessibility
Humans
Influenza Vaccines
Male
Mobility Limitation
Parkinson Disease
Patient Acceptance of Health Care
Pneumococcal Vaccines
United States
Vaccination

Chemicals

Influenza Vaccines
Pneumococcal Vaccines
Journal Article Research Support, N.I.H., Extramural
Article has an altmetric score of 35

Word Cloud

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