Section of Movement Disorders, Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA.
Marlene and Paolo Fresco Institute for Parkinson's and Movement Disorders, Department of Neurology, New York University School of Medicine, New York, NY, USA.
J Parkinsons Dis. 2021;11(3):1057-1065. doi: 10.3233/JPD-202497.
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.
To identify influenza and pneumococcal vaccination rates, including barriers and facilitators to vaccination, among homebound and ambulatory individuals with PD and related disorders.
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.
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.
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.
帕金森病（PD）患者患疫苗可预防的呼吸道感染的风险更高。然而，晚期、居家的患者可能较少获得疫苗接种。鉴于 COVID-19，了解 PD 患者疫苗接种的障碍因素可能有助于制定增加疫苗接种率的策略。
确定居家和非居家 PD 患者及相关疾病患者的流感和肺炎球菌疫苗接种率，包括疫苗接种的障碍因素和促进因素。
这是一项在美国开展的基于横断面的研究，研究对象为年龄＞65 岁的 PD 患者，分为居家和非居家患者。参与者完成了关于疫苗接种率和障碍因素以及医疗保健利用情况的半结构式访谈。
在 143 名参与者中，9.8%的人在过去 5 年中错过了所有流感疫苗接种，32.2%的人未接种任何肺炎球菌疫苗，居家组和非居家组之间无差异。居家组（n=41）报告说前往诊所就诊存在困难（p＜0.01），是疫苗接种的障碍因素，尽管门诊就诊频率相似，但居家组更频繁地前往急诊部就诊（31.7%比 9.8%，p＜0.01）和住院（14.6%比 2.9%，p=0.03）。35%的参与者报告存在疫苗犹豫，19%的参与者报告疫苗拒绝，13.3%的参与者报告未接种疫苗的家庭成员，居家组和非居家组之间无差异。近 13%的参与者认为医生不建议 PD 患者接种疫苗，31.5%的参与者不确定 PD 患者的疫苗接种建议。
在居家和非居家 PD 患者样本中，尽管医疗保健利用率较高，但许多患者未接受适合年龄的免疫接种。许多参与者不确定医生是否建议 PD 患者接种疫苗。鉴于 COVID-19，神经科医生强调疫苗接种是有必要的、安全的且被推荐的，这可能是有益的。
