Life as we knew it changed on January 30, 2020. That was that day when the World Health Organization (WHO) officially declared the COVID-19 outbreak to be a Public Health Emergency of International Concern. Caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), COVID-19 can result in serious, life-threatening complications, regardless of one’s age, race, health status, geographical location, or socio-economic income and including people with Parkinson’s disease. In this article, we’ll examine a new study from a Parkinson’s Foundation Center of Excellence, Nijmegen Parkinson’s Center in the Netherlands, which recommends the COVID-19 vaccination for people with Parkinson’s, unless there is a specific contraindication.
Overall, we know that people with PD who contract COVID-19 are more likely to experience severe respiratory issues and have more difficulty recovering from COVID-19 – particularly among those with advanced PD, compared to people who do not have PD. Another additional concern for those with PD is that COVID-19 may trigger a worsening of both motor and non-motor symptoms and also may increase the risks of mental health challenges. These mental health challenges are known to be higher for people with PD living under social isolation, higher stress levels and without adequate exercise.
The good news is, there is hope on the horizon. Pharmaceutical companies Pfizer/BioNTech and Moderna each received Emergency Use Authorization from the U.S. Food & Drug Administration (FDA) for their respective messenger RNA (mRNA) two-dose vaccines. In terms of safety, of the over 42 million people in the United States who have received at least one of these vaccines, severe, life-threatening allergic reactions have been rare, i.e., Pfizer less than 11.1 cases per one million doses, and Moderna 2.5 cases per million doses administered.
Expert commentary recently published in the Journal of Parkinson’s Disease, titled, “COVID-19 Vaccination for Persons with Parkinson's Disease: Light at the End of the Tunnel?” (Bloem et al., 2021), tackles the question of getting the COVID-19 vaccine for people with Parkinson’s using a scientific, evidence-based approach. Bas Bloem, MD, PhD, works at the Radboud University Nijmegen Medical Centre, a Parkinson’s Foundation Center of Excellence. The Nijmegen Parkinson Center is one 14 international Centers of Excellence and 33 others in the United States.
These experts closely studied the development and approval processes – including the thorough analyses of completed Phase III data as provided by vaccine developers in a transparent process with peer-reviewed publication of the full data sets. In other words, Bloem et al. (2021) were privy to all of the actual data, not just cherry-picked data. Additional COVID-19 vaccination information was provided by the Scientific Issues Committee (IPMDS-SIC) of the International Parkinson and Movement Disorder Society.
- 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 are not known or expected to interact with the PD neurodegenerative process.
- COVID-19 vaccination is not known to interfere with the current PD therapies.
- The types or incidence of side effects of these vaccines in persons with PD were observed to be no different than in the general population – pain and irritation at the injection site, fatigue, muscle pain, headache, low fever/chills.
- The vaccines were observed to be safe for older adults, however caution is needed for the specific subgroup of very frail and terminally ill elderly persons with PD living in long-term care facilities; or for people with PD who have additional chronic illnesses.
- Taken together, (Bloem et al., 2021) recommend COVID-19 vaccination with approved vaccines for persons with PD, unless there is a specific contraindication.
- Vaccinated persons with PD must continue to comply with the public health guidelines to reduce exposure and to possibly reduce transmission of COVID-19.
- Insights may change, conscious monitoring of newly emerging data from both trials and real-life vaccination programs is critical.
- The authors did not examine the recently US FDA approved vaccine produced by Johnson & Johnson so persons with Parkinson’s and family members should not extrapolate the data from this recent study to apply to the new single dose vaccine. Hopefully more information on this approach will be available soon.
Key Facts about COVID-19 Vaccines
1. Vaccines do not use the live virus that causes COVID-19. The new Johnson & Johnson vaccine uses DNA and not RNA and uses an adenovirus (not the corona virus) to deliver the information necessary to protect against COVID-19.
2. Vaccines cannot give someone COVID-19
3. Vaccines do not interact or affect our DNA in any way
4. Vaccines never enter the nucleus of the cell – which is where our DNA (genetic material) is stored
What Does It Mean?
Both the Pfizer/BioNTech and Moderna mRNA vaccines met the high standards required for use authorization after rigorous data scrutiny and validation – as required in the normal US FDA vaccine approval process. This process is essential in determining not only safety and efficacy, but also that the vaccine benefits outweigh its risks. Today, in the United States, the death toll from COVID-19 topped 500,000 people; worldwide, it has been associated with more than 2,462,000 deaths.
Based upon the available data, the incidence of side effects in persons with PD have not been different than in the general population. The approved mRNA-based vaccines, Pfizer/BioNTech and Moderna:
- do not interact with the neurodegenerative process in PD
- have been shown to be highly effective in preventing the severe and even the mild forms of the disease
- help the body more rapidly clear the infection. High efficacy (>90%) has been demonstrated regardless of race, gender, age, and medical conditions. How big of deal is greater than 90 percent efficacy? During the 2019-20 flu season in the United States, the overall effectiveness of the seasonal flu vaccine in children and adults was about 45 percent.
In their MDS COVID-19 Vaccine Statement for Patients, the International Parkinson and Movement Disorder Society and its Scientific Issues Committee included the following, “All considered, we have encouraged our community of health specialists to recommend COVID-19 vaccination to their patients with PD (or their responsible caregivers) unless there is a specific reason that precludes administration. We also recommend that patients come forward to seek the vaccine as quickly as it is available.”
Finally, as stated by the experts, Bloem et al., (2021), even after being fully vaccinated, 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 WHO and the CDC.
The Parkinson’s Foundation believes in empowering the Parkinson’s community through education. Learn more about Covid-19 and PD by vising the below Parkinson’s Foundation resources, or by calling our free Helpline at 1-800-4PD-INFO (473-4636) for answers to all your Parkinson’s questions.
- Parkinson’s & the COVID-19 Vaccine
- Covid-19 & Parkinson’s
- Getting the Care You Need: Parkinson’s in the Hospital - TNKY
- Kit Contents: Hospitalization During COVID-19 Doctor Letter
- COVID-19 vaccines and rare severe allergic reactions.
Bloem, B. R., Trenkwalder, C., Sanchez-Ferro, A., Kalia, L. V., Alcalay, R., Chiang, H. L., . . . Papa, S. M. (2021). COVID-19 Vaccination for Persons with Parkinson's Disease: Light at the End of the Tunnel? J Parkinsons Dis, 11(1), 3-8. doi:10.3233/JPD-212573
Pardi, N., Hogan, M. J., Porter, F. W., & Weissman, D. (2018). mRNA vaccines - a new era in vaccinology. Nat Rev Drug Discov, 17(4), 261-279. doi:10.1038/nrd.2017.243
Shimabukuro, T., & Nair, N. (2021). Allergic Reactions Including Anaphylaxis After Receipt of the First Dose of Pfizer-BioNTech COVID-19 Vaccine. JAMA. doi:10.1001/jama.2021.0600
Team, C. C.-R., Food, & Drug, A. (2021). Allergic Reactions Including Anaphylaxis After Receipt of the First Dose of Moderna COVID-19 Vaccine - United States, December 21, 2020-January 10, 2021. MMWR Morb Mortal Wkly Rep, 70(4), 125-129. doi:10.15585/mmwr.mm7004e1
Weissman, D. (2015). mRNA transcript therapy. Expert Rev Vaccines, 14(2), 265-281. doi:10.1586/14760584.2015.973859