Barriers to Vaccination Among People with Parkinson's Disease and Implications for COVID-19.
Barriers to Vaccination Among People with Parkinson's Disease and Implications for COVID-19.
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DOI：
10.3233/jpd-202497
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Fleisher J
中科院分区：
文献类型：
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作者：
Phanhdone T;Drummond P;Meisel T;Friede N;Di Rocco A;Chodosh J;Fleisher J
帕金森氏病(PD)患者患上疫苗可预防的呼吸道感染的风险更高。然而，年事已高、呆在家里的人获得疫苗接种的机会可能较少。根据新冠肺炎，了解帕金森病患者接种疫苗的障碍可能会为增加疫苗接种量的策略提供依据。确定患有帕金森病和相关疾病的居家和门诊个人的流感和肺炎球菌疫苗接种率，包括接种的障碍和促进者。在65岁的帕金森病患者中进行的以美国为基础的横断面研究，分层为居家或门诊。参与者完成了关于疫苗接种率和障碍以及医疗保健利用的半结构化访谈。在143名参与者中，9.8%的人在过去5年内没有接种过所有流感疫苗，32.2%的人没有接种过肺炎球菌疫苗，组间没有差异。回家的参与者(n=41)报告说，前往诊所接种疫苗有困难(p<；0.01)，尽管门诊就诊频率相似，但他们更频繁地去急诊科(31.7%比9.8%，p<；0.01)和住院(14.6%比2.9%，p=0.03)。35%的参与者报告了疫苗迟疑，19%的人报告了疫苗拒绝，13.3%的人报告了未接种疫苗的家庭成员，组间没有差异。近13%的人认为供应商建议不要为PD患者接种疫苗，31.5%的人不确定PD患者的疫苗建议。在帕金森氏症患者的居家和门诊样本中，许多人缺乏与年龄相适应的免疫接种，尽管医疗保健利用率很高。许多参与者不确定医疗保健提供者是否建议帕金森氏症患者接种疫苗。根据新冠肺炎，神经科医生强调疫苗接种是有适应证的、安全的和推荐的，可能是有益的。
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.