A COVID-19 vaccination should be recommended to people with Parkinson’s disease — with caution reserved for very frail residents of long-term care settings, according to a new commentary published in the Journal of Parkinson’s Disease.

Patients and their physicians have expressed concern about vaccine efficacy and safety in people with Parkinson’s, especially in the context of Parkinson’s treatment. Following a research review and considering data from vaccinations to date, an international panel of neurologists has concluded that the overall risks of contracting COVID-19 for people with Parkinson’s far outweigh the potential risks of vaccination, at least in cases of advanced disease, wrote lead author Stella M. Papa, M.D., of Emory University School of Medicine, Atlanta.

But the jury is still out on the risks to the frail elderly with Parkinson’s due to lack of data, Papa and colleagues wrote. A “cautious approach” may be best in this population while more evidence is gathered, and it is important to openly discuss possible risks with patients and families prior to vaccination, they contend. Limited life expectancy also should be considered in these cases, they added.

Additional conclusions:

  • The approved mRNA-based vaccines and viral vector vaccines under development are not known or expected to interact with the Parkinson’s neurodegenerative process.
  • The types or incidence of side effects of these vaccines in people with Parkinson’s seem no different than those in the general population.
  • The vaccines also seem safe for older adults, but caution is needed for very frail and terminally ill elderly people living in long-term care facilities.
  • COVID-19 vaccination is not known to interfere with the current therapies of Parkinson’s.
  • Vaccinated persons with Parkinson’s must continue to comply with the public health guidelines to reduce exposure and transmission of COVID-19.

The authors encouraged clinicians to periodically refer to the website of the International Parkinson and Movement Disorder Society for updated recommendations as new data are published.