CORONAVIRUS DISEASE 2019 AND THE PD COMMUNITY

APDA COVID-19 INFORMATION & RESOURCES:

The American Parkinson Disease Association (APDA) continues to monitor the COVID-19 situation, particularly as it relates to our Parkinson’s disease (PD) community.

 

Vaccines:  Recently, the first two COVID-19 vaccines have been approved for use in the United States, one manufactured by Pfizer/BioNTech and one manufactured by Moderna. Other vaccines (including one manufactured by Oxford/AstraZeneca) are close to approval and many more are in various stages of clinical trial.  The more people understand about how the vaccines are created and work, the more comfortable they may be about taking them.

How do the new COVID-19 vaccines work? Vaccines work by introducing an element into the body that itself can’t cause illness but is recognized as an infection by the immune system. The immune system then responds to the element, giving the body the ability to defend against the actual infection should it encounter it in the future.

In the past, vaccines were created by taking the actual pathogen and weakening it to the point that it doesn’t cause illness or by taking a piece of the pathogen that itself can’t cause disease. This was then injected into the body, inducing the body to create antibodies, which were protective and long lasting, and would work in the future, should the live pathogen enter.

The currently approved vaccines take a paired down approach. Instead of using a weakened COVID-19 virus or a piece of the virus, the vaccines contain a piece of the mRNA instructions for creating a piece of the virus.  Once injected, our own cells turn these instructions into one of the COVID-19 proteins, which by itself is harmless. The protein is recognized as foreign by the body, triggering the protective immune response, which allows it to “remember” COVID-19 as foreign.

mRNA is easier to manufacture in a laboratory in large quantities than a weakened virus, and using mRNA technology allowed for the rapid creation of the vaccines, which typically take many years to develop.

Do they work and are they safe? Clinical trials of the two vaccines enrolled tens of thousands of people and found that they were up to 95% effective in protecting people against the virus. Those at particularly high risk of developing complications from COVID-19 infection, including those over 65 and with chronic medical conditions, were protected as well. Only mild side effects were reported. To be protected, two doses of the vaccines were necessary, given three weeks (Pfizer/BioNTech) or four weeks (Moderna) apart.

When can I get a vaccine? Distribution across the country of the two vaccines is now underway and vaccination will proceed for different populations based on rules decided by individual states (with priority often going to frontline workers and elderly in nursing homes). This will take some time as the logistics for rolling out this vaccination program are very complicated. Another limitation is the amount of vaccines available. As additional vaccines are approved in the near future, vaccination will be more widespread.

We encourage you to ask your doctor any questions regarding the vaccines and your particular clinical situation. Your doctor will also be the main source of information about exactly where and when you can receive the vaccine.

Are there any reasons why a person with PD should not get a COVID-19 vaccine? There are no substantiated scientific concerns to suggest that the vaccines have a different safety profile in people with PD as compared to the general population, so what we know about the vaccines for all-comers would hold true for those with PD.  Having PD might lead to a more complicated infection should you contract COVID-19, plus people with PD also tend to be older which further increases risk for complicated COVID-19 infection. Because of these issues, vaccination for COVID-19 for people with PD is a good idea. Discuss with your doctor any concerns you have about the COVID-19 vaccine, and to find out when and where you can receive the vaccine.

When will life get back to normal?  We are eager to resume in-person events, groups and classes, but we continue to take extra precautions due to the potential increased risk of COVID-19 complications for people with PD. As such, APDA will continue to offer virtual programming for your safety and convenience, postponing all in-person events through March 31, 2021. We anticipate that by that date we will have more information about vaccine rollout and will be able to make more informed decisions about our in-person programs going forward.

APDA is hopeful that a strong vaccination program across the US will be the turning point that will halt the pandemic and allow for a return to our pre-COVID lives.

Visit APDA’s virtual events calendar to stay supported, engaged and informed at home!

For more information: We will keep our website as up-to-date as possible but we recommend you also consult your local APDA Chapter for the latest virtual class/group schedules and information as we are constantly adding new offerings to help you and support you at home.

For answers to additional COVID-19 questions please visit Dr. Gilbert’s recent blog post

You can also view our Q&A with Dr. Joel Perlmutter about the COVID-19 vaccine and PD.

(Updated December 22, 2020)

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Basic Information About COVID-19 & the PD Community:

There have been a number of studies conducted that probe the relationship between COVID-19 and PD which you can review.

The literature supports that:

  • People with PD demonstrated more anxiety and depression as well as decreased levels of quality of life and physical activity as compared to controls during the COVID-19 lockdown.
  • People with mid-stage PD and COVID-19 demonstrated outcomes that were similar to others of the same age with COVID-19 who did not have PD.
  • People with advanced PD did not fare well in the face of COVID-19 with mortality due to COVID-19 among people with PD correlating with more advanced disease.
  • In people with advanced PD, a rapid worsening of PD could mean onset of COVID-19 infection.

What features of PD could increase complications from coronavirus?

PD motor- and non-motor symptoms can be exacerbated by any medical illness, including COVID-19. This means that in addition to the respiratory symptoms of the virus, people with PD may feel that they are slower and stiffer than usual and that their medications don’t seem to be working as well. Hallucinations may start in a person who never experienced that symptom before. Recovery from the illness can be more drawn out.

In addition, some people with PD may have restrictive lung disease which refers to an inability of the lungs to fully expand with air. Restrictive lung disease can occur in PD because of rigidity of the muscles of the chest wall, as well as bradykinesia, or slowness of the muscles responsible for chest wall expansion and contraction. People with PD may also have abnormalities in the posturing of their trunk including head drop, stooped posture, tilting of the trunk and bending at the waist. These postures can restrict the amount that the lungs can fill up with air. PD can also predispose a person to dysfunction of swallow and difficulty clearing secretions from their airway. These issues could contribute to development of complications during a respiratory illness.

People with advancing PD also may start to experience decreased mobility, with more risk of falls. As PD advances it can cause additional problems including urinary dysfunction and weight loss. All of these elements can contribute to general frailty and increased risk of infection, including increased risk from COVID-19.

All things considered, people with PD, because of age and because of their underlying PD symptoms, should consider themselves at increased risk of complications from COVID-19.

Steps to take to prevent contracting COVID-19

For your own safety and the safety of those around you, you should closely follow the national risk-reduction guidelines as well as those put forth by your local authorities. This includes wearing face masks, maintaining 6-feet of physical distance from others, frequent hand washing, among other recommendations.

What about quarantining?

People who have had contact with someone who is a confirmed case of COVID-19, or who is diagnosed themselves with COVID-19 (and has disease mild enough that does not need hospitalization), should quarantine in order to prevent the spread of the virus to others.  Quarantine rules and recommendations vary from state to state, so please follow the guidance of your local health authorities.

Questions?

If you have a question about COVID-19 and PD that is not answered here, please submit your question to our Ask A Doctor web feature.