COVID-19 vaccination hesitancy among people with chronic neurological disorders: A position paper

Abstract

Background and purpose: Health risks associated with SARS-CoV-2 infection are undisputed. Moreover, the capability of vaccination to prevent symptomatic, severe, and fatal COVID-19 is recognized. There is also early evidence that vaccination can reduce the chance for long COVID-19. Nonetheless, the willingness to get vaccinated and receive booster shots remains subpar among people with neurologic disorders. Vaccine scepticism not only jeopardizes collective efforts to end the COVID-19 pandemic but puts individual lives at risk, as some chronic neurologic diseases are associated with a higher risk for an unfavorable COVID-19 course.

Methods: In this position paper, the NeuroCOVID-19 Task Force of the European Academy of Neurology (EAN) summarizes the current knowledge on the prognosis of COVID-19 among patients with neurologic disease, elucidates potential barriers to vaccination coverage, and formulates strategies to overcome vaccination hesitancy. A survey among the Task Force members on the phenomenon of vaccination hesitancy among people with neurologic disease supports the lines of argumentation.

Results: The study revealed that people with multiple sclerosis and other nervous system autoimmune disorders are most skeptical of SARS-CoV-2 vaccination. The prevailing concerns included the chance of worsening the pre-existing neurological condition, vaccination-related adverse events, and drug interaction.

Conclusions: The EAN NeuroCOVID-19 Task Force reinforces the key role of neurologists as advocates of COVID-19 vaccination. Neurologists need to argue in the interest of their patients about the overwhelming individual and global benefits of COVID-19 vaccination. Moreover, they need to keep on eye on this vulnerable patient group, its concerns, and the emergence of potential safety signals.

Keywords: COVID-19; SARS-CoV-2; advocacy; infectious disease prevention; neurological disorders; vaccination; vaccine skepticism.

FIGURE 1

Neurological disorders and SARS‐CoV‐2 vaccine skepticism. The dots within the spider figures show the averaged scoring. Likert‐style scale scoring: 1, strongly disagree; 2, disagree; 3, neutral; 4, agree; 5, strongly agree. CNS, central nervous system; PNS, peripheral nervous system [Colour figure can be viewed at wileyonlinelibrary.com]

FIGURE 2

Ranking of reasonable interventions aimed at improving vaccine coverage. The dots within the spider figures show the averaged scoring. Likert‐style scale scoring: 1, strongly disagree; 2, disagree; 3, neutral; 4, agree; 5, strongly agree. EAN, European Academy of Neurology [Colour figure can be viewed at wileyonlinelibrary.com]