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. 2025 Apr;46(4):1467-1476.
doi: 10.1007/s10072-025-08017-w. Epub 2025 Feb 4.

Is there still hesitancy towards SARS-CoV-2 vaccination among people with neurological disease- a survey of the NeuroCOVID-19 task force of the European Academy of Neurology

Sonja Hochmeister #  1 , Martin Rakusa #  2 , Elena Moro  3 , Daniel Bereczki  4 , Francesco Cavallieri  5 , Alessandra Fanciulli  6 , Saša R Filipović  7 , Alla Guekht  8   9 , Raimund Helbok  10 , Filippo Martinelli Boneschi  11   12 , Serefnur Özturk  13 , Alberto Priori  14   15 , Barbara Willekens  16   17 , Dauren Ramankulov  18 , Johann Sellner  19   20   21   22
Affiliations

Is there still hesitancy towards SARS-CoV-2 vaccination among people with neurological disease- a survey of the NeuroCOVID-19 task force of the European Academy of Neurology

Sonja Hochmeister et al. Neurol Sci. 2025 Apr.

Abstract

Background: An online 3-item survey was sent to the European Academy of Neurology (EAN) community and inquired about the persistence of SARS-CoV-2 vaccination skepticism and the underlying thoughts and factors restricting vaccine use among patients with neurological conditions.

Results: We obtained 616 responses from 84 countries, predominantly from Europe. In the view of the treating neurologist, patients with multiple sclerosis (MS), neuroimmunological disorders (ND), and chronic neurological infections continued to have high levels of skepticism toward SARS-CoV-2 vaccination. Patients with MS/ND were quoted as the most hesitant group, with 60% of the respondents sharing this impression. The patient group perceived as most confident towards immunization against COVID-19 and with the lowest level of distrust towards the vaccine were those with sleep disorders. For all other conditions, perceived distrust ranged between 42 and 52%. Fear of adverse events of vaccination or disease reactivation was perceived by 87% of patients with MS/ND and more than 70% of patients with stroke/vascular neurology, neuromuscular disorders, chronic neurological infections, and peripheral neuropathy. Patients with sleep disorders (54%), autonomic disorders (46%), movement disorders (43%), and dementia (43%) were sensed as less fearful of vaccine-related adverse events.

Conclusion: Despite the large body of evidence proving the efficacy and safety of SARS-CoV-2 vaccination, patients with certain neurological disorders still have a surprisingly high percentage of distrust and fear of adverse events. Our observations emphasize the importance of continuous evidence-based information delivery and patient education by treating neurologists.

Keywords: Autoimmune; COVID-19; Disease prevention; Multiple sclerosis; Neurological disease; Public health; SARS-CoV-2; Vaccination hesitancy.

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Conflict of interest statement

Declarations. Ethical approval: No ethics approval was required for this anonymized online survey study according to Austrian regulations. Conflict of interest: All authors are members of the NeuroCOVID-19 Task Force of the European Academy of Neurology. No further competing interests.

Figures

Fig. 1
Fig. 1
Geographical distribution of participants
Fig. 2
Fig. 2
Hesitancy to receive SARS-CoV-2 vaccination among people with neurological conditions compared to healthy people of the same age
Fig. 3
Fig. 3
The reasons for vaccine hesitancy among people with neurological conditions from top to bottom: distrust in SARS-CoV-2 vaccination (A), fear of adverse events of vaccination (B), fear of disease reactivation/worsening (C). Stroke– stroke/vascular neurology; NM– neuromuscular; Multiple sclerosis– multiple sclerosis/neuroimmunology; ANS - Autonomic nervous system. %– proportion of answers
Fig. 4
Fig. 4
Heatmaps of average Weighted Average Score (WAS) for neurological conditions
See this image and copyright information in PMC

References

    1. News UN WHO chief declares end to COVID-19 as a global health emergency 2023 [April 4 2024]. Available from: https://news.un.org/en/story/2023/05/1136367
    1. Bodini B, Moro E, Jaarsma J, Cunningham E, Sellner J, Walsh D et al (2022) Lessons learned from people with neurological diseases at the time of COVID-19: the EFNA-EAN survey. Eur J Neurol 29:318–323. 10.1111/ene.15087 - PMC - PubMed
    1. Fanciulli A, Leys F, Krbot Skoric M, Carneiro DR, Calandra-Buonaura G, Camaradou J et al (2023) Impact of the COVID-19 pandemic on clinical autonomic practice in Europe A survey of the European Academy of Neurology (EAN) and the European Federation of Autonomic Societies (EFAS). Eur J Neurol:Online Ahead Print. 10.1111/ene.15787 - PubMed
    1. Sellner J, Taba P, Ozturk S, Helbok R (2020) The need for neurologists in the care of COVID-19 patients. Eur J Neurol 27:e31–e2. 10.1111/ene.14257 - PMC - PubMed
    1. Cavallieri F, Sellner J, Zedde M, Moro E (2022) Neurologic complications of coronavirus and other respiratory viral infections. Handb Clin Neurol 189:331–358. 10.1016/B978-0-323-91532-8.00004-5 - PMC - PubMed

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