Patients with multiple sclerosis or NMOSD may have more complications with the COVID-19 vaccination when compared to the general population.
Although vaccination against COVID-19 provides excellent protection against severe infection, this effect may be mitigated to some degree among those taking immunomodulatory medications, including those with multiple sclerosis or neuromyelitis optica spectrum disorders (NMOSD). This article, published in Multiple Sclerosis and Related Disorders, analyzed vaccination-induced cellular and humoral immune response in patients with multiple sclerosis and NMOSD who were receiving disease-modifying therapies. The study was a monocentric observational study, and relied on data from 82 patients for the final analysis. The median age of patients was 42 years, and there were 54 female patients and 28 male patients. Data were collected between June 1st and September 30, 2021.
Multiple methods were used to determine cellular responses, including interferon gamma release assay (IGRA) and the T-SPOT assay. This study found that most immunomodulators used to treat multiple sclerosis have no effect on the immune response of COVID-19 vaccination, and most patients that received treatment received the same benefits as the control group. Impaired responses were found in patients receiving B-cell-depleting therapies, or S1P inhibitors. The ability of these patients to mount an immune response suggests that they may benefit from additional booster vaccinations, and this is supported by another study investigating the B-cell response to booster vaccinations in patients receiving Rituximab treatment.
The authors conclude by noting that their study provides clear evidence of the cellular and humoral response of patients with multiple sclerosis and NMOSD that receive disease-modifying therapies. With the exception of S1P inhibitors, no treatment inhibited the cellular immune response. Only a small group of patients receiving S1P inhibitors did not show a detectable immune response after vaccination.
Bock, H., Juretzek, T., Handreka, R., Ruhnau, J., Löbel, M., Reuner, K., . . . Dressel, A. (2022). Humoral and cellular immune responses to SARS CoV-2 vaccination in People with Multiple Sclerosis and NMOSD patients receiving immunomodulatory treatments. Mult Scler Relat Disord, 59, 103554. doi:10.1016/j.msard.2022.103554