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COVID-19 vaccination has been recommended as a priority for patients with NMOSD due to their high-risk status. This study investigates the safety profile of these vaccines for patients with NMOSD and other CNS demyelinating disorders, who were not included in previous trials.

Although vaccination against COVID-19 is recommended for patients with neuromyelitis optica spectrum disorder (NMOSD), multiple sclerosis (MS), and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), patients with these conditions were not included in initial vaccine trials. As a result, the way that the various COVID-19 vaccines affect patients with these conditions is still not fully understood. 

Patients with these demyelinating diseases can experience exacerbated clinical relapses following COVID-19 infections, leading to the hypothesis that they may face some complications following vaccinations. These patients are considered high-risk groups, and are prioritized for vaccination, according to CDC recommendations. This study, published in the journal Neurological Sciences, analyzes COVID-19 safety for these patients.

Mild Adverse Vaccine Responses Reported

Data for this study were collected from medical records and included demographic information such as age and sex, as well as medical history, medications, and neurological status. Vaccination status along with schedules, vaccine type, and occurrence of adverse effects, including relapse of neurological disease symptoms or of COVID-19 symptoms or infection were investigated on the bases of these data. 

Of the three demyelinating disorders examined, NMOSD patients were older, on average, and the vast majority (90.9%) were female. Patients reported several side effects following vaccination, with one-third of patients reporting mild symptoms that resolved within a few days. Seven percent of patients exhibited neurologic symptoms, such as tingling in the extremities or limb weakness, with another 7% exhibiting clinical relapse following vaccination. Three patients in the study were unvaccinated, and all exhibited neurologic deterioration following COVID-19 infection, whereas neurological deterioration was only found in 21.4% of vaccinated patients who contracted COVID-19.

COVID-19 Vaccines Safe for Patients with NMOSD, Especially Compared to Unvaccinated Status

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Overall, patients with these demyelinating diseases may require some additional oversight after receiving their vaccines. However, most of the complications that patients faced after vaccination were mild. Vaccinated patients who did contract COVID-19 showed favorable outcomes compared to unvaccinated patients, with only one having to undergo hospitalization. The authors conclude by noting that their study shows a favorable safety profile for these vaccines without serious side effects, but note that the sample size was relatively small.


Kim, S., & Seok, H. Y. (2023). Evaluation of the safety profile of COVID-19 vaccines in patients with MS, NMOSD, and MOGAD. Neurological Sciences, 1-8. https://doi.org/10.1007/s10072-023-06676-1