ABSTRACT
Introduction: In Argentina, multiple sclerosis patients (MSp) are vaccinated against SARS-CoV-2 using different formulations upon availability, including viral vector/inactivated virus/mRNA vaccines, at distinct times between doses. The real-world effectiveness of these unique vaccination schedules is scarce, so asthe efficacy to mount an appropriate immune response even more in MSp under treatment (DMTs) Aims: To analyze the presence of reactive CD4+ and CD8+ T cells for SARS-CoV-2, IgG and IgM anti-Spike and anti-RBD, in MSp after receiving a 3rd vaccine dose Methods: 27 MSp and 9 healthy controls (HC) were included in this study. SARS-CoV-2-reactive T cells were analysed with a T Cell Analysis Kit from Miltenyi as described by the manufacturer. In brief, peripheral blood mononuclear cells (PBMCs) were cultured with a pool of lyophilized peptides, consisting of 15-mer sequences with 11 amino acids overlap, covering the complete protein coding sequence (aa 5-1273) of the surface or Spike glycoprotein (S) of SAR-CoV-2 and controls. After stimulation, the cells were stained with the live/dead marker, washed, fixed, permeabilized and stained for lineage and activation markers as well as cytokines. Cells were analysed using a flow cytometer. Doublets, debris, and dead cells as well as CD14+ and CD20+ cells were excluded. Cells were pregated on CD3 as well as CD4 and CD8. For reactive CD4 T cells CD154 and TNF-alpha were assessed on CD4+ T cells while TNF-alpha and IFN-gamma in CD8+ T cells Results: IgG antibodies (Ab) against S and RBD were found in all analysed HC, while in 22 and 20 out of a total of 27 MSp. Levels of IgG against S were lower in MSp vs HC. IgM levels against RBD were found in all HC and MSp, but 8 MSp had low levels of those Ab.There were no differences between HC and MSp in the % of reactive CD4+ T cells to S (p= 0.151). However, we found a lower % of reactive CD8+ T cells in MSp than HC (p= 0.026). Actually, CD8+ T cells were not detected in 4 out of 5 MSp treated with Fingolimod (FTY) but were present in all patients treated with monoclonal Ab, IFN or DMF. Furthermore, MSp treated with FTY had lower values of reactive CD4+ T cells and IgG anti-RBD than patients receiving other DMTs Conclusion(s): Most MSp vaccinated against SARS-CoV-2 present some humoral and cellular response to SARS-CoV-2. This humoral and cellular response would be lower in MSp treated with FTY.
ABSTRACT
Introduction: Patients with MS (pwMS) are currently receiving different COVID-19 vaccines in several Latin American countries. However, questions arise around the safety of these vaccines and whether vaccination might increase the risk of relapse activity. Therefore, we aimed to assess the safety and occurrence of relapses following COVID-19 vaccination in Latin American pwMS. Methods: A web-based survey was completed by 207 pwMS from Latin America to assess for adverse events associated with COVID-19 vaccination between February 1 and April 30, 2021. Results: All participants received the first dose and 84 the second. The different vaccines administered were: inactivated virus vaccines [(IVV);CoronaVac, BBIBP-CorV) ] in 117 (56.5%) patients, adenovirus vector vaccines [(AdV);Gam-COVID-Vac, AZD1222] in 53 (25.6%) and mRNA vaccines (BNT162b2) in 37 (17.9%). The mean follow-up after vaccination was 24 ± 16 days. Three (1.4%) patients reported having COVID-19 infection after vaccination (all occurring after the first dose). Any adverse events were reported in 61 (29.5%) and 23 (27.4%) individuals after the first and second doses respectively. These included pain at the injection site, headache, fever, flu-like symptoms, fatigue, and muscle or joint pain. A lower frequency of adverse events was found with IVV (x?=7.2, p=0.03). Four (1.9%) patients reported an MS relapse, all occurring after an IVV first dose. Mean time to relapse: 18 ± 13 days. None of these patients had stopped or postponed their MS treatment before vaccination. Conclusion: COVID-19 vaccines seem to be safe for pwMS from Latin America. No major safety signals appeared in this patientreported study.