[COVID-19 Vaccines for Patients with Neuroimmunological Diseases].

More than 2 years have passed since the outbreak of coronavirus disease 2019 (COVID-19), but there is still no sign that the COVID-19 pandemic has ended. Although vaccines have shown high efficacy against severe acute respiratory syndrome coronavirus 2, a risk of adverse reactions and thrombosis has also been reported. Here we review the current knowledge regarding vaccination in patients with neuroimmunological diseases and those receiving immunosuppressive drugs or disease-modifying therapy.

Initial clinical manifestation of multiple sclerosis after immunization with the Pfizer-BioNTech COVID-19 vaccine.

Vaccine administration may be involved in the development of some central nervous system demyelinating diseases. The COVID-19 vaccine is being administered to the entire population, but to date, little association between vaccination and the risk of developing multiple sclerosis (MS) has been suggested, and only a few case reports have been published. Here, we present a 40-year-old woman who developed cervical myelitis after receiving the COVID-19 vaccine. Myelitis was considered the initial clinical manifestation of MS. Our case suggests a possible link between the vaccination and the clinical MS attack.

[Treatment of Multiple Sclerosis, Neuromyelitis Optica Spectrum Disorder and Myasthenia Gravis during the COVID-19 Pandemic].

Coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 has become a global pandemic. Neuroimmunological diseases, such as multiple sclerosis, neuromyelitis optica spectrum disorders, and myasthenia gravis, require long-term immunotherapies having the potential to increase the risk of infection. However, there are no evidence-based guidelines for the management of these disease during the pandemic, despite increasing concerns in patients and neurologists. Currently, there is no evidence of an elevated risk of morbidity and aggravation of COVID-19 in patients with these diseases, irrespective of whether they receive treatment. To prevent relapse or aggravation of the underlying diseases due to COVID-19, all patients should perform general preventive measures, such as social distancing, frequent hand washing, and respiratory hygiene. In patients undergoing immunotherapy, current treatment should be continued to prevent exacerbation of symptoms; however, exceptions to this include high-risk patients for COVID-19, such as the elderly, those with comorbidities including cardiac and respiratory diseases, those taking therapy with immunosuppressive agents, and those with deteriorating symptoms of COVID-19.