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Humoral immunity to SARS-CoV-2 mRNA vaccination in multiple sclerosis: the relevance of time since last rituximab infusion and first experience from sporadic revaccinations.
König, Marton; Lorentzen, Åslaug Rudjord; Torgauten, Hilde Marie; Tran, The Trung; Schikora-Rustad, Stine; Vaage, Eline Benno; Mygland, Åse; Wergeland, Stig; Aarseth, Jan; Aaberge, Ingeborg Aase S; Torkildsen, Øivind; Holmøy, Trygve; Berge, Tone; Myhr, Kjell-Morten; Harbo, Hanne Flinstad; Andersen, Jan Terje; Munthe, Ludvig Andre; Søraas, Arne; Celius, Elisabeth Gulowsen; Vaage, John Torgils; Lund-Johansen, Fridtjof; Nygaard, Gro Owren.
  • König M; Department of Neurology, Oslo University Hospital, Oslo, Norway makoni@ous-hf.no.
  • Lorentzen ÅR; Department of Neurology, Sørlandet Sykehus HF, Kristiansand, Norway.
  • Torgauten HM; The Norwegian National Advisory Unit on Tick-borne Diseases, Arendal, Norway.
  • Tran TT; Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Bergen, Norway.
  • Schikora-Rustad S; Institute of Clinical Medicine, University of Bergen, Bergen, Norway.
  • Vaage EB; Department of Immunology, Oslo University Hospital, Oslo, Norway.
  • Mygland Å; Department of Neurology, Sørlandet Sykehus HF, Kristiansand, Norway.
  • Wergeland S; Department of Immunology, Oslo University Hospital, Oslo, Norway.
  • Aarseth J; Department of Neurology, Sørlandet Sykehus HF, Kristiansand, Norway.
  • Aaberge IAS; Institute of Clinical Medicine, University of Bergen, Bergen, Norway.
  • Torkildsen Ø; Department of Neurology, Haukeland University Hospital, Bergen, Norway.
  • Holmøy T; Norwegian MS Registry and Biobank, Haukeland University Hospital, Bergen, Norway.
  • Berge T; Department of Neurology, Haukeland University Hospital, Bergen, Norway.
  • Myhr KM; Norwegian MS Registry and Biobank, Haukeland University Hospital, Bergen, Norway.
  • Harbo HF; Department of Infectious Disease Immunology, Norwegian Institute of Public Health, Oslo, Norway.
  • Andersen JT; Institute of Clinical Medicine, University of Bergen, Bergen, Norway.
  • Munthe LA; Department of Neurology, Haukeland University Hospital, Bergen, Norway.
  • Søraas A; Department of Neurology, Akershus University Hospital, Lorenskog, Norway.
  • Celius EG; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
  • Vaage JT; Department of Mechanical, Electronic and Chemical Engineering, Oslo Metropolitan University, Oslo, Norway.
  • Lund-Johansen F; Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.
  • Nygaard GO; Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Bergen, Norway.
J Neurol Neurosurg Psychiatry ; 2021 Oct 20.
Article in English | MEDLINE | ID: covidwho-2232035
ABSTRACT

INTRODUCTION:

The effect of disease-modifying therapies (DMT) on vaccine responses is largely unknown. Understanding the development of protective immunity is of paramount importance to fight the COVID-19 pandemic.

OBJECTIVE:

To characterise humoral immunity after mRNA-COVID-19 vaccination of people with multiple sclerosis (pwMS).

METHODS:

All pwMS in Norway fully vaccinated against SARS-CoV-2 were invited to a national screening study. Humoral immunity was assessed by measuring anti-SARS-CoV-2 SPIKE RBD IgG response 3-12 weeks after full vaccination, and compared with healthy subjects.

RESULTS:

528 pwMS and 627 healthy subjects were included. Reduced humoral immunity (anti-SARS-CoV-2 IgG <70 arbitrary units) was present in 82% and 80% of all pwMS treated with fingolimod and rituximab, respectively, while patients treated with other DMT showed similar rates as healthy subjects and untreated pwMS. We found a significant correlation between time since the last rituximab dose and the development of humoral immunity. Revaccination in two seronegative patients induced a weak antibody response.

CONCLUSIONS:

Patients treated with fingolimod or rituximab should be informed about the risk of reduced humoral immunity and vaccinations should be timed carefully in rituximab patients. Our results identify the need for studies regarding the durability of vaccine responses, the role of cellular immunity and revaccinations.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Topics: Vaccines Language: English Year: 2021 Document Type: Article Affiliation country: Jnnp-2021-327612

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Topics: Vaccines Language: English Year: 2021 Document Type: Article Affiliation country: Jnnp-2021-327612