Safety and Tolerability of SARS-Cov-2 Vaccination in Patients with Neuromuscular Disorders: A Single Center Experience

ABSTRACT

Objective: To describe side effects from SARS-Cov-2 vaccination and its effect on underlying neuromuscular disease amongst patients followed at the University of California, Irvine Neuromuscular Center. Background: Extensive data on safety and tolerability of SARS-Cov-2 vaccines exists for healthy individuals. However, patients with neuromuscular conditions and especially those on immune modulatory therapy were not included in the pivotal vaccine trials. It is primarily through expert consensus that vaccination is recommended for this patient population. Design/Methods: Patients were advised to inform the study team about their vaccination status. We collected data during in-person clinic visits or via telehealth encounters using a standardized questionnaire between December 2020 and August 2021. When information was provided about upcoming vaccination dates, patients were contacted within 2 weeks for follow up. Results: Information on 363 administered vaccine doses in 214 patients was recorded, including 199 Pfizer-BioNT, 155 Moderna and 9 Johnson & Johnson doses. Our cohort included 84 patients with myasthenia gravis (MG) and 34 with motor neuron disease (Amyotrophic Lateral Sclerosis, Primary Lateral Sclerosis). The remainder (96 patients) included other immunemediated disorders (idiopathic inflammatory myopathies, Chronic Inflammatory Demyelinating Neuropathy, Guillain-Barre Syndrome and other immune neuropathies) as well as acquired and inherited neuromuscular disorders (Inclusion Body Myositis, muscular dystrophy, inherited and acquired neuropathies). One patient with generalized MG had MG exacerbation, and another experienced impending crisis within one week of vaccine administration;both recovered with appropriate therapy. Detailed analyses of the dataset are being performed and will be presented at the meeting. Conclusions: SARS-Cov-2 vaccinations were well tolerated for the majority of our neuromuscular cohort, similar to what has been reported in healthy individuals. Vaccination did not result in disease exacerbation in the majority of patients with immune-mediated neuromuscular disorders.