Assessing COVID-19 infection probabilities in response to alternate vaccine boosting frequencies for multiple-sclerosis patients undergoing disease-modifying therapy with beta-interferon, dimethyl fumarate, natalizumab, or teriflunomide

Abstract

Multiple sclerosis patients treated with disease-modifying therapies experience varying immune responses to COVID-19 vaccinations. However, guidance regarding the impact of treatments on infection risks remains sparse. Integrating vaccine-based and long-term coronavirus infection-based antibody data, we calculated cumulative probabilities of breakthrough infection for untreated multiple sclerosis patients and patients treated with interferon, dimethyl fumarate, natalizumab, or teriflunomide undergoing alternative Pfizer-BioNTech BNT162b2 booster frequencies. Annual boosters appear to effectively reduce risks for untreated multiple sclerosis patients. For treated patients, booster vaccinations likely provide protection that is nearly equivalent to that obtained in untreated patients, with moderate treatment-specific increases and decreases in immunity.