Immunogenicity and predictors of response to a single dose trivalent seasonal influenza vaccine in multiple sclerosis patients receiving disease‐modifying therapies

Metze, Christoph; Winkelmann, Alexander; Loebermann, Micha; Hecker, Michael; Schweiger, Brunhilde; Reisinger, Emil C.; Zettl, Uwe K.

doi:10.1111/cns.13034

Cited by 71 publications

(101 citation statements)

References 37 publications

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“…Furthermore, the use of DMT was the only statistical predictor of not achieving seroprotection [104]. Interestingly, MS patients previously treated with other DMTs before their current therapy had significantly lower seroprotection when compared to those that were still on their first-choice medication (58% vs. 86% response rates) [104]. Lastly, the total cohort did not develop sufficient herd immunity of >40% seroprotected for influenza B strain [104].…”

Section: Vaccine Effectiveness In Multiple Sclerosismentioning

confidence: 97%

“…Interestingly, MS patients previously treated with other DMTs before their current therapy had significantly lower seroprotection when compared to those that were still on their first-choice medication (58% vs. 86% response rates) [104]. Lastly, the total cohort did not develop sufficient herd immunity of >40% seroprotected for influenza B strain [104]. During the 2009 influenza pandemic, a total of 113 MS patients and 215 controls were vaccinated with H1N1 swine flu vaccine [105].…”

Section: Vaccine Effectiveness In Multiple Sclerosismentioning

confidence: 98%

“…Other open-label, observational studies have utilized mixed patient populations which were treated with different DMTs and determined the overall influenza efficacy. For example, in a study of 102 MS patients, only 28.6% of natalizumab-treated cases achieved seroprotection towards H3N2, whereas the entire cohort had an average seroprotection rate of 72.5% [104]. Furthermore, the use of DMT was the only statistical predictor of not achieving seroprotection [104].…”

Section: Vaccine Effectiveness In Multiple Sclerosismentioning

confidence: 99%

“…For example, in a study of 102 MS patients, only 28.6% of natalizumab-treated cases achieved seroprotection towards H3N2, whereas the entire cohort had an average seroprotection rate of 72.5% [104]. Furthermore, the use of DMT was the only statistical predictor of not achieving seroprotection [104]. Interestingly, MS patients previously treated with other DMTs before their current therapy had significantly lower seroprotection when compared to those that were still on their first-choice medication (58% vs. 86% response rates) [104].…”

Section: Vaccine Effectiveness In Multiple Sclerosismentioning

confidence: 99%

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Infections, Vaccines and Autoimmunity: A Multiple Sclerosis Perspective

et al. 2020

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Background: Multiple sclerosis (MS) is a chronic neuroinflammatory and neurodegenerative disease that is associated with multiple environmental factors. Among suspected susceptibility events, studies have questioned the potential role of overt viral and bacterial infections, including the Epstein Bar virus (EBV) and human endogenous retroviruses (HERV). Furthermore, the fast development of immunomodulatory therapies further questions the efficacy of the standard immunization policies in MS patients. Topics reviewed: This narrative review will discuss the potential interplay between viral and bacterial infections and their treatment on MS susceptibility and disease progression. In addition, the review specifically discusses the interactions between MS pathophysiology and vaccination for hepatitis B, influenza, human papillomavirus, diphtheria, pertussis, and tetanus (DTP), and Bacillus Calmette-Guerin (BCG). Data regarding potential interaction between MS disease modifying treatment (DMT) and vaccine effectiveness is also reviewed. Moreover, HERV-targeted therapies such as GNbAC1 (temelimab), EBV-based vaccines for treatment of MS, and the current state regarding the development of T-cell and DNA vaccination are discussed. Lastly, a reviewing commentary on the recent 2019 American Academy of Neurology (AAN) practice recommendations regarding immunization and vaccine-preventable infections in the settings of MS is provided. Conclusion: There is currently no sufficient evidence to support associations between standard vaccination policies and increased risk of MS. MS patients treated with immunomodulatory therapies may have a lower benefit from viral and bacterial vaccination. Despite their historical underperformance, new efforts in creating MS-based vaccines are currently ongoing. MS vaccination programs follow the set back and slow recovery which is widely seen in other fields of medicine.

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Section: Vaccine Effectiveness In Multiple Sclerosismentioning

confidence: 97%

Section: Vaccine Effectiveness In Multiple Sclerosismentioning

confidence: 98%

Section: Vaccine Effectiveness In Multiple Sclerosismentioning

confidence: 99%

Section: Vaccine Effectiveness In Multiple Sclerosismentioning

confidence: 99%

See 2 more Smart Citations

Infections, Vaccines and Autoimmunity: A Multiple Sclerosis Perspective

et al. 2020

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“…Der Einfluss der DMD auf den Impferfolg gegen Influenza kann für verschiedene Stämme sehr unterschiedlich ausfallen, wie das Beispiel Ocrelizumab zeigt [27]. Wochen nach der Influenza-Impfung lag die Rate seroprotektiver Antikörpertiter unter Ocrelizumab-Therapie bei 55,6 % bis 80,0 % der geimpften Patienten -je nach Influenza-Stamm, die per se ein unterschiedliches Immunogenitätspotenial besitzen [28].…”

Section: Wirksamkeit Von Impfungen Unter Dmdunclassified

Impfungen gegen Infektionskrankheiten bei Multipler Sklerose

Zettl¹

2020

Nervenheilkunde

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ZUSAMMENFASSUNGEinen der größten Erfolge der modernen Medizin stellt die Entwicklung von Impfungen gegen Infektionserkrankungen dar. Dank der Immunisierung sind Ausbrüche von Infektionskrankheiten, die Millionen Menschen das Leben kosten, extrem selten geworden. Bei einer immunvermittelten Erkrankung wie der Multiplen Sklerose und erst recht unter einer immunmodulierenden Therapie (DMT, Disease modifying treatment) sind die Infektionsprophylaxe – und damit auch die Frage des Einsatzes von Impfungen gegen Infektionserkrankungen – von besonderer klinischer Bedeutung.

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Vaccine Safety and Immunogenicity in Patients With Multiple Sclerosis Treated With Natalizumab

Carvajal,

Zabalza,

Carbonell-Mirabent

et al. 2024

JAMA Netw Open

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ImportanceVaccination in patients with highly active multiple sclerosis (MS) requiring prompt treatment initiation may result in impaired vaccine responses and/or treatment delay.ObjectiveTo assess the immunogenicity and safety of inactivated vaccines administered during natalizumab treatment.Design, Setting, and ParticipantsThis self-controlled, prospective cohort study followed adult patients with MS from 1 study center in Spain from September 2016 to February 2022. Eligible participants included adults with MS who completed immunization for hepatitis B virus (HBV), hepatitis A virus (HAV), and COVID-19 during natalizumab therapy. Data analysis was conducted from November 2022 to February 2023.ExposuresPatients were categorized according to their time receiving natalizumab treatment at the time of vaccine administration as short-term (≤1 year) or long-term (&gt;1 year).Main Outcomes and MeasuresDemographic, clinical, and radiological characteristics were collected during the year before vaccination (prevaccination period) and the year after vaccination (postvaccination period). Seroprotection rates and postvaccination immunoglobulin G titers were determined for each vaccine within both periods. Additionally, differences in annualized relapse rate (ARR), new T2 lesions (NT2L), Expanded Disability Status Scale (EDSS) scores, and John Cunningham virus (JCV) serostatus between the 2 periods were assessed.ResultsSixty patients with MS (mean [SD] age, 43.2 [9.4] years; 44 female [73.3%]; 16 male [26.7%]; mean [SD] disease duration, 17.0 [8.7] years) completed HBV, HAV, and mRNA COVID-19 immunization during natalizumab treatment, with 12 patients in the short-term group and 48 patients in the long-term group. The global seroprotection rate was 93% (95% CI, 86%-98%), with individual vaccine rates of 92% for HAV (95% CI, 73%-99%), 93% for HBV (95% CI, 76%-99%), and 100% for the COVID-19 messenger RNA vaccine (95% CI, 84%-100%). Between the prevaccination and postvaccination periods there was a significant reduction in the mean (SD) ARR (0.28 [0.66] vs 0.01 [0.12]; P = .004) and median (IQR) NT2L (5.00 [2.00-10.00] vs 0.81 [0.00-0.50]; P = .01). No changes in disability accumulation were detected (median [IQR] EDSS score 3.5 [2.0-6.0] vs 3.5 [2.0-6.0]; P = .62). No differences in safety and immunogenicity were observed for all vaccines concerning the duration of natalizumab treatment.Conclusions and RelevanceThe findings of this cohort study suggest that immunization with inactivated vaccines during natalizumab therapy was both safe and immunogenic, regardless of the treatment duration. Natalizumab may be a valuable option for proper immunization, averting treatment delays in patients with highly active MS; however, this strategy needs to be formally evaluated.

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Immunogenicity and predictors of response to a single dose trivalent seasonal influenza vaccine in multiple sclerosis patients receiving disease‐modifying therapies

Cited by 71 publications

References 37 publications

Infections, Vaccines and Autoimmunity: A Multiple Sclerosis Perspective

Infections, Vaccines and Autoimmunity: A Multiple Sclerosis Perspective

Impfungen gegen Infektionskrankheiten bei Multipler Sklerose

Vaccine Safety and Immunogenicity in Patients With Multiple Sclerosis Treated With Natalizumab

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