Risk of disease relapse following COVID-19 vaccination in patients with AQP4-IgG-positive NMOSD and MOGAD

To be or not to be vaccinated: The risk of MS or NMOSD relapse after COVID-19 vaccination and infection

“…As for NMOSD, a few post-vaccination disease relapses have been reported via smaller studies ( Dinoto et al., 2021 ; Fragoso et al., 2021 ; Jovicevic et al., 2021 ; Lotan et al., 2021a ). The frequency of relapses within one month of vaccination in the largest one was 4% (one out of 26 patients) ( Dinoto et al., 2021 ), which corresponds with our findings.…”

“…To our knowledge, data assessing the effect of COVID-19 infection and vaccination on the risks of relapse in MS and NMOSD are scarce, inconsistent, and mostly evaluated on relatively small cohorts ( Achiron et al., 2021 ; Barzegar et al., 2021b ; Cai et al., 2021 ; di Filippo et al., 2021 ; Dinoto et al., 2021 ; Etemadifar et al., 2021 ; Fragoso et al., 2021 ; Jovicevic et al., 2021 ; Lotan et al., 2021b , 2021a ). Thus, in the light of the ongoing global COVID-19 pandemic situation and the continuing need for vaccination, we aimed to evaluate the short-term risks of clinical relapse in the 90-day period after the first dose COVID-19 vaccine administration and COVID-19 infection as well as the safety profile of COVID-19 vaccines in patients with MS and NMOSD.…”

Safety profile of SARS-CoV-2 vaccination in patients with antibody-mediated CNS disorders

“…Our multicenter retrospective study shows that SARS-CoV-2 vaccination is safe in patients with neurological disorders associated with antibodies to neuronal and synaptic antigens since 1. vaccine-related side effects occur in about half of patients but are typically mild and showed a rate comparable with other autoimmune neurological conditions ( Dinoto et al, 2021 , Lotan et al, 2021 ); 2. post-vaccination relapses rarely occur in these conditions (7.6%); 3. post-vaccination relapses generally show a favorable outcome to immunotherapy.…”

“…The safety of SARS-CoV-2 vaccines has already been proven in some inflammatory and autoimmune CNS conditions including multiple sclerosis ( Di Filippo et al, 2021 ), aquaporin-4-IgG seropositive neuromyelitis optica, and myelin oligodendrocyte glycoprotein-IgG associated disease ( Dinoto et al, 2021 ).…”

Neuromyelitis optica complicating COVID vaccinations

“…It is well known that SARS-CoV-2 vaccinations can trigger relapses of NMOSD ( Cai et al, 2022 Feb ). In a study of 30 patients with aquaporin (AQP)-IgG positive NMOSD, one of 26 patients (4%) experienced a relapse within one month of the SARS-CoV-2 vaccination ( Dinoto et al, 2022 Feb ). Nonetheless, it was concluded that the potential benefits of SARS-CoV-2 vaccinations outweighs the risk of a NMOSD relapse ( Dinoto et al, 2022 Feb ).…”