Safety and effectiveness of the booster dose of mRNA COVID-19 vaccines in people with multiple sclerosis: A monocentric experience

Bertozzi, Andrea; Mariottini, Alice; Marchi, Leonardo; Cristinzi, Maria Di; Nistri, R; Damato, Valentina; Mechi, Claudia; Barilaro, Alessandro; Massacesi, Luca; Repice, Anna Maria

doi:10.1016/j.msard.2023.104582

Cited by 7 publications

(3 citation statements)

References 28 publications

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“…Indeed, vaccinated patients in our cohort were considerably older than those who were not, similar to patients in the report by Grech et al, who found higher vaccine hesitancy in younger patients with MS and patients with unstable disease [29]. Another study from Italy observed an association between young age at vaccination and risk of COVID-19 infection [30]. Nonetheless, attitudes and behavioural characteristics also play an important role in influencing COVID-19 risk in countries with different social structures, such as Iran, where male gender and employment were identified as the main predictors of COVID-19 incidence [31].…”

Section: Discussionsupporting

confidence: 88%

Influence of Disease Modifying Treatment, Severe Acute Respiratory Syndrome Coronavirus 2 Variants and Vaccination on Coronavirus Disease 2019 Risk and Outcome in Multiple Sclerosis and Neuromyelitis Optica

Eisler,

Disanto,

Sacco

et al. 2023

JCM

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Patients suffering from neuro-inflammatory diseases such as multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD) remain vulnerable to COVID-19. We investigated the risk of COVID-19 in MS and NMOSD patients over time, considering the impact of disease-modifying treatments (DMTs), vaccinations, and the spread of new SARS-CoV-2 variants. We retrospectively collected clinical information regarding all MS and NMOSD consecutive patients seen at the Neurocenter of Southern Switzerland. Logistic regression was used to test variables (age, sex, vaccination status, DMT at vaccination, DMT at infection, disease course, disability scores, prevalent SARS-CoV-2 variant) for association with COVID-19 risk and severe outcome (hospitalization or death). We included 352 individuals in this study; 315 (89.5%) received ≥1 dose of SARS-CoV-2 mRNA-vaccine, and 134 (38.1%) experienced COVID-19 between March 2020 and August 2022. COVID-19 risk decreased in vaccinated patients (OR = 0.10, 95% CI = 0.05–0.20, p < 0.001) and increased in anti-CD20 therapies (OR = 2.26, 95% CI = 1.28–4.00, p = 0.005). Anti-CD20 treatment was associated with severe COVID-19 (OR = 27.41, 95% CI = 3.68–204.25, p = 0.001), whereas Omicron infections were milder compared to Alpha infections (OR = 0.03, 95% CI = 0.01–0.35, p = 0.006). We confirmed a protective effect of mRNA vaccines on COVID-19 risk, which is impaired by anti-CD20 treatment. We provided evidence for milder COVID-19 with the Omicron SARS-CoV-2 variant, which should not, however, discourage vaccinations.

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Section: Discussionsupporting

confidence: 88%

Influence of Disease Modifying Treatment, Severe Acute Respiratory Syndrome Coronavirus 2 Variants and Vaccination on Coronavirus Disease 2019 Risk and Outcome in Multiple Sclerosis and Neuromyelitis Optica

Eisler,

Disanto,

Sacco

et al. 2023

JCM

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“…The effectiveness of vaccination against COVID-19 in the prevention of severe disease in PwMS has been previously observed in various studies [51,52], although certain DMTs seem to reduce the effectiveness of vaccines. Since immunization with SARS -CoV-2 vaccines has been proven to be safe in PwMS [53,54], and the development of severe disease may trigger inflammatory activity and clinical deterioration of their neurological symptoms [13,52,55,56], vaccination against COVID-19 disease is recommended [35,37,38]. The impact of vaccination on mortality risk did not seem to be significant in this study, perhaps due to the small sample size.…”

Section: Discussionmentioning

confidence: 70%

COVID-19 Vaccination and Disease Course in People with Multiple Sclerosis in Greece

Bakirtzis,

Konstantinidou,

Stavropoulou De Lorenzo

et al. 2023

JCM

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Over the past three years, humanity faced the abrupt spread of COVID-19, responsible for a worldwide health crisis. Initially, it was believed that individuals with chronic disorders, including multiple sclerosis, were more likely to be infected and suffer a worse degree of COVID-19 disease. Therefore, data with regard to COVID-19 disease outcomes in these populations may provide additional insight with regard to the management of chronic diseases during viral pandemics. The objective of this study is to evaluate COVID-19 disease course in people with multiple sclerosis (PwMS) during the COVID-19 pandemic in Greece and explore the impact of vaccination in the outcome of SARS-CoV-2 infection in this population. Anonymized data, extracted from nationwide administrative records between February 2020 and December 2021, were retrospectively analyzed in order to identify PwMS with SARS-CoV-2 infection. Demographic data, as well as data regarding COVID-19 infection and vaccination, were additionally collected. The study sample included 2351 PwMS (65.1% females, 51.2% unvaccinated at the time of infection). A total of 260 PwMS were hospitalized, while 25 PwMS died from COVID-19 disease and its complications. Older age, male sex and the presence of comorbidities were independently associated with a higher probability of hospitalization. The risk of hospitalization was decreased in PwMS receiving some disease-modifying treatments. Anti-CD20s demonstrated high odds ratios without reaching statistical significance. Regarding fatal outcome, only age reached statistical significance. Vaccination provided a significant protective effect against hospitalization but did not exhibit a statistically significant effect on mortality.

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“…Notably, none of these studies compared the incidence of relapses prior to and after vaccination. Regarding the long-term safety assessment of the booster dose of anti-SARS-CoV-2 vaccines, in a monocentric Italian study on a cohort of 114 pwMS with a median follow-up of 6 months post-booster dose, MS relapses were observed in four cases (3.5%), two of which occurring within 8 weeks after the booster dose (1.7%) [ 32 ]. However, it's important to highlight that the absence of a control population makes it challenging to draw definitive conclusions from these data.…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 vaccination and multiple sclerosis: a large multicentric study on relapse risk after the third booster dose

Di Filippo,

Ferraro,

Ragonese

et al. 2023

J Neurol

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Background COVID-19 vaccines have been recommended to people with multiple sclerosis (pwMS) and, to ensure durable immunity, a third booster dose has been administered in several countries. Data about potential risks associated with the third booster dose in pwMS, such as vaccine-triggered disease exacerbations, are still scarce. Objective To investigate whether the administration of a third booster dose of mRNA COVID-19 vaccines was associated with an increased risk of short-term disease reactivation in a large cohort of pwMS. Methods We retrospectively selected 1265 pwMS who received a third booster dose of an mRNA COVID-19 vaccine. Demographic and clinical data were collected, including the presence, number and characteristics of relapses in the 60 days prior to and after the third booster dose. Results In the selected cohort, the relapse rate in the two months after administration of the third booster dose of mRNA COVID-19 vaccines did not increase when compared with the prior two months. Indeed, the percentage of pwMS experiencing relapses in the 60 days following the administration of the third booster dose was 2.1%, similar to the percentage recorded in 60 days prior to vaccination, which was 1.9%. Conclusions The third booster dose of mRNA COVID-19 vaccines appeared to be safe for pwMS.

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Safety and effectiveness of the booster dose of mRNA COVID-19 vaccines in people with multiple sclerosis: A monocentric experience

Cited by 7 publications

References 28 publications

Influence of Disease Modifying Treatment, Severe Acute Respiratory Syndrome Coronavirus 2 Variants and Vaccination on Coronavirus Disease 2019 Risk and Outcome in Multiple Sclerosis and Neuromyelitis Optica

Influence of Disease Modifying Treatment, Severe Acute Respiratory Syndrome Coronavirus 2 Variants and Vaccination on Coronavirus Disease 2019 Risk and Outcome in Multiple Sclerosis and Neuromyelitis Optica

COVID-19 Vaccination and Disease Course in People with Multiple Sclerosis in Greece

SARS-CoV-2 vaccination and multiple sclerosis: a large multicentric study on relapse risk after the third booster dose

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