SARS-CoV-2 serology among people with multiple sclerosis on disease-modifying therapies after BBIBP-CorV (Sinopharm) inactivated virus vaccination: Same story, different vaccine

Etemadifar, Masoud; Sedaghat, Nahad; Nouri, Hosein; Lotfi, Noushin; Chitsaz, Ahmad; Khorvash, Reza; Zolfaghari, Hamed; Pourabbas, Mohammad; Salari, Mehri

doi:10.1016/j.msard.2021.103417

Cited by 19 publications

(14 citation statements)

References 26 publications

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“…Bar On et al 2021a and Bar On et al 2021b, confirmed that individuals older than 16, who were administered a Pfizer/BioNTech booster dose had reduced chance of infection and less severe illness, compared to those without a booster dose ( 35 , 36 ). Furthermore, in agreement with our findings, others studies have also shown that individuals with comorbidities, such as Type 2 diabetes, cancer, end-stage renal disease and other immunocompromising conditions, had reduced levels of SARS-CoV-2 antibodies titers after vaccination, when compared to healthy individuals ( 37 – 40 ).…”

Section: Discussionsupporting

confidence: 93%

The Effect of Age, Gender and Comorbidities Upon SARS-CoV-2 Spike Antibody Induction After Two Doses of Sinopharm Vaccine and the Effect of a Pfizer/BioNtech Booster Vaccine

Farid

Herrera-Uribe²,

Stevenson³

2022

Front. Immunol.

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Severe acute respiratory syndrome coronavirus (SARS-CoV)-2 emerged in China in 2019 and has since travelled the world infecting millions. SARS-CoV-2 causes Corona Virus Disease (COVID-19), that has to date taken over 4 million lives. The Kingdom of Bahrain’s vaccine roll-out has consisted of Sinopharm’s BBIBP-CorV (Sinopharm) and Pfizer/BioNtech’s BNT162b2 (Pfizer/BioNtech). Testing for SARS-CoV-2 anti-Spike (S) antibodies is a useful technique in estimating an individual’s immune protection against the infection. In this study we evaluated S antibody levels by electro-chemiluminescence immunoassay in 379 individuals double vaccinated with Sinopharm and 15 of whom were given a booster with the Pfizer/BioNtech vaccine. Among our double vaccinated cohort, we found a spectrum of S antibody levels. Indeed, we found that a significant proportion of individuals with low S antibody levels had clinical conditions, which were mainly immune-related disorders. Furthermore, a significant proportion of individuals with low S antibody levels were above 50 years of age. Finally, we observed a significant increase in S antibody levels after the Pfizer/BioNtech booster was administered. These findings reveal that while a large proportion of Sinopharm vaccinated individuals did not develop high levels of antibodies against the S protein, a booster dose of the Pfizer/BioNtech vaccine significantly enhances S antibody levels, revealing this “triple dose” vaccination strategy as a useful method of ensuring protective immunity against SARS-CoV-2.

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Section: Discussionsupporting

confidence: 93%

The Effect of Age, Gender and Comorbidities Upon SARS-CoV-2 Spike Antibody Induction After Two Doses of Sinopharm Vaccine and the Effect of a Pfizer/BioNtech Booster Vaccine

Farid

Herrera-Uribe²,

Stevenson³

2022

Front. Immunol.

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“…The prior SARS-CoV-2 infection and the low-dose regimen of rituximab both might have played a role in the observed seroconversion. As most people on anti-CD20 therapies fail to elicit humoral immunization following both COVID-19 contraction and vaccination, 7 , 8 similar to another presented case, 9 this case may be interpreted as a highlight of the importance of booster doses of COVID-19 vaccines among these patients.…”

Section: Discussion and Review Of Literaturesupporting

confidence: 68%

Detection of anti-NMDA receptor antibodies following BBIBP-CorV COVID-19 vaccination in a rituximab-treated person with multiple sclerosis presenting with manifestations of an acute relapse

Etemadifar

Nouri

Salari

et al. 2022

Human Vaccines & Immunotherapeutics

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Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a relatively unknown autoimmune entity. Scant reports of post-infection/vaccination anti-NMDAR encephalitis exist. We, hereby, reviewed the relevant cases and added to the literature a possible case of anti-NMDAR encephalitis following COVID-19 vaccination with BBIBP-CorV (Sinopharm). A 50-year-old Persian woman with previously known rituximab-treated MS presented complaining of worsening neurological symptoms all gradually starting and worsening after receiving the second dose of BBVIP-CorV 2 weeks before. Notable findings in her physical examination included ataxic gait and Babinski sign. Considering an acute MS relapse, corticosteroid pulse therapy was initiated, and she was referred for MRI, which revealed multiple new plaques. Her serum sample interestingly tested positive for anti-NMDAR antibodies. CSF analysis was unfortunately not performed. She responded well to the corticosteroid pulse therapy and showed substantial resolution of the symptoms. Considering its relatively low cost of workup and the benefits of correct early diagnosis, clinicians are advised to consider autoimmune encephalitis encountering patients with progressive neurological symptoms after the administration of vaccines, including the ones for COVID-19 which are currently being used extensively.

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“…Evidence suggests with moderate certainty that glatiramer acetate (GA) does not affect the odds of post-vaccination seroconversion (OR (95% CI): 0.87 (0.31 to 2.42), p=0.79) (online supplemental figure 2). GA-treated pwMS who remained seronegative after vaccination were only present in two studies15 16 and all received inactivated vaccination; however, their postvaccination antibody concentrations were similar with UX people in those studies.…”

Section: Resultsmentioning

confidence: 92%

“…S1PRM extensively decrease the odds of post-vaccine seroconversion (OR (95% CI): 0.04 (0.03 to 0.06), p<0.00001) (online supplemental figure 5), according to evidence with high certainty. In all of the included studies,10 11 13–16 19–25 the S1PRM-treated pwMS had significantly lower concentrations of post-vaccine antibodies when compared with UX people; the effect measures were, however, heterogenous. Therefore, evidence indicates with moderate certainty that pwMS on S1PRM are 25 times (95% CI: 16.66 to 33.33) less likely to show anti-S1, and 8.33 times (95% CI: 3.70 to 20) less likely to show anti-S seroconversion following COVID-19 vaccination (χ 2 =7.24, p<0.01).…”

Section: Resultsmentioning

confidence: 97%

Multiple sclerosis disease-modifying therapies and COVID-19 vaccines: a practical review and meta-analysis

Etemadifar

Nouri

Pitzalis

et al. 2022

J Neurol Neurosurg Psychiatry

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Studies among people with multiple sclerosis (pwMS) receiving disease-modifying therapies (DMTs) have provided adequate evidence for an appraisal of COVID-19 vaccination policies among them. To synthesise the available evidence addressing the effect of MS DMTs on COVID-19 vaccines’ immunogenicity and effectiveness, following the Cochrane guidelines, we systematically reviewed all observational studies available in MEDLINE, Scopus, Web of Science, MedRxiv and Google Scholar from January 2021 to January 2022 and extracted their relevant data. Immunogenicity data were then synthesised in a quantitative, and other data in a qualitative manner. Evidence from 28 studies suggests extensively lower B-cell responses in sphingosine-1-phosphate receptor modulator (S1PRM) treated and anti-CD20 (aCD20) treated, and lower T-cell responses in interferon-treated, S1PRM-treated and cladribine-treated pwMS—although most T cell evidence currently comprises of low or very low certainty. With every 10-week increase in aCD20-to-vaccine period, a 1.94-fold (95% CI 1.57 to 2.41, p<0.00001) increase in the odds of seroconversion was observed. Furthermore, the evidence points out that B-cell-depleting therapies may accelerate postvaccination humoral waning, and boosters’ immunogenicity is predictable with the same factors affecting the initial vaccination cycle. Four real-world studies further indicate that the comparative incidence/severity of breakthrough COVID-19 has been higher among the pwMS treated with S1PRM and aCD20—unlike the ones treated with other DMTs. S1PRM and aCD20 therapies were the only DMTs reducing the real-world effectiveness of COVID-19 vaccination among pwMS. Hence, it could be concluded that optimisation of humoral immunogenicity and ensuring its durability are the necessities of an effective COVID-19 vaccination policy among pwMS who receive DMTs.

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SARS-CoV-2 serology among people with multiple sclerosis on disease-modifying therapies after BBIBP-CorV (Sinopharm) inactivated virus vaccination: Same story, different vaccine

Cited by 19 publications

References 26 publications

The Effect of Age, Gender and Comorbidities Upon SARS-CoV-2 Spike Antibody Induction After Two Doses of Sinopharm Vaccine and the Effect of a Pfizer/BioNtech Booster Vaccine

The Effect of Age, Gender and Comorbidities Upon SARS-CoV-2 Spike Antibody Induction After Two Doses of Sinopharm Vaccine and the Effect of a Pfizer/BioNtech Booster Vaccine

Detection of anti-NMDA receptor antibodies following BBIBP-CorV COVID-19 vaccination in a rituximab-treated person with multiple sclerosis presenting with manifestations of an acute relapse

Multiple sclerosis disease-modifying therapies and COVID-19 vaccines: a practical review and meta-analysis

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