COVID-19 vaccination in patients with multiple sclerosis: Safety and humoral efficacy of the third booster dose

Sapir Dreyer-Alster; Shay Menascu; Mathilda Mandel; Emanuel Shirbint; David Magalashvili; Mark Dolev; Shlomo Flechter; Uri Givon; Diana Guber; Yael Stern; Shmuel Miron; Michael Polliack; Rina Falb; Polina Sonis; Michael Gurevich; Anat Achiron

doi:10.1016/j.jns.2022.120155

Sapir Dreyer-Alster, Shay Menascu, Mathilda Mandel, Emanuel Shirbint ^iD, David Magalashvili, Mark Dolev, Shlomo Flechter, Uri Givon, Diana Guber, Yael Stern, Shmuel Miron, Michael Polliack, Rina Falb, Polina Sonis, Michael Gurevich, Anat Achiron

Abstract

Background As immunity against SARS-COV-2 wanes following first and second doses of vaccination, a third dose is administered in several countries around the world. Similarly to the first doses, risks related to vaccination and humoral immune response in patients with multiple sclerosis (MS) need to be assessed. Objective Characterize safety and humoral immune response following the third dose of COVID-19 vaccination in a large cohort of MS patients. Methods We assessed the safety of the third dose of the BNT162b2-COVID-19 mRNA vaccination in adult MS patients and evaluated SARS-CoV-2 IgG response. Results Two hundred and eleven adult MS patients received a third dose of BNT162b2 COVID-19 vaccination. Median follow up time was 66 days from vaccine administration (IQR 54-84). The frequency of any adverse event was 54.5%, with the most common reported adverse events being fatigue, local pain at the injection site, fever and muscle or joint pain. Transient increase in MS symptoms was reported in 3.8% of patients, none of them requiring treatment. The rate of acute relapses treated with IV steroids was 3.3%. In a sub-group of 55 patients, 20 untreated and 35 treated with vaccination-safe disease-modifying treatments, SARS-CoV-2 IgG levels increased 21-fold (median ± SD 21.6 ± 53.05). Conclusions The third dose of COVID-19-BNT162b2 vaccine proved safe for MS patients, with no increased risk of relapse activity. Untreated patients and patients treated with vaccination-safe disease-modifying treatments show significant increase in SARS-CoV-2 IgG levels following the third dose of vaccination.

Keywords — multiple sclerosis, COVID-19, vaccination, immune response, third booster dose

1.Research problem

As immunity against SARS-CoV-2 wanes, risks and humoral response related to a third vaccine dose in multiple sclerosis patients need to be assessed.

2.Contribution

Safety and SARS-CoV-2 IgG response characterised after a third BNT162b2 dose in 211 adult MS patients.

3.Architecture, methodology & evidence status

Evidence & statusThis is a peer-reviewed journal article published in Journal of the Neurological Sciences (2022). The full text and record of version are held by the publisher; this page is an archival record with a link to the official version.

The abstract above is the authoritative summary of the work as posted at the official source. This archival record does not add results, figures or claims beyond those in the published/posted manuscript. For the complete methodology, results and references, consult the official record.

4.Related research

Part of the series Clinical AI and Multiple Sclerosis Research.

5.How to cite

Choose a format below. BibTeX and RIS files are also downloadable directly.

Dreyer-Alster, S., Menascu, S., Mandel, M., Shirbint, E., Magalashvili, D., Dolev, M., Flechter, S., Givon, U., Guber, D., Stern, Y., Miron, S., Polliack, M., Falb, R., Sonis, P., Gurevich, M., & Achiron, A. (2022). COVID-19 vaccination in patients with multiple sclerosis: Safety and humoral efficacy of the third booster dose. Journal of the Neurological Sciences. https://doi.org/10.1016/j.jns.2022.120155

Sapir Dreyer-Alster, Shay Menascu, Mathilda Mandel, Emanuel Shirbint, David Magalashvili, Mark Dolev, Shlomo Flechter, et al. 2022. “COVID-19 vaccination in patients with multiple sclerosis: Safety and humoral efficacy of the third booster dose.” Journal of the Neurological Sciences. https://doi.org/10.1016/j.jns.2022.120155.

@article{shirbint2022msthirdbooster,
  title = {COVID-19 vaccination in patients with multiple sclerosis: Safety and humoral efficacy of the third booster dose},
  author = {Sapir Dreyer-Alster and Shay Menascu and Mathilda Mandel and Emanuel Shirbint and David Magalashvili and Mark Dolev and Shlomo Flechter and Uri Givon and Diana Guber and Yael Stern and Shmuel Miron and Michael Polliack and Rina Falb and Polina Sonis and Michael Gurevich and Anat Achiron},
  year = {2022},
  doi = {10.1016/j.jns.2022.120155},
  url = {https://doi.org/10.1016/j.jns.2022.120155},
  note = {Peer-reviewed journal article}
}

TY  - JOUR
AU  - Sapir Dreyer-Alster
AU  - Shay Menascu
AU  - Mathilda Mandel
AU  - Emanuel Shirbint
AU  - David Magalashvili
AU  - Mark Dolev
AU  - Shlomo Flechter
AU  - Uri Givon
AU  - Diana Guber
AU  - Yael Stern
AU  - Shmuel Miron
AU  - Michael Polliack
AU  - Rina Falb
AU  - Polina Sonis
AU  - Michael Gurevich
AU  - Anat Achiron
TI  - COVID-19 vaccination in patients with multiple sclerosis: Safety and humoral efficacy of the third booster dose
PY  - 2022
DO  - 10.1016/j.jns.2022.120155
UR  - https://doi.org/10.1016/j.jns.2022.120155
N1  - Peer-reviewed journal article
ER  -

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