#MSCOVID19-Oldies Respond to vaccine..Good news for MS

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The race is on for a vaccine for the general public. The USA has COVID Operation Warp speed. However, they have lost the race, just as they came second in the Space Race…..Yuri Gagarin beat NASA to be the first person in Space and the Russians beat the World with the first satellite…..Sputnik.

The World's First Artificial Satellite

The Russians already have a vaccine that they have licenced. They have called it Sputnik V. It hasn’t had the proper phase III testing that is required elsewhere, but I guess the Russian government think “Hey…It’s only our citizens”. However, the Chinese will say on this race…”We were first with Ad5-nCoV” which has been approved for use by the military personnel. I guess they say “It’s only our citizens”….We wouldn’t want to be susceptible to COVID-19, if it was used in Germ Warfare:-)

Sputnik V vaccine consists of two adenovirus molecules that produce SARS-CoV-2 Spike protein. They are different virus adenovirus molecules so that you won’t get an infusion reaction due to immunity to the first adenovirus, when you boost with the second one and hopefully all you do is boost the antibody response to Spike.

The Oxford vaccine is also an adenovirus, but theirs is from a chimpanzee.

However the bad news for people with MS is that live vaccines are contra-indicated, especially if you are on a disease modifying treatment.

So you may have to wait for a non-live vaccine.

Here the Amercians are saying Charge” …..no not cash for the vaccine but “Tally Ho” as they race for the prize of being the first RNA vaccine. The real “Charge comes later:-). This codes for Spike protein so the RNA is made into protein and then you make an antibody response against it. Big question is, will the rest of the World get it? Given the past history of US drugs for US citizens. I guess they say “It’s only for our citizens:-)”. So there is a plan B. In the UK, Imperial (AKA Collonial) College are making a RNA vaccine, but it is a bit behind the US. Britain isn’t known for being in the Space race…and remember the Mars Landing:-(.

Vaccine Tracker

Any way older people have been given the vaccine and they produce antibodies. Will this be enough and importantly will it be for long enough?

It’s a start

To work out if the vaccine tests are working, you need a quantiative read-out…Some of the current commercial tests are rubbish for this

Safety and Immunogenicity of SARS-CoV-2 mRNA-1273 Vaccine in Older Adults. Andersson et al. N Eng J Med

BACKGROUND. Testing of vaccine candidates to prevent infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in an older population is important, since increased incidences of illness and death from coronavirus disease 2019 (Covid-19) have been associated with an older age.

METHODS.We conducted a phase 1, dose-escalation, open-label trial of a messenger RNA vaccine, mRNA-1273, which encodes the stabilized prefusion SARS-CoV-2 spike protein (S-2P) in healthy adults. The trial was expanded to include 40 older adults, who were stratified according to age (56 to 70 years or ≥71 years). All the participants were assigned sequentially to receive two doses of either 25 μg or 100 μg of vaccine administered 28 days apart.

RESULTS. Solicited adverse events were predominantly mild or moderate in severity and most frequently included fatigue, chills, headache, myalgia, and pain at the injection site. Such adverse events were dose-dependent and were more common after the second immunization. Binding-antibody responses increased rapidly after the first immunization. By day 57, among the participants who received the 25-μg dose, the anti–S-2P geometric mean titer (GMT) was 323,945 among those between the ages of 56 and 70 years and 1,128,391 among those who were 71 years of age or older; among the participants who received the 100-μg dose, the GMT in the two age subgroups was 1,183,066 and 3,638,522, respectively. After the second immunization, serum neutralizing activity was detected in all the participants by multiple methods. Binding- and neutralizing-antibody responses appeared to be similar to those previously reported among vaccine recipients between the ages of 18 and 55 years and were above the median of a panel of controls who had donated convalescent serum. The vaccine elicited a strong CD4 cytokine response involving type 1 helper T cells.

CONCLUSIONS.In this small study involving older adults, adverse events associated with the mRNA-1273 vaccine were mainly mild or moderate. The 100-μg dose induced higher binding- and neutralizing-antibody titers than the 25-μg dose, which supports the use of the 100-μg dose in a phase 3 vaccine trial.

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MouseDoctor

2 comments

  • I guess I am a bit skeptical of the contraindication of live vaccines for people w/ MS (with the exception of a few DMTs). If you are on an injectable or some of the oral pills and you have a normal white blood cell count or it is only mildly reduced, not sure what the big deal is? DMTs seems to have decoupled the association between the most common URI and relapse. Injected vaccines also stimulate an immune response. If you can handle a cold, not sure why you can’t handle an attenuated live vaccine.

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