COVID-19 and MS:

C

Having just got back from Coventry after an exforced exile for putting my mouth where silence should be. I have to be a bit more careful with what I say, as “I must not ruffle any more feathers“, Yes “I must not ruffle any more feathers”. I am on double secret probation. So I am happy to say I won’t be making certain posts on stuff that simply winds me up. Yep the balance may go but I will make an effort to not say “It is rubbish…throw it in the bin”

There have been a sea of COVID-19 papers, some people get themselves together to proclaim themselves experts….but what makes you an expert? You have written a few COVID-19 papers? You have had a few papers written for you by some medical writer and plonked on an ECTRIMS stage? ….Oops” “I must not ruffle any more feathers”..but if you don’t read the stuff, the things you write are out of date before it arrives. Each week, I sit though expert COVID-19 lectures and think all you are telling me is stuff I already know. I can read too. Importantly I have read more than you….Maybe I should be more self-assertive and write “expert review in big letters” on my next paper…but I’m too modest.

Actually as a disclaimer….I did not lauch this post, but it was a nudge by the gatekeeper to get back in the ring. It was not quite finished at the time of posting. There have now been 124,000 published papers in a year compared to 94,000 papers in MS. There are many more pre-prints and this is where the gold dust is lurking. You don’t need to speculate on what may or may not happen, the data is there. So, as for experts there are thousands of COVID experts. We will see a number of papers recommending vaccination schedules based on hypothetical data, but if you dig a bit deeper the data is there and these papers are going to be out of date, before they even surface. Some are going to prove that you have or haven’t quite got it right.

Data has already surfaced of vaccine responses in B cell depleted individuals and these authors are now the experts as they know something that the rest of us don’t. Get a gaggle of geese together to give a consensus and remember you can get a camel when you design a horse, or you can get common sense.

However, congrats to Israel for getting their SH1 together. Their data is surfacing and says do not worry too much about getting the Jab.

COVID-19 vaccination in patients with multiple sclerosis: What we have learnt by February 2021.Achiron A, Dolev M, Menascu S, Zohar DN, Dreyer-Alster S, Miron S, Shirbint E, Magalashvili D, Flechter S, Givon U, Guber D, Stern Y, Polliack M, Falb R, Gurevich M.Mult Scler. 2021 Apr 15:13524585211003476. doi: 10.1177/13524585211003476.

Background: Since vaccination against coronavirus disease 2019 (COVID-19) became available, risks related to vaccinating patients with multiple sclerosis (MS) need to be carefully assessed.

Objective: Characterize safety and occurrence of immediate relapses following COVID-19 vaccination in a large cohort of MS patients.

Methods: We assessed the safety of BNT162b2 COVID-19 vaccination in adult MS patients.

Results: Between 20 December 2020 and 25 January 2021, 555 MS patients received the first dose of BNT162b2 vaccine and 435 received the second dose. There were three cases of COVID-19 infection encountered after the first dose. Safety profile of COVID-19 vaccine was characterized by pain at the injection site, fatigue, and headache. No increased risk of relapse activity was noted over a median follow-up of 20 and 38 days after first and second vaccine doses, respectively. The rate of patients with acute relapse was 2.1% and 1.6% following the first and second doses, respectively, similar to the rate in non-vaccinating patients during the corresponding period. Mild increase in the rate of adverse events was noted in younger patients (18-55 years), among patients with lower disability (Expanded Disability Status Scale (EDSS) ⩽3.0), and in patients treated with immunomodulatory drugs.

Conclusion: COVID-19 BNT162b2 vaccine proved safe for MS patients. No increased risk of relapse activity was noted.

Not quite 500 but so as you are aware

Allen-Philbey K, Stennett A, Begum T, Johnson AC, Dobson R, Giovannoni G, Gnanapavan S, Marta M, Smets I, Turner BP, Baker D, Mathews, Schmierer K. Experience with Oxford AstraZeneca vaccination against SARS-CoV2 in people with multiple sclerosis: Preprint

Background: Some people with multiple sclerosis (pwMS) are at increased risk of severe
Coronavirus disease 19 (COVID-19). Use of the ChAdOx1nCoV-19 (Oxford AstraZeneca, OAZ)
vaccine in immunosuppressed individuals has been controversial.
Objectives: To report early experience of pwMS receiving OAZ vaccination.
Methods: pwMS using the service at Barts Health NHS Trust were sent questionnaires to
report symptoms following vaccination.
Results: Thirty-three responses were returned, 29/33 pwMS received the OAZ vaccination.
Side-effects were common and short-lived. No severe adverse effects occurred.
Conclusions: PwMS report transient symptoms following OAZ vaccination; which are in part
explained by Uhthoff’s phenomenon.

So the expert consenus so far is that vaccination is relatively safe and there are more risks form not having them.

About the author

MouseDoctor

39 comments

    • I always say
      Ex is someone who used to be and
      Spurt is a drip under pressure.
      Similar, but either way not someone to be intimidated by.
      And welcome back MD! 😀

  • MD have you read this paper? What do you think of it?

    Centonze D, Rocca MA, Gasperini C, Kappos L, Hartung HP, Magyari M, Oreja-Guevara C, Trojano M, Wiendl H, Filippi M. Disease-modifying therapies and SARS-CoV-2 vaccination in multiple sclerosis: an expert consensus. J Neurol. 2021 Apr 12:1–8. doi: 10.1007/s00415-021-10545-2. Epub ahead of print. PMID: 33844056; PMCID: PMC8038920.

      • Managing multiple sclerosis in the Covid19 era: a review of the literature and consensus report from a panel of experts in Saudi Arabia.
        Al Jumah M, Abulaban A, Aggad H, Al Bunyan R, AlKhawajah M, Al Malik Y, Almejally M, Alnajashi H, Alshamrani F, Bohlega S, Cupler EJ, ElBoghdady A, Makkawi S, Qureshi S, Shami S.
        Mult Scler Relat Disord. 2021 Mar 25;51:102925.

        Didnt read this either but on glance of the abstact one asked is the advice correct given we have seen the effect of 40-50 peoplevaccinated already

  • Yay! MD’s back!! I would stop following BartsMS if there is no MD plus ProfG kept posting and posting…

    • Unfortunately, there are some very fragile egos out there, so unfiltered 100% honest opinion is off the menu 🙁

      • As an old guy I have noticed that accepting criticism has been lost. I don’t know if this is a by-product of our connected world or social media but we have become much more thin-skinned. Remember criticism can be constructive.

    • No but I will try, I have a big supply from a year of online shopping. Who can resist about of bubble popping?

      • Lol. Yeah, ego pruning in academia isn’t advised. Remember, “when they discover the centre of the universe, a lot of people will be disappointed to discover they are not in it”. – Bernard Bailey.

        Welcome back! Try and ignore the schoolyard bullies.

  • Oh Big Smiley Moment = MD is back! 😀
    May you share your knowledge and opinions with us as openly and ably as ever!
    If you have to be careful due to the easily offended then let them be aware of there being more than a mere handful of your supportive admirers.

  • I’m nothing but grateful for this blog and all who contribute to it.
    None more than Mouse MD.
    Anyone who has had MS for awhile, or made a career of studying this dreadful disease
    and has NOT expressed any anger or frustration hasn’t been paying attention.
    Please,
    Please,
    Rage on Mr. Mouse!

  • “I can be changed by what happens to me. But I refuse to be reduced by it.” — Maya Angelou

    We missed you MD!!! Keep fighting to change the status quo in the world of MS research. As they say in my profession…….if you are not ruffling a few feathers, then you are not doing your job. Glad to see they did not beat the humor out of you during your brief exile to the island of Elba.

  • Hi MD, welcome back & please, please do not become one of these people that has to filter everything with fear of offending. The egos can take it & if not they should toughen up & understand that we are all entitled to our own opinions, along with honest information, whether it ruffle our feathers or not! To critique something, is to give your honest opinion – not let them make a fool of themselves on stage or be part of the misinformation culture.

    We morn HRH Prince Philip this week & the reason why most people are doing this – is because, he spoke his mind, showed his human side & tried to make people laugh (sometimes inappropriately granted!) – but also, much forgotten, all the great & good things he did for the UK & Commonwealth. He fought for this country, enabled prisoners of war to be emancipated – the list goes on of all the charities & green spaces we so enjoy everyday. I’m not a royalist – so I’ll stop going on & I know his straight-forward thinking & the no nonsense type of man – will be greatly missed and we all hope moving forward that more men and women in the spotlight, continue his great work & style (with a bit more good ol’ fashion banter & compassion!)

    If you can – carry on regardless, just fluff it up a bit for those that need to toughen up a bit 🙂 Their egos will heal 🙂

    PS – Can you obtain an antibody test to find out if you’ve developed any antibodies, if you’re on a DMT such as ocrelizumab & vaccine 1/2 doses down the line? Otherwise you could be putting yourself at risk – if you start going out and about.

  • Perfection is elusive. We have all said and written some things which were not perfectly framed and were offensive without ever intending offense. Personally, I and many, many others find plainspokenness desirable and helpful. Information and opinion, like ore, must be processed for value but that task is greatly improved minus the overburden created making certain there is no possibility of offending anyone.

    BTW, perfection was worded by FI… April 15, 2021 at 1:55 pm
    “Oh Big Smiley Moment = MD is back! 😀
    May you share your knowledge and opinions with us as openly and ably as ever!
    If you have to be careful due to the easily offended then let them be aware of there being more than a mere handful of your supportive admirers.”

      • Ouch! When I was stationed at RAF Fairfield I read the local news paper and watched the British news, it seem to me like you have freedom of speech. Hundreds of protestors outside the base and they were cursing, throwing shit, and spiting on us the whole time. Looked pretty free to me. And what is the deal with warm beer?!?

          • In the US first amendment rights are exercised quite liberally but the Daily Mail and those in the UK apparently may not always exercise speech as freely, unfortunately. The Daily Mail lawsuit by the Trumps was laughable to anyone with an internet connection. God and Stormy Daniels know Melania and Donald have never had anything to do with porn or porn stars! I just googled Melania Trump porn and viewed Melania topless and naked suggestively embracing other women. Whether one views that as porn or not is personal viewpoint but can you imagine the press if Michele Obama or Jill Biden had “porn” photos available to anyone with internet? Heads would be poppin’ in certain circles and oh, the moral indignation! How scandalous! My guess is that Melania was proud enough of her porn past but Donald filed the Daily Mail lawsuit as an opportunity to recover the $160k he admits (depending on the day) paying another porn worker, Stormy Daniels, when Melania was with their newborn.
            No, people don’t always enjoy or agree with what is said but that is the only way truth surfaces, that spiritual force the universe compels. To be sure, people can be offensive but truth is downright brutal. Those struggling with MS want the truth no matter how brutal. Anything else is indecent and immoral; porn, if you will, a distraction not medically relevant. Melania physically bared all for money, surely we can intellectually for the good of humanity.

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