#MSCOVID19 vaccines 6 months on

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This the follow-up from Israel on the Vaccine study looking at 6 month follow-up ocrelizumab and fingolimod never got going maybe there is a drop with other DMT around 6 months and supports the view that boosters should be taken to boost protective antibody levels.

Fig. 1

Achiron A, Mandel M, Dreyer-Alster S, Harari G, Dolev M, Menascu S, Magalashvili D, Flechter S, Givon U, Guber D, Sonis P, Zilkha-Falb R, Gurevich M. Humoral immune response in multiple sclerosis patients following PfizerBNT162b2 COVID19 vaccination: Up to 6 months cross-sectional study. J Neuroimmunol. 2021 Oct 9;361:577746.

Appropriate immune response following COVID-19 vaccination is important in the context of disease-modifying treatments (DMTs). In a prospective cross-sectional study, we determined SARS-COV-2 IgG response up to 6 months following PfizerBNT162b2 vaccination in 414 multiple sclerosis (MS) patients and 89 healthy subjects. Protective response was demonstrated in untreated MS patients (N = 76, 100%), treated with Cladribine (N = 48, 100%), Dimethyl fumarate (N = 35, 100%), Natalizumab (N = 32, 100%), and Teriflunomide (N = 39, 100%), similarly to healthy subjects (N = 89, 97.8%). Response was decreased in Fingolimod (N = 42, 9.5%), Ocrelizumab (N = 114, 22.8%) and Alemtuzumab (N = 22, 86.4%) treated patients. IgG response can help tailor adequate vaccine guidelines for MS patients under various DMTs.

UK reported Outcomes from COVID-19

Your risks are similar to the risks in the general population

Middleton RM, Craig EM, Rodgers WJ, Tuite-Dalton K, Garjani A, Evangelou N, das Nair R, Hunter R, Tallantyre EC, Cauchi M, Cairn C, Paling D, Fuller S, McDonnell G, Petheram K, Liu B, Nock U, Ingram G, Brownlee W, Taylor J, Nicholas R; UK Multiple Sclerosis Register Research Group. COVID-19 in Multiple Sclerosis: Clinically reported outcomes from the UK Multiple Sclerosis Register. Mult Scler Relat Disord. 2021 Oct 8;56:103317.

Background: In March 2020, the United Kingdom Multiple Sclerosis Register (UKMSR) established an electronic case return form, designed collaboratively by MS neurologists, to record data about COVID-19 infections in people with MS (pwMS).

Objectives: Examine how hospital admission and mortality are affected by disability, age and disease modifying treatments (DMTs) in people with Multiple Sclerosis with COVID-19.

Methods: Anonymised data were submitted by clinical teams. Regression models were tested for predictors of hospitalisation and mortality outcomes. Separate analyzes compared the first and second ‘waves’ of the pandemic.

Results: Hospitalisation and mortality were associated with increasing age, male gender, comorbidities, severe disability, and progressive MS; severe disability showed the highest magnitude of association. Being on a DMT was associated with a small, lower risk. Multivariable analysis found only age and male gender were significant. Post hoc analysis demonstrated that factors were significant for hospitalisation but not mortality. In the second wave, hospitalisation and mortality were lower. Separate models of the first and second wave using age and gender found they had a more important role in the second wave.

Conclusions: Features associated with poor outcome in COVID-19 are similar to other populations and being on a DMT was not found to be associated with adverse outcomes, consistent with smaller studies. Once in hospital, no factors were predictive of mortality. Reassuringly, mortality appears lower in the second wave.

General Disclaimer: Please note that the opinions expressed here are those of the author and do not necessarily reflect the positions of the Barts and The London School of Medicine and Dentistry nor Barts Health NHS Trust and are not meant to be interpreted as personal clinical advice.

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MouseDoctor

4 comments

  • Is there any information on immune response after a third jab? I am on Fingolimod, had two Pfizer jabs (2nd one 5 months ago) and am scheduled for a third with Moderna next week. Are there any issues with getting Moderna after Pfizer?

    • No information on fingolimod and third jab…Moderna is likely to give you the best chance of making a response

      • I managed to get Moderna for the third jab and it paid off. Just got the results from the antibody test and while not spectacular it firmly pushed me over the threshold and I can now say I have antibodies. Thanks for all the information on this blog! Greatly appreciated and making a big difference!

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