“We know that patients on CD20 depleting treatment have a higher risk of a more severe Covid 19 course and that the humoral (antibody) immune response in these patients is reduced after vaccination, so there is probably reduced protection. Now, our data from Switzerland show that CD20-depleted patients who did not respond to the first two vaccinations hardly develop any antibodies even after the third vaccination. It may be that the infusion interval needs to be spread to improve the antibody response.”
Lutz Achtnichts, Barbara Jakopp,Michael Oberle ,Krassen Nedeltchev ,Christoph Andreas Fux ,Johann Sellner and Oliver Findling Humoral Immune Response after the Third SARS-CoV-2 mRNA Vaccination in CD20 Depleted People with Multiple Sclerosis. Vaccines 2021, 9(12), 1470; https://doi.org/10.3390/vaccines9121470,
CD20 depletion is a risk factor for unfavorable outcomes of COVID-19 in people with MS (pwMS). Evidence suggests that protective IgG response to mRNA-based vaccines in B cell-depleted individuals is limited. We studied the seroconversion after the third mRNA SARS-CoV-2 vaccine in B cell-depleted pwMS with limited or no IgG response after the standard immunization. Sixteen pwMS treated with ocrelizumab or rituximab received a third homologous SARS-CoV-2 mRNA vaccine, either the Moderna mRNA-1273 or Pfizer-BioNTech’s BNT162b2 vaccine. We quantified the response of IgG antibodies against the spike receptor-binding domain of SARS-CoV-2 four weeks later. An antibody titer of 100 AU/mL or more was considered clinically relevant. The median time between the last infusion of the anti-CD20 treatment and the third vaccination was 22.9 weeks (range 15.1–31.3). After the third vaccination, one out of 16 patients showed an IgG titer deemed clinically relevant. Only the seroconverted patient had measurable B-cell counts at the time of the third vaccination. The development of a humoral immune response remains rare in pwMS on anti-CD20 therapy, even after third dose of the homologous SARS-CoV-2 mRNA vaccine. It remains to be determined whether T-cell responses can compensate for the lack of seroconversion and provide sufficient protection against CoV-2 infections
This is the link: https://www.mdpi.com/2076-393X/9/12/1470
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Disclaimer: Disclaimer: Please note that the opinions expressed here are those of the author and do not reflect the positions of the Barts and The London School of Medicine and Dentistry nor Barts Health NHS Trust or Queen Mary Univeristy of London or the University of Basel