COVID-19 Vaccination in Multiple Sclerosis and Inflammatory Diseases: Effects from Disease-Modifying Therapy, Long-Term Seroprevalence and Breakthrough Infections
Background: To determine the effect of disease-modifying therapies (DMT) on humoral postvaccine seroconversion, long-term humoral response, and breakthrough COVID-19 infections in persons with multiple sclerosis (PwMS) and other neuroinflammatory disorders. Methods: A total of 757 PwMS and other neu...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-04-01
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| Series: | Vaccines |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2076-393X/10/5/695 |
| _version_ | 1827666063081340928 |
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| author | Dejan Jakimovski Karen Zakalik Samreen Awan Katelyn S. Kavak Penny Pennington David Hojnacki Channa Kolb Alexis A. Lizarraga Svetlana P. Eckert Rosila Sarrosa Kamath Vineetha Keith Edwards Bianca Weinstock-Guttman |
| author_facet | Dejan Jakimovski Karen Zakalik Samreen Awan Katelyn S. Kavak Penny Pennington David Hojnacki Channa Kolb Alexis A. Lizarraga Svetlana P. Eckert Rosila Sarrosa Kamath Vineetha Keith Edwards Bianca Weinstock-Guttman |
| author_sort | Dejan Jakimovski |
| collection | DOAJ |
| description | Background: To determine the effect of disease-modifying therapies (DMT) on humoral postvaccine seroconversion, long-term humoral response, and breakthrough COVID-19 infections in persons with multiple sclerosis (PwMS) and other neuroinflammatory disorders. Methods: A total of 757 PwMS and other neuroinflammatory disorders were recruited in two MS centers and vaccinated with one of the FDA-approved vaccines (BNT162b2, mRNA-1273, Ad26.COV2.S). The primary outcomes are the rate of humoral postvaccine seroconversion and anti-severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2) immunoglobulin G (IgG) differences between patients on different DMTs. Secondary measures include breakthrough infections and humoral response after six months. Other outcomes include differences in vaccine response between SARS-CoV-2 vaccines and the effects of age and comorbidities on the vaccine response. Results: A total of 465 (68.4%) PwMS and 55 (74.3%) patients with neuroinflammatory diseases were seropositive at 4–12 weeks after vaccination. A significant difference in seroconversion based on the DMT used at the time of vaccination (<i>p</i> < 0.001) was observed, with the lowest rates seen in patients treated with anti-CD20 antibodies (23.2%) and sphingosine-1-phosphate modulators (S1P) (30.8%). In seropositive patients, there was a significant decrease in anti-SARS IgG from mean 20.0 to 4.7 at six months (<i>p</i> = 0.004). Thirty-nine patients had breakthrough infection, but only two seronegative patients required hospitalization. mRNA vaccines resulted in significantly greater seroconversion compared to Ad26.COV2.S (<i>p</i> < 0.001). Older age and presence of cardiovascular comorbidities were associated with lower anti-SARS IgG (<i>p</i> = 0.021 and <i>p</i> = 0.003, respectively) Conclusions: PwMS and neuroinflammatory disorders treated with anti-CD20 and S1P medications have lower humoral response after anti-SARS-CoV-2 vaccination, even after booster dose. Waning of the humoral response puts vaccinated PwMS at a greater risk of COVID-19 breakthrough. |
| first_indexed | 2024-03-10T01:40:43Z |
| format | Article |
| id | doaj.art-c2827aeb3bb74cec81dcd5f0a0b5eb0c |
| institution | Directory Open Access Journal |
| issn | 2076-393X |
| language | English |
| last_indexed | 2024-03-10T01:40:43Z |
| publishDate | 2022-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Vaccines |
| spelling | doaj.art-c2827aeb3bb74cec81dcd5f0a0b5eb0c2023-11-23T13:25:41ZengMDPI AGVaccines2076-393X2022-04-0110569510.3390/vaccines10050695COVID-19 Vaccination in Multiple Sclerosis and Inflammatory Diseases: Effects from Disease-Modifying Therapy, Long-Term Seroprevalence and Breakthrough InfectionsDejan Jakimovski0Karen Zakalik1Samreen Awan2Katelyn S. Kavak3Penny Pennington4David Hojnacki5Channa Kolb6Alexis A. Lizarraga7Svetlana P. Eckert8Rosila Sarrosa9Kamath Vineetha10Keith Edwards11Bianca Weinstock-Guttman12Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY 14203, USAJacobs Comprehensive MS Treatment and Research Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14202, USAJacobs Comprehensive MS Treatment and Research Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14202, USAJacobs Comprehensive MS Treatment and Research Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14202, USAJacobs Comprehensive MS Treatment and Research Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14202, USAJacobs Comprehensive MS Treatment and Research Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14202, USAJacobs Comprehensive MS Treatment and Research Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14202, USAJacobs Comprehensive MS Treatment and Research Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14202, USAJacobs Comprehensive MS Treatment and Research Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14202, USAMS Center of Northeastern NY—Empire Neurology, P.C., Latham, NY 12110, USAMS Center of Northeastern NY—Empire Neurology, P.C., Latham, NY 12110, USAMS Center of Northeastern NY—Empire Neurology, P.C., Latham, NY 12110, USAJacobs Comprehensive MS Treatment and Research Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14202, USABackground: To determine the effect of disease-modifying therapies (DMT) on humoral postvaccine seroconversion, long-term humoral response, and breakthrough COVID-19 infections in persons with multiple sclerosis (PwMS) and other neuroinflammatory disorders. Methods: A total of 757 PwMS and other neuroinflammatory disorders were recruited in two MS centers and vaccinated with one of the FDA-approved vaccines (BNT162b2, mRNA-1273, Ad26.COV2.S). The primary outcomes are the rate of humoral postvaccine seroconversion and anti-severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2) immunoglobulin G (IgG) differences between patients on different DMTs. Secondary measures include breakthrough infections and humoral response after six months. Other outcomes include differences in vaccine response between SARS-CoV-2 vaccines and the effects of age and comorbidities on the vaccine response. Results: A total of 465 (68.4%) PwMS and 55 (74.3%) patients with neuroinflammatory diseases were seropositive at 4–12 weeks after vaccination. A significant difference in seroconversion based on the DMT used at the time of vaccination (<i>p</i> < 0.001) was observed, with the lowest rates seen in patients treated with anti-CD20 antibodies (23.2%) and sphingosine-1-phosphate modulators (S1P) (30.8%). In seropositive patients, there was a significant decrease in anti-SARS IgG from mean 20.0 to 4.7 at six months (<i>p</i> = 0.004). Thirty-nine patients had breakthrough infection, but only two seronegative patients required hospitalization. mRNA vaccines resulted in significantly greater seroconversion compared to Ad26.COV2.S (<i>p</i> < 0.001). Older age and presence of cardiovascular comorbidities were associated with lower anti-SARS IgG (<i>p</i> = 0.021 and <i>p</i> = 0.003, respectively) Conclusions: PwMS and neuroinflammatory disorders treated with anti-CD20 and S1P medications have lower humoral response after anti-SARS-CoV-2 vaccination, even after booster dose. Waning of the humoral response puts vaccinated PwMS at a greater risk of COVID-19 breakthrough.https://www.mdpi.com/2076-393X/10/5/695COVID-19SARS-CoV-2 vaccinationBNT162b2mRNA-1273Ad26.COV2.Sbreakthrough infection |
| spellingShingle | Dejan Jakimovski Karen Zakalik Samreen Awan Katelyn S. Kavak Penny Pennington David Hojnacki Channa Kolb Alexis A. Lizarraga Svetlana P. Eckert Rosila Sarrosa Kamath Vineetha Keith Edwards Bianca Weinstock-Guttman COVID-19 Vaccination in Multiple Sclerosis and Inflammatory Diseases: Effects from Disease-Modifying Therapy, Long-Term Seroprevalence and Breakthrough Infections Vaccines COVID-19 SARS-CoV-2 vaccination BNT162b2 mRNA-1273 Ad26.COV2.S breakthrough infection |
| title | COVID-19 Vaccination in Multiple Sclerosis and Inflammatory Diseases: Effects from Disease-Modifying Therapy, Long-Term Seroprevalence and Breakthrough Infections |
| title_full | COVID-19 Vaccination in Multiple Sclerosis and Inflammatory Diseases: Effects from Disease-Modifying Therapy, Long-Term Seroprevalence and Breakthrough Infections |
| title_fullStr | COVID-19 Vaccination in Multiple Sclerosis and Inflammatory Diseases: Effects from Disease-Modifying Therapy, Long-Term Seroprevalence and Breakthrough Infections |
| title_full_unstemmed | COVID-19 Vaccination in Multiple Sclerosis and Inflammatory Diseases: Effects from Disease-Modifying Therapy, Long-Term Seroprevalence and Breakthrough Infections |
| title_short | COVID-19 Vaccination in Multiple Sclerosis and Inflammatory Diseases: Effects from Disease-Modifying Therapy, Long-Term Seroprevalence and Breakthrough Infections |
| title_sort | covid 19 vaccination in multiple sclerosis and inflammatory diseases effects from disease modifying therapy long term seroprevalence and breakthrough infections |
| topic | COVID-19 SARS-CoV-2 vaccination BNT162b2 mRNA-1273 Ad26.COV2.S breakthrough infection |
| url | https://www.mdpi.com/2076-393X/10/5/695 |
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