Humoral immunity to SARS-CoV-2 mRNA vaccination in multiple sclerosis: the relevance of time since last rituximab infusion and first experience from sporadic revaccinations

• DOI: 10.1136/jnnp-2021-327612
• Publication Date: 2021-10-20T18:03:14Z
• Authors: Marton König; Åslaug Rudjord Lo...; Hilde Marie Torga...; The Trung Tran; Stine Schikora-Ru...; Eline Benno Vaage; Åse Mygland; Stig Wergeland; Jan Aarseth; Ingeborg Aase S A...; Øivind Torkildsen; Trygve Holmøy; Tone Berge; Kjell-Morten Myhr; Hanne Flinstad Harbo; Jan Terje Andersen; Ludvig Andre Munthe; Arne Søraas; Elisabeth Gulowse...; John Torgils Vaage; Fridtjof Lund-Joh...; Gro Owren Nygaard
• Keywords: Humoral immunity; Cellular immunity; Herd Immunity

Introduction The effect of disease-modifying therapies (DMT) on vaccine responses is largely unknown. Understanding the development protective immunity paramount importance to fight COVID-19 pandemic. Objective To characterise humoral after mRNA-COVID-19 vaccination people with multiple sclerosis (pwMS). Methods All pwMS in Norway fully vaccinated against SARS-CoV-2 were invited a national screening study. Humoral was assessed by measuring anti-SARS-CoV-2 SPIKE RBD IgG response 3–12 weeks full vaccination, and compared healthy subjects. Results 528 627 subjects included. Reduced (anti-SARS-CoV-2 <70 arbitrary units) present 82% 80% all treated fingolimod rituximab, respectively, while patients other DMT showed similar rates as untreated pwMS. We found significant correlation between time since last rituximab dose immunity. Revaccination two seronegative induced weak antibody response. Conclusions Patients or should be informed about risk reduced vaccinations timed carefully patients. Our results identify need for studies regarding durability responses, role cellular revaccinations.