The mRNA-COVID-19 vaccines are safe and well-tolerated in patients with myasthenia gravis (MG) and should be highly recommended due to the high risk of complications in case of SARS-CoV-2 infection, according to a new study published last week in the European Journal of Neurology.

Even though patients with MG were identified as being at high risk of developing the severe disease during the COVID-19 pandemic, the lack of direct safety and tolerability information about the emerging vaccines led to hesitancy.

To address this problem, a team of researchers led by Valentina Damato, MD, PhD, from the Department of Neurosciences, Drugs, and Child Health at the University of Florence in Italy conducted a multicenter study on 104 patients with MG. Of those, 98 (94.2%) had at least 2 COVID-19 vaccines and 63 had the booster vaccine.

“Overall, only minor side effects were reported, most commonly local pain and fever,” the researchers wrote. 

Read more about MG overview

Disease worsening was seen in only 8 patients (7.7% of all patients) following the vaccination. However, this ratio was significantly higher among patients who had MuSK-MG and was observed in 3 out of 9 patients with this type of disease. In 6 out of 8 cases, spontaneous symptoms regression occurred. Of all patients, 12 had SARS-CoV-2 infection and none of these got worse following vaccination.

“Our data support the safety and tolerability of COVID-19 vaccination, which should be strongly recommended in MG patients,” the researchers wrote, “particularly in those at higher risk of complications when exposed to SARS-CoV-2 infection.”

Future work should now focus on confirming these results and assessing the efficacy of SARS-CoV-2 vaccines in patients with MG who are receiving immunosuppressive therapy.


Farina A, Falso S, Cornacchini S, et al. Safety and tolerability of SARS-Cov2 vaccination in patients with myasthenia gravis: a multicenter experience. Eur J Neurol. Published online April 7, 2022. doi:10.1111/ene.15348