Researchers investigated if COVID-19 occurred in patients with neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) and reported a number of such cases, thus reinforcing the need for further research to be conducted to evaluate COVID-19 vaccine efficacy among patients with NMOSD and MS.

Anti-CD20 is a class of immunosuppressants widely used to treat NMOSD and MS. The data shows that they work by reducing the rate of relapse and disability accumulation. When the COVID-19 vaccines first became available, patients with MS on anti-CD20 therapies were prioritized.

“As anti-CD20 therapies exposure is associated with COVID-19 severity and with lower anti-spike humoral immunity after vaccination, we aimed to assess whether COVID-19 had occurred among previously vaccinated patients and determine the characteristics of these patients,” the researchers wrote in the study published in the Multiple Sclerosis Journal.


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They carried out their study using the French database COVISEP and identified 1650 patients with MS and 67 patients with NMOSD. They then identified all cases of COVID-19 (n=460). 

Read more about NMOSD etiology

The results demonstrated that 16 patients with MS became infected with COVID-19 after receiving their first dose of the vaccine. In addition, the researchers discovered that 17 patients with MS and 1 aquaporin-4 positive patient with NMOSD were diagnosed with COVID-19 after receiving 2 doses of the BNT162b2 vaccine. 

The concern reported was the low immunogenicity of COVID-19 vaccines among patients treated with anti-CD20. The French health authority recommendation is that a third dose should be given 4 weeks after the second dose among patients treated with anti-CD20. 

“Our results reinforce this recommendation, even if we cannot be sure that this third dose would guarantee the same protection as vaccinated non-immunocompromised patients,” the researchers wrote.

“These preliminary findings stress the need for a prospective clinical and biological follow-up on COVID-19 vaccine efficacy among this population exposed to immunosuppressive therapies, and further studies are needed to assess the impact of prior vaccination on COVID-19 severity among immunocompromised patients.”

Reference

Januel E, De Seze J, Vermersch P, et al. Post-vaccine COVID-19 in patients with multiple sclerosis or neuromyelitis optica. Mult Scler. Published online December 21, 2021. doi:10.1177/13524585211049737