Susana Otero-Romero1,2, Alberto Ascherio3,4, Christine Lebrun-Frénay5. 1. Preventive Medicine and Epidemiology Department. Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona. 2. Centro de Esclerosis Múltiple de Catalunya (Cemcat), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain. 3. Department of Nutrition, Harvard T. H. Chan School of Public Health. 4. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA. 5. CRCSEP Côte d'Azur, CHU de Nice Pasteur2, Université Nice Cote d'Azur UR2CA-URRIS, Nice, France.
Abstract
PURPOSE OF REVIEW: This review focuses on new evidence supporting the global immunization strategy for multiple sclerosis (MS) patients receiving disease-modifying drugs (DMDs), including the recently available vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. RECENT FINDINGS: New data strengthen the evidence against a causal link between MS and vaccination. Recent consensus statements agree on the need to start vaccination early. Timings for vaccine administration should be adjusted to ensure safety and optimize vaccine responses, given the potential interference of DMDs. Patients treated with Ocrelizumab (and potentially other B-cell depleting therapies) are at risk of diminished immunogenicity to vaccines. This has relevant implications for the upcoming vaccination against SARS-CoV-2. SUMMARY: An early assessment and immunization of MS patients allows optimizing vaccine responses and avoiding potential interference with treatment plans. Vaccinations are safe and effective but some specific considerations should be followed when vaccinating before, during, and after receiving immunotherapy. A time-window for vaccination taking into account the kinetics of B cell repopulation could potentially improve vaccine responses. Further understanding of SARS-CoV-2 vaccine response dynamics in MS patients under specific therapies will be key for defining the best vaccination strategy.
PURPOSE OF REVIEW: This review focuses on new evidence supporting the global immunization strategy for multiple sclerosis (MS) patients receiving disease-modifying drugs (DMDs), including the recently available vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. RECENT FINDINGS: New data strengthen the evidence against a causal link between MS and vaccination. Recent consensus statements agree on the need to start vaccination early. Timings for vaccine administration should be adjusted to ensure safety and optimize vaccine responses, given the potential interference of DMDs. Patients treated with Ocrelizumab (and potentially other B-cell depleting therapies) are at risk of diminished immunogenicity to vaccines. This has relevant implications for the upcoming vaccination against SARS-CoV-2. SUMMARY: An early assessment and immunization of MS patients allows optimizing vaccine responses and avoiding potential interference with treatment plans. Vaccinations are safe and effective but some specific considerations should be followed when vaccinating before, during, and after receiving immunotherapy. A time-window for vaccination taking into account the kinetics of B cell repopulation could potentially improve vaccine responses. Further understanding of SARS-CoV-2 vaccine response dynamics in MS patients under specific therapies will be key for defining the best vaccination strategy.
Authors: Ana Muñoz-Jurado; Begoña M Escribano; Eduardo Agüera; Javier Caballero-Villarraso; Alberto Galván; Isaac Túnez Journal: J Neurol Date: 2022-07-05 Impact factor: 6.682
Authors: Z L E van Kempen; L Wieske; E W Stalman; L Y L Kummer; P J van Dam; A G Volkers; L Boekel; A A Toorop; E M M Strijbis; S W Tas; G J Wolbink; M Löwenberg; C van Sandt; A Ten Brinke; N J M Verstegen; M Steenhuis; T W Kuijpers; S M van Ham; T Rispens; F Eftimov; J Killestein Journal: Mult Scler Relat Disord Date: 2021-11-23 Impact factor: 4.339