Response to COVID-19 booster vaccinations in seronegative people with multiple sclerosis

Background

People with MS treated with anti-CD20 therapies and fingolimod often have attenuated responses to initial COVID-19 vaccination. However, uncertainties remain about the benefit of a 3rd (booster) COVID-19 vaccine in this group.

Methods

PwMS without a detectable IgG response following COVID-19 vaccines 1&2 were invited to participate. Participants provided a dried blood spot +/- venous blood sample 2–12 weeks following COVID-19 vaccine 3. Humoral and T cell responses to SARS-CoV-2 spike protein and nucleocapsid antigen were measured.

Results

Of 81 participants, 79 provided a dried blood spot sample, of whom 38 also provided a whole blood sample; 2 provided only whole blood. Anti-SARS-CoV-2-spike IgG seroconversion post-COVID-19 vaccine 3 occurred in 26/79 (33%) participants; 26/40 (65%) had positive T-cell responses. Overall, 31/40 (78%) demonstrated either humoral or cellular immune response post-COVID-19 vaccine 3. There was no association between laboratory evidence of prior COVID-19 and seroconversion following vaccine 3.

Conclusions

Approximately one third of pwMS who were seronegative after initial COVID-19 vaccination seroconverted after booster (third) vaccination, supporting the use of boosters in this group. Almost 8 out of 10 had a measurable immune response following 3rd COVID-19 vaccine.

Author list

 

Affiliations:

  1. Division of Psychological Medicine and Clinical Neuroscience, School of Medicine, Cardiff University, United Kingdom
  2. Department of Neurology, University Hospital of Wales, Cardiff, United Kingdom
  3. Division of Infection and Immunity, School of Medicine, Cardiff University, United Kingdom
  4. ImmunoServ Ltd, Cardiff CF15 7AB, United Kingdom
  5. Preventive Neurology Unit, Wolfson Institute of Population Health, Queen Mary University London, Charterhouse Square, EC1M 6BQ, United Kingdom
  6. Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom
  7. Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, United Kingdom
  8. Centre for Oral Immunobiology and Regenerative Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom
  9. Department of Clinical Neurology, University of Nottingham, United Kingdom
  10. Department of Neurology, Barts Health NHS Trust, London, United Kingdom
  11. Department of Neurology, Royal Gwent Hospital, Newport, United Kingdom
  12. Department of Neurology, Morriston Hospital, Swansea, United Kingdom
  13. Wales Newborn Screening Laboratory, Department of Medical Biochemistry, Immunology and Toxicology, University Hospital of Wales, Cardiff, United Kingdom
  14. School of Medicine, Cardiff University, United Kingdom

Authors:

Emma C Tallantyrea2, Martin J Scurrc4, Nicola Vickaryouse, Aidan Richardsa, Valerie Anderson 1, David Baker 6, Randy Chance 6,8, Nikos Evangelou 9, Katila George 5, Gavin Giovannoni 5,6,10, Katharine E Harding 11, Aimee Hibbert 9, Gillian Ingram 12, Stephen Jollesc,7, Meleri Jones6, Angray S Kang6,8, Samantha Loveless1, Stuart J Moat13.14, Neil P Robertson1,2, Francesca Rios5, Klaus Schmierer6,10, Mark Willis2, Andrew Godkinc4, Ruth Dobsone,10,*

Novel Coronavirus SARS-CoV-2

10.1016/j.msard.2022.103937

Multiple Sclerosis and Related Disorders