Risk of COVID-19 in people with multiple sclerosis who are seronegative following vaccination

Zaloum, Safiya, Wood, Callum, Tank, Pooja, Upcott, Matthew, Vickaryous, Nicola, Anderson, Valerie, Baker, David, Randy, Chance, Evangelou, Nikos, George, Katila, Giovannoni, Gavin, Harding, Katherine, Hibbert, Aimee, Ingram, Gillian, Jolles, Stephen, Kang, Angray, Loveless, Samantha ORCID: https://orcid.org/0000-0002-5124-4115, Moat, Stuart J., Richards, Aidan, Robertson, Neil P. ORCID: https://orcid.org/0000-0002-5409-4909, Rios, Francesca, Schmierer, Klaus, Willis, Mark, Dobson, Ruth and Tallantyre, Emma ORCID: https://orcid.org/0000-0002-3760-6634 2023. Risk of COVID-19 in people with multiple sclerosis who are seronegative following vaccination. Multiple Sclerosis Journal 29 (8) , pp. 979-989. 10.1177/13524585231185247

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Abstract

Background: People with multiple sclerosis (pwMS) treated with certain disease-modifying therapies (DMTs) have attenuated IgG response following COVID-19 vaccination; however, the clinical consequences remain unclear. Objective: To report COVID-19 rates in pwMS according to vaccine serology. Methods: PwMS with available (1) serology 2–12 weeks following COVID-19 vaccine 2 and/or vaccine 3 and (2) clinical data on COVID-19 infection/hospitalisation were included. Logistic regression was performed to examine whether seroconversion following vaccination predicted risk of subsequent COVID-19 infection after adjusting for potential confounders. Rates of severe COVID-19 (requiring hospitalisation) were also calculated. Results: A total of 647 pwMS were included (mean age 48 years, 500 (77%) female, median Expanded Disability Status Scale (EDSS) 3.5% and 524 (81%) exposed to DMT at the time of vaccine 1). Overall, 472 out of 588 (73%) were seropositive after vaccines 1 and 2 and 222 out of 305 (73%) after vaccine 3. Seronegative status after vaccine 2 was associated with significantly higher odds of subsequent COVID-19 infection (odds ratio (OR): 2.35, 95% confidence interval (CI): 1.34–4.12, p = 0.0029), whereas seronegative status after vaccine 3 was not (OR: 1.05, 95% CI: 0.57–1.91). Five people (0.8%) experienced severe COVID-19, all of whom were seronegative after most recent vaccination. Conclusion: Attenuated humoral response to initial COVID-19 vaccination predicts increased risk of COVID-19 in pwMS, but overall low rates of severe COVID-19 were seen.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Publisher:	SAGE Publications
ISSN:	1352-4585
Date of First Compliant Deposit:	30 May 2023
Date of Acceptance:	22 April 2023
Last Modified:	19 Apr 2024 06:28
URI:	https://orca.cardiff.ac.uk/id/eprint/160037

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