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COVID-19 Vaccination Reactogenicity in Persons With Multiple Sclerosis.

Farren Basil Shaw Briggs1, Farrah J Mateen2, Hollie Schmidt2

  • 1From the Department of Population and Quantitative Health Science (F.B.S.B.), School of Medicine, Cleveland, OH; Department of Neurology (F.J.M.), Massachusetts General Hospital, Boston; Accelerated Cure Project for MS (H.S., S.L., R.N.M.), Waltham, MA; Currie Consultancy (K.M.C.), LLC Eastover, SC; International AIDS Vaccine Initiative (H.M.S.), Frederick, MD; Mammoth Hospital (S.C.), Mammoth Lakes, CA; National Multiple Sclerosis Society (B.F.B., J.F.); Medical Affairs (M.K.R.), Quest Diagnostics, Secaucus, NJ; Departments of Neurology and Immunobiology (K.C.O.), Yale University School of Medicine, New Haven, CT; and iConquerMS (L.G.K., P.K.), Waltham, MA. farren.briggs@case.edu.

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine reactions in people with multiple sclerosis (PwMS) were similar to the general population. Certain disease-modifying therapies (DMTs) were associated with fewer vaccine reactions in PwMS.

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Area of Science:

  • Neurology
  • Immunology
  • Vaccinology

Background:

  • Limited data exist on SARS-CoV-2 vaccine reactogenicity in people with multiple sclerosis (PwMS).
  • Understanding vaccine safety in PwMS, especially concerning disease-modifying therapies (DMTs), is crucial for informed decision-making and addressing vaccine hesitancy.

Purpose of the Study:

  • To assess SARS-CoV-2 vaccine reactogenicity in PwMS.
  • To investigate the influence of various DMTs on vaccine reactions.
  • To provide real-world safety data for vaccine-hesitant PwMS.

Main Methods:

  • A retrospective cross-sectional study using data from the iConquerMS online research network.
  • Participants reported local and systemic reactions within 24 hours of SARS-CoV-2 vaccination.
  • Multivariable models analyzed associations between clinical factors, DMT use, and vaccine reactogenicity.

Main Results:

  • 64% of 719 PwMS reported reactions after the first dose; 17% reported severe reactions. Common reactions included injection site pain, fatigue, and headache.
  • Second vaccine doses in 442 PwMS showed similar reaction profiles, with 74% reporting reactions and 22% reporting severe reactions.
  • Younger age, female sex, prior infection, and specific vaccines (Oxford-AstraZeneca, Moderna) were associated with increased reactogenicity. Certain DMTs (alpha4-integrin blockers, S1P receptor modulators, fumarates) were linked to lower reactogenicity.

Conclusions:

  • SARS-CoV-2 vaccine reactogenicity in PwMS is comparable to the general population.
  • Specific DMTs may reduce vaccine reactions in PwMS.
  • Short-term vaccine reactions were generally self-limiting.