Self-reported longitudinal COVID-19 vaccination reactogenicity profiles in persons with multiple sclerosis

Area of Science:

• Neurology
• Immunology
• Vaccinology

Background:

• Preventing severe COVID-19 in persons with multiple sclerosis (PwMS) is critical.
• Previous analysis indicated short-term vaccine reactions in PwMS were similar to the general population.

Purpose of the Study:

• To assess short-term reactogenicity of SARS-CoV-2 vaccines (first through fourth doses) in PwMS.
• To evaluate reactogenicity based on different vaccine sequences for the first three doses in PwMS.

Main Methods:

• Electronic self-reporting of SARS-CoV-2 vaccine details and reactions by PwMS from March 2021 to March 2023.
• Analysis of local and systemic reactions within 24 hours of vaccination.
• Multivariable models to identify associations between demographics, disease characteristics, and reactogenicity.

Main Results:

• Over 1,000 PwMS reported reactions; 54-71% experienced reactions per dose, with severe reactions ranging from 14-22%.
• Age and sphingosine-1-phosphate receptor modulator use were inversely associated with reactions.
• mRNA-1273 vaccine was associated with a higher burden of reactions compared to BNT162b2, particularly in specific sequences (e.g., M-M-M, B-B-M).

Conclusions:

• Short-term vaccine reactions in PwMS are generally self-limiting and decrease after the second dose.
• The mRNA-1273 vaccine, especially as a third dose, was linked to more reactions than BNT162b2.