Early immunological responses to the mRNA SARS-CoV-2 vaccine in patients with neuromuscular disorders

Iwayama, Hideyuki; Ishihara, Naoko; Kawahara, Kohei; Madokoro, Yuta; Togawa, Yasuko; Muramatsu, Kanji; Murakami, Ayuka; Kuru, Satoshi; Kumagai, Toshiyuki; Ohashi, Wataru; Nanya, Kengo; Hasegawa, Shin; Katsuno, Masahisa; Okumura, Akihisa

doi:10.3389/fimmu.2022.996134

Cited by 5 publications

(10 citation statements)

References 13 publications

(16 reference statements)

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“…Antibody responses were robust, an observation which was consistent with adolescent and adult patients with NMDs and myasthenia gravis who were able to generate antibody responses against WT. (20,21,33) It is reassuring that even for pediatric patients with NMDs and on corticosteroids, all patients had successful seroconversion after at least two doses of BNT162b2 or CoronaVac, which was also observed in adolescent and adult patients who received BNT162b2. (20,33) Additionally, there were no apparent interactions between the COVID-19 vaccines and treatments for NMDs, and our cohort of patients did not encounter NMD-related complications or hospitalization.…”

Section: Resultsmentioning

confidence: 89%

“…There were similar profiles of ARs between pediatric patients with NMDs, our healthy cohort, as well as adolescents and adults with NMDs and multiple sclerosis who received two doses of BNT162b2 or mRNA-1273. (20,27,32,33) This is also the first study to demonstrate the inactivated whole-virus COVID-19 vaccine, CoronaVac, is immunogenic in pediatric patients with NMDs. Antibody responses were robust, an observation which was consistent with adolescent and adult patients with NMDs and myasthenia gravis who were able to generate antibody responses against WT.…”

Section: Resultsmentioning

confidence: 94%

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Vaccine hesitancy, reactogenicity and immunogenicity of BNT162b2 and CoronaVac in pediatric patients with neuromuscular diseases

Chan

Cheng

et al. 2022

Preprint

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Introduction COVID-19 causes global health and psychosocial devastation, particularly to high-risk patients such as those with neuromuscular diseases (NMDs). The mRNA-based BNT162b2 and inactivated whole-virus CoronaVac are two novel COVID-19 vaccines widely used across the world that confer immune protection to healthy individuals. However, hesitancy towards COVID-19 vaccination was common for patients with NMDs early in the pandemic due to the paucity of data on the safety and efficacy in this specific patient population. Therefore, we examined the underlying factors associated with vaccine hesitancy across time for these patients and included the assessment of the reactogenicity and immunogenicity of these two vaccines. Methods Pediatric patients were screened from our NMD registry. For the vaccine hesitancy arm, those aged 8-18 years with no cognitive delay were invited to complete surveys in January and April 2022. For the reactogenicity and immunogenicity arm, patients aged 2-21 years were enrolled for COVID-19 vaccination between June 2021 to April 2022. Participants recorded adverse reactions (ARs) for 7 days after vaccination. Peripheral blood was obtained before BNT162b2 or CoronaVac and within 49 days after vaccination to measure their serological antibody responses as compared to healthy children and adolescents. Results Forty-one patients completed vaccine hesitancy surveys for both timepoints, and 22 joined our reactogenicity and immunogenicity arm of the study. Two or more family members vaccinated against COVID-19 was positively associated with intention of vaccination (odds ratio 11.7, 95% CI 1.81-75.1, p=0.010). Pain at the injection site, fatigue and myalgia were the commonest ARs. Most ARs were mild (75.5%, n=71/94). All 19 patients seroconverted against the wildtype SARS-CoV-2 after two doses of BNT162b2 or CoronaVac, although there was lower neutralization against the Omicron BA.1 variant. Discussion This study demonstrated vaccine hesitancy amongst patients with NMDs was influenced by family members and changed across time. BNT162b2 and CoronaVac were safe and immunogenic even for patients on low-dose corticosteroids. Future research is required to assess the durability of the COVID-19 vaccines, the effectiveness of booster doses and other routes of administration against emerging SARS-CoV-2 variants for these patients.

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Section: Resultsmentioning

confidence: 89%

Section: Resultsmentioning

confidence: 94%

Vaccine hesitancy, reactogenicity and immunogenicity of BNT162b2 and CoronaVac in pediatric patients with neuromuscular diseases

Chan

Cheng

et al. 2022

Preprint

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“…We speculate that disease types in MDs may be important contributing factors in predicting antibody response; therefore, further studies will lead to better management of vaccination in MDs. Fourth, previous studies have also showed the immunogenicity associated with SARS-CoV-2 vaccination in patients with MDs using only an intramuscular mRNA vaccine (7,8), but not other SARS-CoV-2 vaccines including protein subunit vaccines and viral vector-based vaccines. In addition, we speculate that a 3rd primary dose, with a higher dose, shorter intervals between vaccines such as 3 months, or an altered delivery method, such as nasal spray or aerosol inhalation, might help to improve vaccine responses in patients with MDs.…”

Section: Limitations In Our Studymentioning

confidence: 96%

“…and Iwayama et al. reported that intramuscular mRNA immunization resulted in a strong IgG antibody response in patients with advanced MDs ( 7 , 8 ). However, there are limited reports on the effect of SARS-CoV-2 vaccines on MDs, in particular for long periods.…”

Section: Introductionmentioning

confidence: 99%

“…MDs are often associated with progressive or degenerative muscular weakness, so evaluating whether SARS-CoV-2 mRNA intramuscular immunization affects patients with MDs is crucial. Demeonbreun et al and Iwayama et al reported that intramuscular mRNA immunization resulted in a strong IgG antibody response in patients with advanced MDs (7,8). However, there are limited reports on the effect of SARS-CoV-2 vaccines on MDs, in particular for long periods.…”

Section: Introductionmentioning

confidence: 99%

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Immunogenicity of SARS-CoV-2 mRNA intramuscular vaccination in patients with muscular disorders

Kasai

Funato²,

Maruta³

et al. 2023

Front. Immunol.

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BackgroundsLittle clinical data is available on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patients with muscular disorders (MDs). The immunogenicity of SARS-CoV-2 vaccines against MDs, in particular, remains unknown. Thus, this study aimed to confirm the immunogenicity and safety of the SARS-CoV-2 vaccine against MDs.MethodsAll participants were vaccinated with two doses of mRNA vaccines (BNT162b2, Pfizer-BioNTech). The serum samples were collected from each patient on the day of second dose of vaccination, and then, consecutively, after one month, three months, and six months. Anti-SARS-CoV-2 IgG levels were determined using the Abbott SARS-CoV-2 IgG II Quant assay.ResultsWe evaluated 75 individuals, including 42 patients with MDs and 33 patients with non-muscular disorders (non-MDs). Non-MD patients primarily include those with severe motor and intellectual disabilities. The median age of the patients was 32 years (range 12–64 years). After one and three months following the second immunization, patients with MDs had lower antibody responses. Furthermore, three months following the second immunization, the proportion of high responders among patients with MDs decreased significantly compared to that among patients without MDs (p-value of less than 0.01). No serious adverse events were observed in patients with or without MDs.ConclusionIntensity and latency of antibody response were suppressed in patients with MDs. Although MDs may be a key contributor in predicting the antibody response to SARS-CoV-2 vaccination, SARS-CoV-2 immunization in MDs needs extensive research.

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Hesitancy, reactogenicity and immunogenicity of the mRNA and whole-virus inactivated Covid-19 vaccines in pediatric neuromuscular diseases

Chan

Cheng

et al. 2023

Human Vaccines & Immunotherapeutics

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The mRNA-based BNT162b2 and inactivated whole-virus CoronaVac are two widely used COVID-19 vaccines that confer immune protection to healthy individuals. However, hesitancy toward COVID-19 vaccination appeared to be common for patients with neuromuscular diseases (NMDs) due to the paucity of data on the safety and efficacy in this high-risk patient population. Therefore, we examined the underlying factors associated with vaccine hesitancy across time for NMDs and assessed the reactogenicity and immunogenicity of these two vaccines. Patients aged 8–18 years with no cognitive delay were invited to complete surveys in January and April 2022. Patients aged 2–21 years were enrolled for COVID-19 vaccination between June 2021 and April 2022, and they recorded adverse reactions (ARs) for 7 days after vaccination. Peripheral blood was obtained before and within 49 days after vaccination to measure serological antibody responses compared to healthy children and adolescents. Forty-one patients completed vaccine hesitancy surveys for both timepoints, while 22 joined the reactogenicity and immunogenicity arm of the study. Two or more family members vaccinated against COVID-19 was positively associated with intention of vaccination (odds ratio 11.7, 95% CI 1.81–75.1, p = .010). Pain at the injection site, fatigue, and myalgia were the commonest ARs. Most ARs were mild (75.5%, n = 71/94). All 19 patients seroconverted against the wildtype SARS-CoV-2 after two doses of either vaccine, similar to 280 healthy counterparts. There was lower neutralization against the Omicron BA.1 variant. BNT162b2 and CoronaVac were safe and immunogenic for patients with NMDs, even in those on low-dose corticosteroids.

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Early immunological responses to the mRNA SARS-CoV-2 vaccine in patients with neuromuscular disorders

Cited by 5 publications

References 13 publications

Vaccine hesitancy, reactogenicity and immunogenicity of BNT162b2 and CoronaVac in pediatric patients with neuromuscular diseases

Vaccine hesitancy, reactogenicity and immunogenicity of BNT162b2 and CoronaVac in pediatric patients with neuromuscular diseases

Immunogenicity of SARS-CoV-2 mRNA intramuscular vaccination in patients with muscular disorders

Hesitancy, reactogenicity and immunogenicity of the mRNA and whole-virus inactivated Covid-19 vaccines in pediatric neuromuscular diseases

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