New Onset Multiple Sclerosis Post-COVID-19 Vaccination and Correlation With Possible Predictors in a Case-Control Study

Alluqmani, Majed

doi:10.7759/cureus.36323

Cited by 5 publications

(9 citation statements)

References 16 publications

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“…Toljan and coll. described a series of ve patients who developed MS during 1 daytwo months' timeframe after a mRNA-based COVID-19 vaccine [22]. In Oxford COVID Vaccine Trial, one case of MS reactivation 10 days after rst dose of ChAdOx1 vaccine was observed among 11636 participants [23].…”

Section: Discussionmentioning

confidence: 99%

“…The time interval by which to de ne a temporal relationship between a triggering event (e.g., a vaccine) and the onset of MS is controversial. We established a one-month timeframe based on recent literature about in ammatory events related to SARS-CoV-2 vaccination [17]; the same timeframe was chosen by Alluqmani in his casecontrol study including thirty-two patients with vaccine-related MS onset [22].…”

Section: Discussionmentioning

confidence: 99%

“…After the early stages of vaccination campaigns, in late 2020, many cases of neurological disorder onset after vaccination have been reported [15][16][17][18]. Few cases of reactivation or new-onset of demyelinating diseases of the CNS have been described as well, both after vaccination with mRNA-based [19][20][21][22] and with adenovirus-vectored formulations of vaccine [22][23][24]. The assumption that anti-COVID-19 vaccination may increase the risk to develop MS is still debated and this potential causal relationship could change the riskbene t pro le of anti-COVID-19 vaccination, at least in some population subgroups.…”

Section: Introductionmentioning

confidence: 99%

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Different HLA genotype pattern in patients with Multiple Sclerosis onset after COVID-19 vaccine.

Bianco,

Sante,

Colò

et al. 2023

Preprint

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Background: Few cases of Multiple Sclerosis (MS) onset after COVID-19 vaccination have been reported, even though the evidence is insufficient to establish causality. The aim of this study is to compare cases of newly diagnosed MS before and after the outbreak of COVID-19 pandemic and the impact of COVID-19 vaccination. Potential environmental and genetic predisposing factors were also investigated, as well as clinical patterns. Methods: This is a single-centre retrospective cohort study including all patients who presented with MS onset between January 2018 and July 2022. Data on COVID-19 vaccination administration, dose, and type were collected. HLA-DRB1 genotyping was performed in three subgroups. Results: 266 patients received a new diagnosis of MS in our centre, 143 before the COVID-19 pandemic (until and including March 2020) and 123 during COVID-19 era (from April 2020). The mean number of new MS onset per year was not different before and during COVID-19 era, as well as baseline patients’ characteristics, type of onset, clinical recovery, and radiological patterns. Fourteen (11.4%) patients who subsequently received a new diagnosis of MS had a history of COVID-19 vaccination within one month before symptoms onset. Patients’ characteristics, type of onset, clinical recovery, and radiological patterns do not differ from those of patients with non-vaccine-related new diagnosis of MS. The allele frequencies of HLA-DRB1*15 were 17.6% and 22.2% in patients with not-vaccine-related disease onset before and during COVID-19 era respectively, while no case of HLA-DRB1*15 was identified among patients with a new diagnosis of MS post-COVID-19 vaccine. In contrast HLA-DRB1*08+ or HLA-DRB1*10+ MS patients were present only in this subgroup. Conclusions: Although a causal link between COVID-19 vaccination and MS cannot be detected, it is interesting to note and speculate about the peculiarities and heterogeneities underlying disease mechanisms of MS, where the interactions of genetic and environment could be crucial also for the follow up and the evaluation of therapeutic options.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Different HLA genotype pattern in patients with Multiple Sclerosis onset after COVID-19 vaccine.

Bianco,

Sante,

Colò

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…After the early stages of vaccination campaigns, in late 2020, many cases of neurological disorder onset after vaccination were reported [24][25][26][27]. A few cases of reactivation or new onset of demyelinating diseases of the CNS have been described as well, both after vaccination with mRNA-based [28][29][30][31] and with adenovirus-vectored formulations of the vaccine [31][32][33]. The assumption that anti-COVID-19 vaccination may increase the risk of developing MS is still debated, and this potential causal relationship could change the risk-benefit profile of anti-COVID-19 vaccination, at least in some population subgroups.…”

Section: Introductionmentioning

confidence: 99%

Multiple Sclerosis Onset before and after COVID-19 Vaccination: Can HLA Haplotype Be Determinant?

Bianco,

Di Sante,

Colò

et al. 2024

IJMS

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A few cases of multiple sclerosis (MS) onset after COVID-19 vaccination have been reported, although the evidence is insufficient to establish causality. The aim of this study is to compare cases of newly diagnosed relapsing–remitting MS before and after the outbreak of the COVID-19 pandemic and the impact of COVID-19 vaccination. Potential environmental and genetic predisposing factors were also investigated, as well as clinical patterns. This is a single-centre retrospective cohort study including all patients who presented with relapsing–remitting MS onset between January 2018 and July 2022. Data on COVID-19 vaccination administration, dose, and type were collected. HLA-DRB1 genotyping was performed in three subgroups. A total of 266 patients received a new diagnosis of relapsing–remitting MS in our centre, 143 before the COVID-19 pandemic (until and including March 2020), and 123 during the COVID-19 era (from April 2020). The mean number of new MS onset cases per year was not different before and during the COVID-19 era and neither were baseline patients’ characteristics, type of onset, clinical recovery, or radiological patterns. Fourteen (11.4%) patients who subsequently received a new diagnosis of MS had a history of COVID-19 vaccination within one month before symptoms onset. Patients’ characteristics, type of onset, clinical recovery, and radiological patterns did not differ from those of patients with non-vaccine-related new diagnoses of MS. The allele frequencies of HLA-DRB1*15 were 17.6% and 22.2% in patients with non-vaccine-related disease onset before and during the COVID-19 era, respectively, while no case of HLA-DRB1*15 was identified among patients with a new diagnosis of MS post-COVID-19 vaccine. In contrast, HLA-DRB1*08+ or HLA-DRB1*10+ MS patients were present only in this subgroup. Although a causal link between COVID-19 vaccination and relapsing–remitting MS cannot be detected, it is interesting to note and speculate about the peculiarities and heterogeneities underlying disease mechanisms of MS, where the interactions of genetics and the environment could be crucial also for the follow-up and the evaluation of therapeutic options.

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“…Our study clearly suggests that COVID-19 mRNA vaccines had the highest number of vaccine-associated MS reports, which was significantly disproportionate to vaccineassociated MS reporting. COVID-19 vaccines were granted with emergency use authorization, and several case reports of vaccineassociated MS pointed out safety concerns 6,[33][34][35][36][37][38]. Moreover, Ad5vectored COVID-19 vaccines and inactivated whole-virus COVID-19 vaccines did not exhibit disproportionate MS signals among the various vaccines analyzed 39.…”

mentioning

confidence: 99%

Global burden of vaccine‐associated multiple sclerosis, 1967–2022: A comprehensive analysis of the international pharmacovigilance database

Woo,

Kim,

Park

et al. 2024

Journal of Medical Virology

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Vaccine‐associated multiple sclerosis (MS) is rare, with insufficient evidence from case reports. Given the scarcity of large‐scale data investigating the association between vaccine administration and adverse events, we investigated the global burden of vaccine‐associated MS and potential related vaccines from 1967 to 2022. Reports on vaccine‐associated MS between 1967 and 2022 were obtained from the World Health Organization International Pharmacovigilance Database (total number of reports = 120 715 116). We evaluated global reports, reporting odds ratio (ROR), and information components (IC) to investigate associations between 19 vaccines and vaccine‐associated MS across 156 countries and territories. We identified 8288 reports of vaccine‐associated MS among 132 980 cases of all‐cause MS. The cumulative number of reports on vaccine‐associated MS gradually increased over time, with a substantial increase after 2020, owing to COVID‐19 mRNA vaccine‐associated MS. Vaccine‐associated MS develops more frequently in males and adolescents. Nine vaccines were significantly associated with higher MS reporting, and the highest disproportional associations were observed for hepatitis B vaccines (ROR 19.82; IC025 4.18), followed by encephalitis (ROR 7.42; IC025 2.59), hepatitis A (ROR 4.46; IC025 1.95), and papillomavirus vaccines (ROR 4.45; IC025 2.01). Additionally, MS showed a significantly disproportionate signal for COVID‐19 mRNA vaccines (ROR 1.55; IC025 0.52). Fatal clinical outcomes were reported in only 0.3% (21/8288) of all cases of vaccine‐associated MS. Although various vaccines are potentially associated with increased risk of MS, we should be cautious about the increased risk of MS following vaccination, particularly hepatitis B and COVID‐19 mRNA vaccines, and should consider the risk factors associated with vaccine‐associated MS.

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New Onset Multiple Sclerosis Post-COVID-19 Vaccination and Correlation With Possible Predictors in a Case-Control Study

Cited by 5 publications

References 16 publications

Different HLA genotype pattern in patients with Multiple Sclerosis onset after COVID-19 vaccine.

Different HLA genotype pattern in patients with Multiple Sclerosis onset after COVID-19 vaccine.

Multiple Sclerosis Onset before and after COVID-19 Vaccination: Can HLA Haplotype Be Determinant?

Global burden of vaccine‐associated multiple sclerosis, 1967–2022: A comprehensive analysis of the international pharmacovigilance database

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