Vaccination in neuromyelitis optica spectrum disorders: Friend or enemy?

To be or not to be vaccinated: The risk of MS or NMOSD relapse after COVID-19 vaccination and infection

“…The frequency of relapses within one month of vaccination in the largest one was 4% (one out of 26 patients) ( Dinoto et al., 2021 ), which corresponds with our findings. COVID-19 infection itself has already been demonstrated as a risk factor for NMOSD relapses ( Cai et al., 2021 ) and above all, the largest systematic review suggests that one-third of COVID-19 infected NMOSD patients were hospitalised, approximately 15% admitted to ICU and more than 3% died ( Barzegar et al., 2021a ). Based on this unfortunately scarce data, the potential benefits of vaccination seem to clearly overcome the risk of relapses in NMOSD patients.…”

“…To our knowledge, data assessing the effect of COVID-19 infection and vaccination on the risks of relapse in MS and NMOSD are scarce, inconsistent, and mostly evaluated on relatively small cohorts ( Achiron et al., 2021 ; Barzegar et al., 2021b ; Cai et al., 2021 ; di Filippo et al., 2021 ; Dinoto et al., 2021 ; Etemadifar et al., 2021 ; Fragoso et al., 2021 ; Jovicevic et al., 2021 ; Lotan et al., 2021b , 2021a ). Thus, in the light of the ongoing global COVID-19 pandemic situation and the continuing need for vaccination, we aimed to evaluate the short-term risks of clinical relapse in the 90-day period after the first dose COVID-19 vaccine administration and COVID-19 infection as well as the safety profile of COVID-19 vaccines in patients with MS and NMOSD.…”

Vaccination and immunotherapies in neuroimmunological diseases

“…Studies of patients receiving anti-CD20 therapy for non-neurological disease have demonstrated similar reduced antibody responses to SARS-CoV-2 vaccines 210 , 211 . In one comparison of responses in patients receiving anti-CD20 therapy for MS and rheumatoid arthritis, humoral responses to mRNA SARS-CoV-2 vaccination were impaired in both groups compared with those in healthy control participants but T cell responses were adequate 212 , 213 .…”

Severe disease exacerbation after mRNA COVID-19 vaccination unmasks suspected multiple sclerosis as neuromyelitis optica spectrum disorder: a case report

“…Also, specific testing for serum autoantibodies against SARS-CoV-2 as a potential marker for the immune response to the COVID-19 vaccine has not been performed. Furthermore, it has to be taken into account that the patient received three types of vaccinations in a short period of time, so possible delayed effects of the first vaccinations or combined effects of an unspecific “bystander immune activation” as a consequence of these different vaccinations could be associated with the disease exacerbation observed in this particular case [ 9 ]. The patient’s history suggests that she suffered from a long-standing latent NMOSD misdiagnosed as MS that flared up after the vaccination.…”