Vaccines and the association with relapses in patients with neuromyelitis optica spectrum disorder

Mealy, Maureen A.; Cook, Lawrence J.; Pache, Florence; Velez, Diego L.; Borisow, Nadja; Becker, Daniel; Arango, Jorge Andrés Jiménez; Paul, Friedemann; Lévy, Michaël

doi:10.1016/j.msard.2018.05.003

Cited by 41 publications

(43 citation statements)

References 26 publications

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“…However, there is concern for vaccine-induced relapse, as live vaccines usually produce stronger immune responses, especially in the absence of immunotherapy. Indeed, vaccine studies in neuromyelitis optica have shown increased risks of vaccine-related relapses in untreated patients while treated patients were protected (Mealy et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of COVID-19 vaccines in multiple sclerosis patients

Kelly

Sokola

Abboud

2021

Journal of Neuroimmunology

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COVID-19 vaccination is recommended for multiple sclerosis patients. Disease-modifying therapies can influence the safety and efficacy of COVID-19 vaccines. RNA, DNA, protein, and inactivated vaccines are likely safe for multiple sclerosis patients. A few incidences of central demyelination were reported with viral vector vaccines, but their benefits likely outweigh their risks if alternatives are unavailable. Live-attenuated vaccines should be avoided whenever possible in treated patients. Interferon-beta, glatiramer acetate, teriflunomide, fumarates, and natalizumab are not expected to impact vaccine efficacy, while cell-depleting agents (ocrelizumab, rituximab, ofatumumab, alemtuzumab, and cladribine) and sphingosine-1-phosphate modulators will likely attenuate vaccine responses. Coordinating vaccine timing with dosing regimens for some therapies may optimize vaccine efficacy.

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Section: Discussionmentioning

confidence: 99%

Safety and efficacy of COVID-19 vaccines in multiple sclerosis patients

Kelly

Sokola

Abboud

2021

Journal of Neuroimmunology

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“…Onset of relapse symptoms can occur in up to 90 days following vaccination but the incidence is highest at 30 days. Those on preventive immunotherapy for NMOSD have an 81% lower risk of disease relapse following vaccinations [4,5].…”

Section: Discussionmentioning

confidence: 99%

Neuromyelitis Optica in a Healthy Female After Severe Acute Respiratory Syndrome Coronavirus 2 mRNA-1273 Vaccine

Fujikawa¹,

Shah²,

Braford³

et al. 2021

Cureus

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Neuromyelitis optica spectrum disorder is an autoimmune demyelinating disease with high relative prevalence in the East Asian population. Clinical manifestations include optic neuritis, longitudinally extensive transverse myelitis, area postrema syndrome, brainstem syndromes, and diencephalic syndromes.In this case report, we present a case of neuromyelitis optica spectrum disorder that developed 10 days after the first dose of the severe acute respiratory syndrome coronavirus 2 mRNA-1273 vaccine. The patient was a previously healthy White female, completely independent and functional at baseline. She presented with bilateral lower-extremity numbness/tingling, weakness, and urinary retention. Although her neuromyelitis optica IgG was negative, the MRI was consistent with neuromyelitis optica involving and spanning longitudinally the C6-T2 vertebrae. She was treated with IV steroids and her symptoms improved.Given the novelty of the COVID-19 vaccines and the paucity of literature regarding their adverse effects, case reports such as ours provide unique information that aids healthcare providers in accurately diagnosing and treating patients, ultimately minimizing long-term neurologic deficits.

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“…Vaccines are intended to provide protection against specific antigens, but in ramping up an immune response, rogue autoimmune elements may also become activated and potentially trigger an unwanted attack. Vaccine-associated attacks have been linked to neuroimmunological disorders including TM, optic neuritis, ADEM, and NMOSD (Agmon-- Levin et al, 2009;Huynh et al, 2008;Karussis and Petrou, 2014;Mealy et al, 2018;Zanoni et al, 2002). Infections are also potent triggers of attack; more than 40 cases of TM following COVID have been reported (Mondal et al, 2021;Schulte et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

Patient-reported safety and tolerability of the COVID-19 vaccines in persons with rare neuroimmunological diseases

Lotan

Romanow

Lévy

2021

Multiple Sclerosis and Related Disorders

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Background : The COVID-19 vaccines are currently recommended for people with rare neuroimmunological diseases such as Neuromyelitis optica spectrum disorder (NMOSD), MOG-antibody disease (MOGAD), and transverse myelitis. However, the safety profile of the vaccines in this population is uncertain. Objective : To report real-world safety data of the COVID-19 vaccines in persons with rare neuroimmunological diseases. Methods : An anonymous survey was distributed to patients recruited on social media. Participants answered general demographic and disease-related questions, and specific questions about their experiences with the COVID-19 vaccines. Results : 438 participants completed the questionnaire. The median age was 51 (range 18-82 years); 366 were female (83.6%); 102 (23.3%) had associated comorbidities, and 354 (80.1%) were treated with immunotherapies. 242 participants (55.3%) reported a diagnosis of NMOSD; 99 (22.6%) had MOGAD; 79 (18%) had transverse myelitis. 239 participants (66.2%) were younger than 55 years of age. 138 participants (31.5%) reported immediate adverse events. Of these, 93 (67.4%) were < 55 years old, and 45 (32.6%) were > 55 years old (p=0.0086). The most common adverse events were local reactions, including pain, redness, and swelling at the injection site, reported by 155 participants (35.4%). 73 participants (16.7%) reported new or worsening neurological symptoms following the vaccination. Most symptoms occurred within the first week after vaccination and resolved within three days. Conclusions : This survey indicates an overall favorable safety and tolerability profile of the COVID-19 vaccines among persons with rare neuroimmunological diseases. Longer-term studies are warranted to confirm these data.

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Vaccines and the association with relapses in patients with neuromyelitis optica spectrum disorder

Cited by 41 publications

References 26 publications

Safety and efficacy of COVID-19 vaccines in multiple sclerosis patients

Safety and efficacy of COVID-19 vaccines in multiple sclerosis patients

Neuromyelitis Optica in a Healthy Female After Severe Acute Respiratory Syndrome Coronavirus 2 mRNA-1273 Vaccine

Patient-reported safety and tolerability of the COVID-19 vaccines in persons with rare neuroimmunological diseases

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