Response to COVID-19 booster vaccinations in seronegative people with multiple sclerosis
Emma Tallantyre, Martin Scurr, Nicola Vickaryous, Aidan Richards, Valerie Anderson, David Baker, Randy Chance, Nikos Evangelou, Katila George, Gavin Giovannoni, Katharine Harding, Aimee Hibbert, Gillian Ingram, Stephen Jolles, Meleri Jones, Angray S. Kang, Samantha Loveless, Stuart J. Moat, Neil P. Robertson, Francesca Rios, Klaus Schmierer, Mark Willis, Andrew Godkin, Ruth Dobson
Abstract
BACKGROUND: People with MS treated with anti-CD20 therapies and fingolimod often have attenuated responses to initial COVID-19 vaccination. However, uncertainties remain about the benefit of a 3rd (booster) COVID-19 vaccine in this group. METHODS: PwMS without a detectable IgG response following COVID-19 vaccines 1&2 were invited to participate. Participants provided a dried blood spot +/- venous blood sample 2-12 weeks following COVID-19 vaccine 3. Humoral and T cell responses to SARS-CoV-2 spike protein and nucleocapsid antigen were measured. RESULTS: Of 81 participants, 79 provided a dried blood spot sample, of whom 38 also provided a whole blood sample; 2 provided only whole blood. Anti-SARS-CoV-2-spike IgG seroconversion post-COVID-19 vaccine 3 occurred in 26/79 (33%) participants; 26/40 (65%) had positive T-cell responses. Overall, 31/40 (78%) demonstrated either humoral or cellular immune response post-COVID-19 vaccine 3. There was no association between laboratory evidence of prior COVID-19 and seroconversion following vaccine 3. CONCLUSIONS: Approximately one third of pwMS who were seronegative after initial COVID-19 vaccination seroconverted after booster (third) vaccination, supporting the use of boosters in this group. Almost 8 out of 10 had a measurable immune response following 3rd COVID-19 vaccine.