COVID vaccines have implications for MS disease-modifying therapies
“Vaccine readiness” has become a hot topic in MS, which is often treated with immunosuppressive drugs. In a recent webinar (held on 21st May) hosted by MS Academy, Professor Gavin Giovannoni and Professor David Baker discussed the likelihood of people living with MS being able to respond to a COVID-19 vaccine.
At that time, just one month ago, the possibility of a vaccine for COVID-19 seemed unlikely within a 12-18 month time period. However, the recent publication in the New England Medical Journal of Moderna's positive phase 1 results from the mRNA Vaccine Against COVID-19 (mRNA-1273) trials suggests a vaccine could be more imminent than initially thought.
During the webinar discussion, David was clear that people with MS appear to have similar risks for developing severe COVID-19 as the general population and that they appear to be recovering from COVID-19 in similar numbers, irrespective of whether they are on a DMT. However, he noted that whilst this suggests that those with MS will respond similarly to a vaccine as the general populace, there are some disease-modifying therapies (DMTs) which can blunt antibody vaccination responses.
In a subsequent blog post following Moderna's phase 1 trial findings, Gavin provided further information on this, noting that DMTs in anti-CD20 and S1P-modulator categories are known to impair protective vaccine responses (see Gavin's blog for a full list of applicable drugs).
For people who are not on immunotherapy, Gavin is clear that the benefits of immunisation outweigh the risks, sharing that immune response to antigenic stimulation is similar between people with and without MS.
The new trial results suggest that there may be a need for people to be 'vaccine-ready within a 6-9 month time period', but regardless of COVID-19, discussing immunisation should be an integral part of routine care in MS, and the expectations for a COVID-19 vaccine further highlight the need for this element of care going forward.