Vaccines (Dec 2023)

Occurrence and Risk Factors of Relapse Activity after Vaccination against COVID-19 in People with Multiple Sclerosis: 1-Year Follow-Up Results from a Nationwide Longitudinal Observational Study

  • Firas Fneish,
  • Niklas Frahm,
  • Melanie Peters,
  • David Ellenberger,
  • Judith Haas,
  • Micha Löbermann,
  • Dieter Pöhlau,
  • Anna-Lena Röper,
  • Sarah Schilling,
  • Alexander Stahmann,
  • Herbert Temmes,
  • Friedemann Paul,
  • Uwe K. Zettl

DOI
https://doi.org/10.3390/vaccines11121859
Journal volume & issue
Vol. 11, no. 12
p. 1859

Abstract

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Several studies reported post-SARS-CoV-2-vaccination (PV) symptoms. Even people with multiple sclerosis (PwMS) have concerns about disease activity following the SARS-CoV-2 vaccination. We aimed to determine the proportion of PwMS with PV relapses, the PV annualized relapse rate (ARR), the time from vaccination to subsequent relapses, and identify sociodemographic/clinical risk factors for PV relapses. PwMS were surveyed several times at baseline and four follow-ups as part of a longitudinal observational study regarding the safety and tolerability of the SARS-CoV-2 vaccination. The inclusion criteria for this analysis were age ≥18 years, ≥1 SARS-CoV-2 vaccination, and ≥1-year observation period since initial vaccination. Of 2466 PwMS, 13.8% reported PV relapses (mostly after second [N = 147] or booster vaccination [N = 145]) at a median of 8.0 (first/third quantile: 3.55/18.1) weeks PV, with the shortest period following initial vaccination (3.95 weeks). The ARR was 0.153 (95% confidence interval: 0.138–0.168), with a median observation period since initial vaccination of 1.2 years. Risk factors for PV relapses were younger age, female gender, moderate-severe disability levels, concurrent autoimmune diseases, relapsing-remitting MS courses, no DMT, and relapses within the year prior to the first vaccination. Patients’ health conditions before/during initial vaccination may play a more important role in PV relapse occurrence than vaccination per se.

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