@article{3fe61617f68d49c3a037dc10c1cd4799,
title = "Vaccine Considerations for Multiple Sclerosis in the COVID-19 Era",
abstract = "People with multiple sclerosis (MS) are at risk for infections that can result in amplification of baseline symptoms and possibly trigger clinical relapses. Vaccination can prevent infection through the activation of humoral and cellular immune responses. This is particularly pertinent in the era of emerging novel vaccines against severe acute respiratory syndrome coronavirus 2, the virus that causes coronavirus disease 2019 (COVID-19). MS disease-modifying therapies (DMTs), which affect the immune system, may impact immune responses to COVID-19 vaccines in people with MS. The objective of this article is to provide information on immune system responses to vaccinations and review previous studies of vaccine responses in people with MS to support the safety and importance of receiving currently available and emerging COVID-19 vaccines. Immunological studies have shown that coordinated interactions between T and B lymphocytes of the adaptive immune system are key to successful generation of immunological memory and production of neutralizing antibodies following recognition of vaccine antigens by innate immune cells. CD4+ T cells are essential to facilitate CD8+ T cell and B cell activation, while B cells drive and sustain T cell memory. Data suggest that some classes of DMT, including type 1 interferons and glatiramer acetate, may not significantly impair the response to vaccination. DMTs—such as sphingosine-1-phosphate receptor modulators, which sequester lymphocytes from circulation; alemtuzumab; and anti-CD20 therapies, which rely on depleting populations of immune cells—have been shown to attenuate responses to conventional vaccines. Currently, three COVID-19 vaccines have been granted emergency use authorization in the USA on the basis of promising interim findings of ongoing trials. Because analyses of these vaccines in people with MS are not available, decisions regarding COVID-19 vaccination and DMT choice should be informed by data and expert consensus, and personalized with considerations for disease burden, risk of infection, and other factors.",
keywords = "COVID-19, Multiple sclerosis, SARS-CoV-2, Vaccines",
author = "Coyle, {Patricia K.} and Anne Gocke and Megan Vignos and Newsome, {Scott D.}",
note = "Funding Information: Patricia K. Coyle receives consulting and nonbranded speaker fees from Accordant, Biogen, Bristol-Myers Squibb, Celgene, Genzyme/Sanofi, GlaxoSmithKline, Janssen, Novartis, and Viela Bio; receives research support from Actelion, Alkermes, Celgene, Corrona, Genentech/Roche, MedDay, NINDS, and Novartis. Anne Gocke and Megan Vignos are employees of and own stock/stock options in Biogen. Scott D. Newsome has received consultant fees for scientific advisory boards from Biogen, Genentech, Bristol-Myers Squibb, EMD Serono, Novartis, Greenwich Biosciences; is an advisor for Autobahn Therapeutics and BioIncept; is a clinical adjudication committee member for a MedDay Pharmaceuticals clinical trial; and has received research funding (paid directly to institution) from Biogen, Novartis, Genentech, National MS Society, Department of Defense, and Patient Centered Outcomes Institute. Funding Information: Biogen provided funding for this review and the journal?s Rapid Service and Open Access Fees. Meryl Mandle from Excel Medical Affairs wrote the first draft of the manuscript based on input from the authors, and Nathaniel Hoover and Jackie Parker from Excel Medical Affairs copyedited and styled the manuscript per journal requirements. Biogen provided funding for the medical writing support. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published. Anne Gocke and Megan Vignos were involved with the conception and design of the work. Megan Vignos was involved in searches of the literature. Patricia K. Coyle, Anne Gocke, Megan Vignos, and Scott D. Newsome interpreted data for the work, reviewed and revised the work critically for important intellectual content, and provided final approval of the version to be published. Patricia K. Coyle receives consulting and nonbranded speaker fees from Accordant, Biogen, Bristol-Myers Squibb, Celgene, Genzyme/Sanofi, GlaxoSmithKline, Janssen, Novartis, and Viela Bio; receives research support from Actelion, Alkermes, Celgene, Corrona, Genentech/Roche, MedDay, NINDS, and Novartis. Anne Gocke and Megan Vignos are employees of and own stock/stock options in Biogen. Scott D. Newsome has received consultant fees for scientific advisory boards from Biogen, Genentech, Bristol-Myers Squibb, EMD Serono, Novartis, Greenwich Biosciences; is an advisor for Autobahn Therapeutics and BioIncept; is a clinical adjudication committee member for a MedDay Pharmaceuticals clinical trial; and has received research funding (paid directly to institution) from Biogen, Novartis, Genentech, National MS Society, Department of Defense, and Patient Centered Outcomes Institute. This article is based on previously conducted studies and does not contain any new studies with human participants or animals performed by any of the authors. Publisher Copyright: {\textcopyright} 2021, The Author(s).",
year = "2021",
month = jul,
doi = "10.1007/s12325-021-01761-3",
language = "English (US)",
volume = "38",
pages = "3550--3588",
journal = "Advances in Therapy",
issn = "0741-238X",
publisher = "Health Communications Inc.",
number = "7",
}