Study Finds that COVID Vaccines Generate Immune Responses Beyond Antibodies in People with MS on Immune-Suppressing Therapies
September 15, 2021
In a study of 20 people with MS who had taken therapies that deplete antibody producing immune B cells, researchers found that COVID-19 vaccines stimulated immune responses that may be protective against the virus, although the responses were reduced compared with people without MS. This study is already informing advice regarding timing of therapies and vaccinations. Further study, now ongoing, is needed to understand how well-protected people with MS on certain disease-modifying therapies are from getting COVID-19 once they’re vaccinated. Learn more
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- People taking certain MS disease-modifying therapies can sometimes have reduced and possibly undetectable antibody responses to the COVID-19 vaccines. Antibodies are proteins produced by the immune system and their presence is one indication that the vaccine is providing protection from the virus. Other components of the immune system are triggered by the vaccine and could also contribute to protection. Research is underway to explore these other components of the immune response to the vaccine and how they might play a role in protection against COVID-19.
- Investigators at the University of Pennsylvania and other institutions studied 20 people with MS who were treated with ocrelizumab (Ocrevus®, Genentech) or rituximab, and 10 people without MS. Blood samples were taken before and after each dose of either the Pfizer-BioNTech (Comirnaty) or Moderna COVID-19 vaccine. The blood was examined for COVID-19-targeted antibodies and other immune cell activity (including B cells, the cells depleted by ocrelizumab and rituximab, and T cells.
- Although those with MS showed weaker antibody production after vaccination, all generated robust T cell responses, which may help fight COVID-19. Those with a longer duration since their last B cell-depleting treatment were more likely to show stronger B cell responses, including antibody production. People with MS who had comparable numbers of circulating B cells to people without MS before the vaccine was administered had comparable antibody responses. This suggests that measuring individuals’ B cells may help predict who will respond better to vaccination.
- This study provides evidence that vaccination provides some immunity to COVID-19 and emerging variants in people with MS who take B cell-depleting therapies. It shows the importance of vaccination for all people with MS regardless of the anticipated antibody response.
- Investigators are continuing to study immune responses of immunocompromised people. This team is now contributing to an ongoing study of 600 people with MS and other disorders that is assessing responses to an extra dose of COVID-19 vaccines. That study is funded by the National Institute of Health’s National Institute of Allergy and Infectious Diseases.
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“Cellular and humoral immune responses following SARS-CoV-2 mRNA vaccination in patients with multiple sclerosis on anti-CD20 therapy”
by Sokratis A. Apostolidis, Amit Bar-Or, and colleagues (University of Pennsylvania Perelman School of Medicine) is available via open access from Nature Medicine
(Published: 14 September 2021).