Multiple Sclerosis Patients on Anti-CD20 Therapy Create Antibodies Following COVID Vaccination 

September 30, 2021

A study published in Nature has shown that multiple sclerosis patients undergoing anti-CD20 therapy were able to create robust T-cells following vaccination with an mRNA vaccine. 

Anti-CD20 treatments are often used for cancer immunotherapy, neurology, and rheumatology, depleting B cells which attack the myelin sheath and eventually erode the nerves in those living with MS. These B cells contribute to antibody production; without them, the body’s ability to produce antibodies against SARS-CoV-2 is decreased.  

The study measured the antibody and T cell responses in 20 MS patients on anti-CD20 therapy. No participants had COVID-19 prior to enrolling in the study. By 30 days after the second dose of a Pfizer or Moderna mRNA vaccine, 85% of participants had developed anti-spike antibodies. This antibody response was generally delayed and lower compared to the control group, but antibodies were still detectable. That being said, those on anti-CD20 therapies may not neutralize viral particles after coming into contact as quickly as others not on anti-CD20 therapies, making them more likely to be contagious, as well as carry the virus. 

Timing of anti-CD20 infusion correlated with the patient’s immune response – patients with more B cells prior to vaccination mounted a more robust antibody response to the vaccine. The results of this study provide insight on how MS patients, as well as patients living with other autoimmune diseases, can approach vaccination while on immunosuppressive treatments. Additionally, testing for antibodies as well as T-cells offers more understanding into whether someone is protected after receiving the COVID-19 vaccine.