SARS-CoV-2 Vaccination in Patients with Multiple Sclerosis

October 19, 2022

Patients with chronic diseases like Multiple Sclerosis (MS) were excluded from SARS-CoV-2 vaccination trials. At the same time, vaccination is recommended for this vulnerable population.

A survey-based study recently published in The Lancet analyzed vaccination reactions and disease deterioration after SARS-CoV-2 vaccination among more than 6,000 MS patients in Germany and the United Kingdom.  

The most frequently used vaccines in Germany were by Pfizer and Moderna, while in the UK, the majority of people included in the study received AstraZeneca’s COVID-19 vaccine. The most common vaccination reactions recorded in the study were fatigue, headache, and pain at the injection site; reactions were observed more frequently in women than in men.

19% of study participants from Germany experienced worsened MS symptoms or the onset of new symptoms. The most common reported symptom was fatigue, followed by impaired mobility and pain. Gender-specific differences were not observed.

Researchers hypothesized a few reasons for worsened symptoms or the uptick in new symptoms:

  1. Worsened MS symptoms or the onset of new symptoms were associated with moderate or severe disability. Authors hypothesized that since more disabled patients have more severe disease progression, this may correlate with the perception of worsened or new symptoms.
  2. Lack of DMD treatment (disease-modifying drugs), which also correlated with worsened MS symptoms or new symptoms, may result in a more robust immune response to vaccination. 
  3. There is a possibility that people who experienced more severe symptoms were more likely to follow up during the study. In contrast, those who did not experience negative reactions were less likely to follow up with the survey, creating bias in reporting. 

Authors of the study could not determine whether vaccination directly caused the worsening or onset of new symptoms. Additional research and improved study design could help to answer those questions. Authors mentioned that it would be worth comparing vaccinated MS patients with unvaccinated MS patients to determine whether the worsening of MS symptoms is associated with vaccination status. The authors also point out the need for longitudinal studies to determine the prevalence of long-term vaccination reactions and MS deterioration.