Safety of COVID-19 Vaccination in Those with MS, NMOSD, and MOGAD

July 12, 2023

A recent paper outlined the findings of a new study on the safety and efficacy of COVID-19 vaccines in patients with Multiple Sclerosis (MS), Neuromyelitis Optica spectrum disorder (NMOSD), and Myelin Oligodendrocyte Glycoprotein antibody disease (MOGAD). Researchers in South Korea examined the medical records of 56 patients (19 with MS, 22 with NMOSD, and 15 with MOGAD) to determine the effects of vaccination on this population. 

Most vaccine side effects were minor. Researchers found that about a third of patients experienced minor side effects after vaccination, such as fever or injection site pain. 7% of patients in the study had neurological side effects from vaccination, such as tingling sensations or muscle weakness; another 7% experienced disease relapse after vaccination. Researchers also reported that three patients experienced disease worsening or new onset. One MS patient experienced “Facial sensory changes with a brainstem lesion” following vaccination, and a MOGAD patient got myelitis (1).  A third patient was diagnosed with optic neuritis and MOGAD following vaccination (1) (though a causal link cannot be established from this information).

The efficacy of COVID vaccines in this population is unclear. The majority of patients in the study were vaccinated (43 people out of 56); however, 32% (14 people) of the vaccinated patients got covid, while only 23% (3 people) of the unvaccinated patients got the disease. The rates of hospitalization between the two groups remained the same. All three (100%) of the unvaccinated patients who caught covid experienced neurologic deterioration following their illness, while only three (21%) of the fourteen vaccinated patients did. This suggests that the COVID-19 vaccine may prevent neurological exacerbations related to COVID-19, even if it does not prevent infection.

The lower level of immunity following vaccination in patients with MS, NMOSD, and MOGAD is thought to be caused by the immunosuppressive drugs taken to manage these diseases. Previous research has shown that MS patients taking fingolimod, alemtuzumab, or anti-CD20 monoclonal antibodies (ocrelizumab and rituximab) and NMOSD patients on corticosteroids have less response to vaccination.

The authors of the study concluded that their study “demonstrated a favorable safety profile with no serious adverse events associated with COVID-19 vaccines in patients with MS, NMOSD, and MOGAD” (1).