Humoral Immune Response after the Third SARS-CoV-2 mRNA Vaccination in CD20 Depleted People with Multiple Sclerosis

Vaccines

Christoph Andreas Fux¹  Barbara Jakopp¹  Oliver Findling²  Krassen Nedeltchev²  Lutz Achtnichts²  Johann Sellner³  Michael Oberle⁴ 

[1] Department of Infectious Diseases and Hospital Infection Prevention, Aarau Cantonal Hospital, 5000 Aarau, Switzerland;Department of Neurology, Aarau Cantonal Hospital, 5000 Aarau, Switzerland;Department of Neurology, Landesklinikum Mistelbach-Gänserndorf, 2130 Mistelbach, Austria;Institute for Laboratory Medicine, Aarau Cantonal Hospital, 5000 Aarau, Switzerland;

关键词: SARS-CoV-2;    B cell depletion;    humoral immune response;    vaccination;    COVID-19;   

DOI  :  10.3390/vaccines9121470

来源: DOAJ

【 摘 要 】

CD20 depletion is a risk factor for unfavorable outcomes of COVID-19 in people with MS (pwMS). Evidence suggests that protective IgG response to mRNA-based vaccines in B cell-depleted individuals is limited. We studied the seroconversion after the third mRNA SARS-CoV-2 vaccine in B cell-depleted pwMS with limited or no IgG response after the standard immunization. Sixteen pwMS treated with ocrelizumab or rituximab received a third homologous SARS-CoV-2 mRNA vaccine, either the Moderna mRNA-1273 or Pfizer-BioNTech’s BNT162b2 vaccine. We quantified the response of IgG antibodies against the spike receptor-binding domain of SARS-CoV-2 four weeks later. An antibody titer of 100 AU/mL or more was considered clinically relevant. The median time between the last infusion of the anti-CD20 treatment and the third vaccination was 22.9 weeks (range 15.1–31.3). After the third vaccination, one out of 16 patients showed an IgG titer deemed clinically relevant. Only the seroconverted patient had measurable B-cell counts at the time of the third vaccination. The development of a humoral immune response remains rare in pwMS on anti-CD20 therapy, even after third dose of the homologous SARS-CoV-2 mRNA vaccine. It remains to be determined whether T-cell responses can compensate for the lack of seroconversion and provide sufficient protection against CoV-2 infections.

【 授权许可】

Unknown