COVID-19 vaccines are not associated with axonal injury in patients with multiple sclerosis

Front Immunol. 2024 Aug 22:15:1439393. doi: 10.3389/fimmu.2024.1439393. eCollection 2024.

Abstract

Objective: To evaluate the safety of COVID-19 vaccines in patients with multiple sclerosis (MS) by assessing their impact on serum neurofilament light chain (sNfL) levels as a marker of neuroaxonal damage.

Methods: Single-center observational longitudinal study including patients with MS who consecutively received their initial vaccination against SARS-CoV-2 at Hospital Universitario Ramón y Cajal, following the first national immunization program in Spain. Serum samples were collected at baseline and after receiving the second dose of the vaccine. sNfL levels were quantified using the single molecule array (SIMOA) technique. Adverse events, including clinical or radiological reactivation of the disease, were recorded.

Results: Fifty-two patients were included (median age, 39.7 years [range, 22.5-63.3]; 71.2% female). After SARS-CoV-2 vaccination, no increased inflammatory activity, either determined by the presence of relapses and/or new MRI lesions and/or high sNfL levels, was detected. Accordingly, there was no difference between median sNfL levels before and after vaccination (5.39 vs. 5.76 pg/ml, p=0.6). Despite this, when looking at baseline patient characteristics before vaccination, younger age associated with disease activity after vaccination (OR 0.87, 95% CI: 0.77-0.98, p=0.022). Larger studies are needed to validate these results.

Conclusion: COVID-19 vaccines did not cause reactivation of disease at a clinical, radiological or molecular level, thus suggesting that they are safe in MS patients.

Keywords: COVID-19 vaccines; SARS-CoV-2 immunization; multiple sclerosis; neuroaxonal damage; sNfL; safety.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Axons / pathology
  • Biomarkers / blood
  • COVID-19 Vaccines* / adverse effects
  • COVID-19 Vaccines* / immunology
  • COVID-19* / blood
  • COVID-19* / immunology
  • COVID-19* / prevention & control
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Multiple Sclerosis* / blood
  • Multiple Sclerosis* / immunology
  • Neurofilament Proteins* / blood
  • SARS-CoV-2* / immunology
  • Spain / epidemiology
  • Vaccination / adverse effects
  • Young Adult

Substances

  • COVID-19 Vaccines
  • Neurofilament Proteins
  • neurofilament protein L
  • Biomarkers

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study has been funded by Instituto de Salud Carlos III (ISCIII) through the project "PI21/00828" and by grant RD21/0002/0053 from La Red Española de Enfermedades Inflamatorias and co-funded by the European Union.