Abstract Details

Immunological studies have measured humoral and cellular immune responses to COVID-19 vaccines among MS patients receiving DMTs, but their clinical relevance is unclear. Using cumulative data of the entire population of MS patients on DMTs in England, we showed that the incidence of SARS-CoV-2 infection among patients on fingolimod and ocrelizumab did not decrease following mass vaccination as opposed to the general population or patients on other MS DMTs.

To assess the clinical effectiveness of COVID-19 vaccines in multiple sclerosis (MS) patients receiving disease-modifying therapies (DMTs)

We have now access to individual-level data on COVID-19 vaccination and COVID-19 related outcomes of all MS patients receiving DMTs in England from the start of the pandemic. These prospectively and longitudinally collected data are provided by the National Health Service (NHS) England and NHS Improvement and the UK Health Security Agency. We calculated the incidence of SARS-CoV-2 infection (i.e., a positive test) and COVID-19 related hospitalisation (i.e., hospitalisation of >1 day within 0-28 days of a positive test) following vaccination (i.e., ≥14 days after the second dose) from December-2020 to January-2022.

A total of 38,039 MS patients on DMTs (90%) had at least two doses of COVID-19 vaccines. Following vaccination, the incidence of infection was 24% (859/3624) for ocrelizumab, 22% (819/3797) for fingolimod, and ranged from 11% to 16% for other DMTs. The hospitalisation rate among infected patients was 7% (n=61) for ocrelizumab, 4% (n=33) for fingolimod, and ranged from 1% to 4% for other DMTs.

Patients on ocrelizumab have higher rates of infection and hospitalisation than other DMTs using current vaccination protocols. Patients on fingolimod also have higher rates of infection but their hospitalisation rate is similar to other DMTs. Further analysis of booster vaccination, unvaccinated patients, and COVID-19 related mortality is ongoing and will be presented at the meeting.