Diminished seroconversion following a single SARS-COV-2 vaccine in ocrelizumab-treated relapsing-remitting multiple sclerosis patients

Mult Scler. 2022 Jun;28(7):1126-1130. doi: 10.1177/13524585211046786. Epub 2021 Oct 1.

Abstract

Background: Despite impressive efficacy in immunocompetent individuals, the immunogenicity of a single dose of COVID-19 vaccine in B-cell-deplete patients remains unknown.

Objectives: We aimed to quantify real-world vaccine immunogenicity in ocrelizumab recipients.

Methods: We measured post-vaccination SARS-COV-2 immunoglobulin G (IgG) in ocrelizumab recipients using a highly sensitive Luminex assay.

Results: 44.1% of patients had detectable SARS-COV-2-IgG 21+ days after one vaccine dose, regardless of vaccine type (AZD1222 vs BNT162b2, odds ratio (OR) = 0.62, 95% confidence interval (CI) = 0.157-2.32, p = 0.72). B-cell count strongly predicted seroconversion (β1 = 12.38, 95% CI = 4.59-20.16, p = 0.0029), but undetectable B-cells did not preclude it. The second vaccine seroconverted 53% of the patients who had not already responded to dose 1.

Conclusion: Humoral response after one COVID-19 vaccine dose is lower than expected in CD20-deplete patients.

Keywords: COVID-19; Ocrelizumab; SARS-COV-2; antibodies; vaccination.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Monoclonal, Humanized
  • Antibodies, Viral
  • BNT162 Vaccine
  • COVID-19 Vaccines
  • COVID-19* / prevention & control
  • ChAdOx1 nCoV-19
  • Humans
  • Immunoglobulin G / therapeutic use
  • Multiple Sclerosis* / drug therapy
  • Multiple Sclerosis, Relapsing-Remitting* / drug therapy
  • SARS-CoV-2
  • Seroconversion

Substances

  • Antibodies, Monoclonal, Humanized
  • Antibodies, Viral
  • COVID-19 Vaccines
  • Immunoglobulin G
  • ocrelizumab
  • ChAdOx1 nCoV-19
  • BNT162 Vaccine