COVID-19 Vaccine Side Effects With MS Similar to Public at Large

Side effects upon receiving the COVID-19 vaccine in people with multiple sclerosis (MS) are similar to those reported in the general population, and patients on certain disease-modifying therapies are less likely to have vaccine reactions, a survey-based study found.

The findings provide “a reassuring picture” for those who feel hesitant about vaccination or are yet to be vaccinated. Further research on the immune response to vaccination is underway, according to a press release from the National MS Society, which funded the work.

The study, “COVID-19 vaccination reactogenicity in persons with multiple sclerosis,” was published in Neurology: Neuroimmunology & NeuroInflammation.

While most people with relapsing and progressive forms of MS are encouraged to get vaccinated against COVID-19, about 20% are hesitant due to specific concerns related to the vaccine’s safety, efficacy, and potential side effects, the study noted.

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To gather real-world information related to COVID-19 vaccines and how safe they are for people with MS, scientists associated with the iConquerMS research network conducted a survey that is part of a larger study called COVER-MS.

Between March and June 2021, a total of 719 patients answered a set of questions about their experiences with the vaccines, including side effects after their first and second shots. Their mean age was 53 and most (70%) had relapsing-remitting MS, with a mean disease duration of 14 years.

A majority received the Pfizer-BioNTech (BNT162b2) vaccine (57%), followed by the Moderna (mRNA-1273) vaccine (36%). Among the 442 patients who had a second shot, most received the Pfizer-BioNTech (61%) or Moderna (38%) vaccine within one month of the first shot.

Nearly two-thirds (64%) of patients reported a side effect within one day after their first shot, and 17% reported a severe side effect. The most common side effects were pain at the injection site (54%), fatigue (34%), headache (28%), and a general feeling of discomfort (21%).

After the second shot, 74% of patients reported a side effect and 22% reported a severe side effect. These side effects were similar to those reported after the first shot.

“The short-term vaccine reactions experienced in the study population were mostly self-limiting, including pain at the injection site, fatigue, headache, and fever,” the researchers wrote.

People who were younger, female, or had a prior infection with the COVID-19-causing virus were more likely to experience side effects after the first shot. Those who were younger or received the Moderna vaccine were more likely to experience side effects after their second shot.

Furthermore, patients who experienced a reaction after the first shot were found to have a substantially higher likelihood of experiencing a reaction after the second shot.

Researchers also collected data on disease-modifying therapies (DMTs) in relation to vaccination. About one-quarter of these patients, or 180 people, were not actively using a DMT at the time of the survey.

Those taking an alpha-4-integrin blocker such as Tysabri (natalizumab) or a sphingosine-1-phosphate receptor modulator such as Gilenya (fingolimod), Mayzent (siponimod) or Zeposia (ozanimod) were less likely to have a severe side effect after the first shot compared to those not receiving a DMT, the study noted.

Those using a sphingosine-1-phosphate receptor modulator or taking Tecfidera (dimethyl fumarate) or Vumerity (diroximel fumarate) were less likely to have a side effect after the second shot.

“Our findings do not suggest that there is an excess of short-term side effects in [MS patients] compared with the general population after SARS-CoV-2 [COVID-19] vaccinations,” the researchers concluded.

“In summary, we hope that the experiences of [MS patients] in this cohort can inform vaccine-hesitant [patients] and provide important information to health care providers, particularly those in countries where vaccine accessibility is still limited,” they added.