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Review
. 2021 Jan 28;9(2):99.
doi: 10.3390/vaccines9020099.

Multiple Sclerosis and SARS-CoV-2 Vaccination: Considerations for Immune-Depleting Therapies

Johann Sellner  1   2   3 , Paulus S Rommer  4
Affiliations
Review

Multiple Sclerosis and SARS-CoV-2 Vaccination: Considerations for Immune-Depleting Therapies

Johann Sellner et al. Vaccines (Basel). .

Abstract

Several concerns have been raised about the use of immunodepleting agents including alemtuzumab, cladribine and CD20-depleting antibodies in people with multiple sclerosis (pwMS) during the coronavirus disease (COVID) 2019 pandemic. As the end of the pandemic is not yet in sight, vaccination against severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) may be an elegant strategy to overcome the potential hazards associated with initiating and continuing treatment with immune-depleting agents. In this review, we summarize the immunological effects of immune-depleting therapy and underlying considerations for the hitherto existing recommendations that suggest a restricted use of immune-deleting therapies during the pandemic. Moreover, we critically discuss open questions regarding vaccination in general and against SARS-CoV-2 in pwMS.

Keywords: CD20 depletion; COVID-19; SARS-CoV-2; alemtuzumab; cladribine; disease-modifying drugs; immune-depleting therapies; multiple sclerosis; vaccination.

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Conflict of interest statement

The authors declare no conflict of interest. J.S. is member of advisory boards and/or received honoraria for lectures from Alexion, BMS, Biogen, Boehringer, Immunic, Novartis, Roche and Sanofi. P.S.R. is a member of advisory board and/or received honoraria for lectures from AbbVie, Amicus, Biogen, Daiichi-Sankyo, Merck Serono, Novartis, Roche, Sandoz, Sanofi Genzyme, and Teva.

Figures

Figure 1
Figure 1
Principles of maintenance/escalation therapy (A) and immune-depleting therapy (B).
See this image and copyright information in PMC

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