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Clinical Trial
. 2021 Aug 26:12:718895.
doi: 10.3389/fimmu.2021.718895. eCollection 2021.

Tetravalent Influenza Vaccine Is Not Associated With Neuroaxonal Damage in Multiple Sclerosis Patients

Tobias Moser  1 , Michael Seiberl  1 , Julia Feige  1 , Lara Bieler  1 , Richard F Radlberger  1 , Ciara O'Sullivan  1 , Georg Pilz  1 , Andrea Harrer  1 , Kerstin Schwenker  1 , Elisabeth Haschke-Becher  2 , Lukas Machegger  3 , Jochen Grimm  3 , Monika Redlberger-Fritz  4 , Arabella Buchmann  5 , Michael Khalil  5 , Erich Kvas  6 , Eugen Trinka  1   7 , Peter Wipfler  1
Affiliations
Clinical Trial

Tetravalent Influenza Vaccine Is Not Associated With Neuroaxonal Damage in Multiple Sclerosis Patients

Tobias Moser et al. Front Immunol. .

Abstract

Background: Efficacy of vaccines and disease activity linked to immunization are major concerns among people with multiple sclerosis (pwMS).

Objective: To assess antibody responses to seasonal influenza antigens and vaccine-associated neuroaxonal damage utilizing serum neurofilament light chain (sNfL) in pwMS receiving dimethyl fumarate (DMF).

Methods: In this prospective study, the 2020/2021 seasonal tetravalent influenza vaccine was administered to 20 pwMS treated with DMF and 15 healthy controls (HCs). The primary endpoints were responder rate of strain-specific antibody production (seroconversion or significant (4-fold) increase in influenza-antibody titers for ≥2/4 strains) at 30 days post-vaccination and changes in sNfL levels.

Results: All patients treated with DMF fulfilled the responder criteria for immunization compared with 53% of the controls. However, higher proportions of HCs already had influenza-antibody titers ≥1:40 at baseline (53% vs. 41%, p = 0.174). sNfL levels were comparable among both groups at baseline and did not increase 34 days after vaccination. In addition, no clinical or radiological disease reactivation was found.

Conclusion: DMF-treated patients mount an adequate humoral immune response to influenza vaccines. Within the limits of the small cohort investigated, our data suggest that influenza immunization is not associated with clinical or subclinical disease reactivation.

Keywords: COVID-19; NfL; antibody response; immunization; influenza; titers; vaccination.

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Conflict of interest statement

Author EK was employed by company Hermesoft. TM received travel support and honoraria for presentations or participation on advisory boards from Biogen Idec, Celgene, Novartis, Roche, Sanofi, Merck, and Teva. ET has received consultation fees and/or speakers honoraria from Arvelle, Argenix, Angellini, Bial, Biogen Idec, Boehringer Ingelheim, Eisai, Epilog, GL Pharma, GW Pharmaceuticals, Ever Pharma, Hikma, LivaNova, Marinus, Medtronics, Newbridge, Novartis, Sanofi, Genzyme, and UCB Pharma. MK has received speaker honoraria from Bayer, Novartis, Merck, Biogen Idec, and Teva Pharmaceutical Industries Ltd. and serves on scientific advisory boards for Biogen Idec, Merck Serono, Roche, Novartis, Bristol-Myers Squibb, and Gilead. He received research grants from Teva Pharmaceutical Industries Ltd., Biogen, and Novartis. AB was trained within the frame of the PhD Program Molecular Medicine of the Medical University of Graz. JF received travel support and honoraria for presentations from Biogen, Merck, Roche, and Sanofi. MS received travel support from Biogen, Merck, Bristol-Myers Squibb, Sanofi, Roche, Teva, and Novartis. PW has received consultation fees and/or speakers honoraria from Bayer, Biogen Idec, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi Genzyme, and Teva Pharmaceutical Industries Ltd. He received research grants from Biogen Idec and Merck. EK has received consultation fees from Astra Zeneca, Biogen, Bristol-Myers Squibb, Chiesi, Genzyme-Sanofi, Gilead, Glock, Merck, Novartis Pharma, Pfizer, Roche, Servier, and Vertex. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Vaccine efficacy to influenza immunization in multiple sclerosis (MS) patients on dimethyl fumarate (DMF) and healthy controls. (A) Pre- and post-vaccine seroprotection rates, defined by a strain-specific anti-influenza titer of ≥1:40. (B) Vaccine responder rates among the two cohorts. Vaccine response was defined by seroconversion and/or significant (≥4-fold) specific titer increases in ≥2/4 influenza strains. (C) Increases in strain-specific antibody titers among the two cohorts at 34.1 days ( ± 9.4) post-vaccination compared with baseline. Dotted lines indicate the cut-off titer for seroprotection.
Figure 2
Figure 2
No subclinical disease activity as measured by serum neurofilament light chain (sNfL) associated with influenza vaccination was found. Displayed are sNfL values for patients and controls at baseline and 34.1 days ( ± 9.4) after immunization with influenza vaccine. Bars indicate median and interquartile range (IQR).
Figure 3
Figure 3
Course of inflammatory proteins and main immune cells at baseline and 29.1 ( ± 2.9) days after influenza vaccination for 20 patients on dimethyl fumarate (DMF). No statistically significant alterations were found. Green areas display the reference range. CRP, C-reactive protein; IL-6, interleukin 6; NK, natural killer.
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References

    1. Greenwood B. The Contribution of Vaccination to Global Health: Past, Present and Future. Philos Trans R Soc Lond B Biol Sci (2014) 369(1645):20130433. 10.1098/rstb.2013.0433 - DOI - PMC - PubMed
    1. World Health Organization (WHO) . Report of the SAGE Working Group on Vaccine Hesitancy. Vaccine Hesitancy (2014) 33:4161–64. 10.1016/j.vaccine.2015.04.036 - DOI
    1. Larson HJ, Jarrett C, Eckersberger E, Smith DM, Paterson P. Understanding Vaccine Hesitancy Around Vaccines and Vaccination From a Global Perspective: A Systematic Review of Published Literature, 2007-2012. Vaccine (2014) 32(19):2150–9. 10.1016/j.vaccine.2014.01.081 - DOI - PubMed
    1. Williamson EM, Berger JR. Infection Risk in Patients on Multiple Sclerosis Therapeutics. CNS Drugs (2015) 29(3):229–44. 10.1007/s40263-015-0226-2 - DOI - PubMed
    1. Wingerchuk DM, Carter JL. Multiple Sclerosis: Current and Emerging Disease-Modifying Therapies and Treatment Strategies. Mayo Clin Proc (2014) 89(2):225–40. 10.1016/j.mayocp.2013.11.002 - DOI - PubMed

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