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. 2023 Aug 10;60(3):252-256.
doi: 10.29399/npa.28503. eCollection 2023.

The Effect of Smoking on Inactivated and mRNA Vaccine Responses Applied to Prevent COVİD-19 in Multiple Sclerosis

Sedat Şen  1 , Gökhan Arslan  2 , Melih Tütüncü  3 , Serkan Demir  4 , Öykü Dinç  5 , Tuncay Gündüz  6 , Cihat Uzunköprü  7 , Haluk Gümüş  8 , Mesude Tütüncü  9 , Ruveyda Akçin  10 , Serkan Özakbaş  11 , Mesrure Köseoğlu  9 , Sena Destan Bünül  12 , Ozan Gezer  3 , Damla Çetinkaya Tezer  4 , Cavid Baba  13 , Pınar Acar Özen  14 , Rabia Koç  15 , Tuğrul Elverdi  16 , Uğur Uygunoğlu  3 , Murat Kürtüncü  6 , Yeşim Beckmann  7 , İpek Güngör Doğan  4 , Ömer Faruk Turan  15 , Cavit Boz  17 , Murat Terzi  1 , Aslı Tuncer  14 , Sabahattin Saip  3 , Rana Karabudak  14 , Bekir Kocazeybek  18 , Hüsnü Efendi  12 , Uğur Bilge  19 , Aksel Siva  3
Affiliations

The Effect of Smoking on Inactivated and mRNA Vaccine Responses Applied to Prevent COVİD-19 in Multiple Sclerosis

Sedat Şen et al. Noro Psikiyatr Ars. .

Abstract

Introduction: Coronavirus disease 2019 (COVID-19) is the biggest health challenge of recent times. Studies so far reveal that vaccination is the only way to prevent this pandemic. There may be factors that decrease or increase vaccine effectiveness. In multiple sclerosis (MS), some of these factors may cause changes in the effectiveness of the vaccine, depending on the nature of the disease and disease-modifying treatments (DMT). In this study, we aimed to investigate the relationship between antibody titer and smoking in non-treated and DMT-treated MS patients who received inactivated vaccine (Sinovac) and messenger RNA BNT162b2 (BioNTech) mRNA vaccines.

Method: Vaccine antibody responses were measured between 4-12 weeks after two doses of inactivated vaccine and mRNA vaccines. Patients were separated into 6 groups as: patients with MS without treatment PwMS w/o T, ocrelizumab, fingolimod, interferons (interferon beta-1a and interferon beta-1b), dimethyl fumarate, and teriflunomide. Antibody titers of smokers and non-smokers were compared for both vaccines and for each group.

Results: The study included 798 patients. In the mRNA vaccine group, smokers (n=148; 2982±326 AU/mL) had lower antibody titers compared to the non-smokers (n=244; 5903±545 AU/mL) in total (p=0.020). In the inactivated vaccine group, no significant difference was detected between smokers (n=136; 383±51 AU/mL) and non-smokers (n=270; 388±49 AU/mL) in total (p=0.149). In both vaccine groups, patients receiving ocrelizumab and fingolimod had lower antibody titers than those receiving other DMTs or PwMS w/o T. In untreated MS patients, antibody levels in smokers were lower than in non-smokers in the mRNA vaccine group. No difference was found between antibody levels of smokers and non-smokers in any of the inactivated vaccine groups.

Conclusion: Ocrelizumab and fingolimod have lower antibody levels than PwMS w/o T or other DMTs in both mRNA and inactivated vaccine groups. Smoking decreases antibody levels in the mRNA vaccine group, while it has no effect in the inactivated vaccine group.

Keywords: COVID-19; disease modifying therapy; multiple sclerosis; smoking; vaccine.

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Conflict of interest statement

Conflict of Interest: S. Şen, M. Tütüncü, S. Demir, T. Gündüz, C. Uzunköprü, H. Gümüş have received honoraria or consultancy fees for participating to advisory boards, giving educational lectures and/or travel and registration coverage for attending scientific congresses or symposia from F. Hoffmann-La Roche Ltd, Sanofi-Genzyme, Merck-Serono, Novartis, Teva, Biogen Idec/Gen Pharma. Aslı Tuncer has received honoraria or consultancy fees for partici- pating to advisory boards, giving educational lectures and/or travel and registration coverage for attending scientific congresses or symposia from F. Hoffmann-La Roche Ltd, Sanofi-Genzyme, Merck-Serono, Novartis, Teva, Biogen Idec/Gen Pharma. Serkan Özakbaş has received honoraria or consultancy fees for participating to advisory boards, giving educational lectures and/or travel and registration coverage for attending scientific congresses or symposia from F. Hoffmann-La Roche Ltd, Sanofi-Genzyme, Merck- Serono, Novartis, Teva, Biogen Idec/Gen Pharma. H. Efendi has received honoraria or consultancy fees for partici- pating to advisory boards, giving educational lectures and/or travel and registration coverage for attending scientific congresses or symposia from F. Hoffmann-La Roche Ltd, Sanofi-Genzyme, Merck-Serono, Novartis, Teva, Biogen Idec/Gen Pharma of Turkey and Abdi Ibrahim Rana Karabudak has received honoraria for giving educational lec- tures, consultancy fees for participating advisory boards, and travel grants for attending scientific congresses or symposia from Roche, Sanofi-Genzyme, Merck-Serono, Novartis, Teva, Biogen Idec/Gen Pharma of Turkey, Abdi Ibrahim Ilac, Deva and ARIS. Aksel Siva has received honoraria or consultancy fees for partici- pating to advisory boards, giving educational lectures and/or travel and registration coverage for attending scientific congresses or symposia from F. Hoffmann-La Roche Ltd, Sanofi-Genzyme, Merck-Serono, Novartis, Teva, Biogen Idec/Gen Pharma of Turkey and Abdi Ibrahim Ilac. The rest of authors declare no conflict of interest with the study project.

Figures

Figure 1
Figure 1
Distribution of antibody titer by vaccine type according to smoking.
Figure 2
Figure 2
Antibody titer distribution of mRNA vaccine group, DMTs according to smoking status.
Figure 3
Figure 3
Antibody titer distribution of inactivated vaccine group, DMTs according to smoking status.
See this image and copyright information in PMC

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