Evaluation of immunological responses to third COVID-19 vaccine among people treated with sphingosine receptor-1 modulators and anti-CD20 therapy

• Published in: Multiple sclerosis and related disorders 2023-02, Vol.70, p.104486, Article 104486
• Main Authors: Katz Sand, Ilana, Gnjatic, Sacha, Krammer, Florian, Tuballes, Kevin, Carreño, Juan Manuel, Satyanarayan, Sammita, Filomena, Susan, Staker, Erin, Tcheou, Johnstone, Miller, Aaron, Fabian, Michelle, Safi, Neha, Nichols, Jamie, Patel, Jasmin, Krieger, Stephen, Tankou, Stephanie, Horng, Sam, Klineova, Sylvia, Beck, Erin, Merad, Miriam, Lublin, Fred
• Format: Article
• Language: English
• Subjects: Antibodies, Neutralizing; Antibodies, Viral; Booster; COVID-19; COVID-19 Vaccines; Humans; Multiple sclerosis; SARS-CoV-2; Sphingosine; Vaccination; Vaccine
• ISSN: 2211-0348; 2211-0356; 2211-0356
• DOI: 10.1016/j.msard.2022.104486

•Neutralizing antibodies to wild-type SARS-CoV-2 were significantly reduced compared to healthy controls and neutralizing antibodies to BA.1 were undetectable in those on B cell therapies.•Cellular responses, including to omicron-specific peptides, were intact in those on B cell therapies.•Neutralizing antibodies to wild-type SARS-CoV-2 were reduced and few had detectable antibodies to BA.1 among those on S1P modulators.•Cellular responses were significantly reduced and not “boosted” by a third injection among those on S1P modulators. People living with multiple sclerosis (MS) and other disorders treated with immunomodulatory therapies remain concerned about suboptimal responses to coronavirus disease 2019 (COVID-19) vaccines. Important questions persist regarding immunological response to third vaccines, particularly with respect to newer virus variants. The objective of this study is to evaluate humoral and cellular immune responses to a third COVID-19 vaccine dose in people on anti-CD20 therapy and sphingosine 1-phosphate receptor (S1PR) modulators, including Omicron-specific assays. This is an observational study evaluating immunological responses to third COVID-19 vaccine dose in participants treated with anti-CD20 agents, S1PR modulators, and healthy controls. Neutralizing antibodies against USA-WA1/2020 (WA1) and B.1.1.529 (BA.1) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were measured before and after third vaccine. Groups were compared by one-way ANOVA with Tukey multiple comparisons. Cellular responses to spike peptide pools generated from WA1 and BA.1 were evaluated. Pre-post comparisons were made by Wilcoxon paired t-tests, inter-cohort comparisons by Mann-Whitney t-test. This cohort includes 25 participants on anti-CD20 therapy, 12 on S1PR modulators, and 14 healthy controls. Among those on anti-CD20 therapy, neutralizing antibodies to WA1 were significantly reduced compared to healthy controls (ID50% GM post-vaccination of 8.1 ± 2.8 in anti-CD20 therapy group vs 452.6 ± 8.442 healthy controls, P