{
  "abstract": "Background We aimed to assess antibody responses and COVID-19 outcomes after vaccination in people with multiple sclerosis (pwMS) receiving disease-modifying therapies.Methods NevroVAX is a Norwegian multicentre cohort study including 3559 pwMS and 449 healthy controls (HCs) who received at least one dose of BNT162b2 (Pfizer-BioNTech), mRNA-1273 (Moderna) or ChAdOx1 (AstraZeneca/Oxford) between January 2021 and December 2022. Data from records, registries, questionnaires and blood samples collected June 2021–November 2023 were analysed. Primary outcomes were humoral immune responses assessed by seroconversion (anti-spike and anti-receptor-binding domain (RBD) IgG ≥5 binding antibody units/mL). Secondary outcomes included quantitative anti-RBD IgG levels, breakthrough SARS-CoV-2 infection, COVID-19-related hospitalisation and death. Associations with breakthrough infection were evaluated using multivariable logistic regression.Results Among 3559 pwMS, 1201 received anti-CD20 monoclonal antibodies and 324 sphingosine-1-phosphate receptor (S1PR) modulators. After three vaccine doses, seroconversion was observed in 43.0% of anti-CD20-treated patients and 48.4% of S1PR-treated patients. In multivariable analysis, seroconversion was associated with lower risk of breakthrough infection (OR 0.67, 95% CI 0.58 to 0.78). During follow-up, 58 pwMS (1.6%) were hospitalised for COVID-19; 4 (0.1%) required non-invasive ventilatory support, no patients required invasive ventilation and no deaths occurred.Conclusions Humoral vaccine responses were impaired in pwMS receiving anti-CD20 or S1PR therapies, but severe COVID-19 was rare. These findings support continued vaccination programmes and tailored protective measures for immunomodulated populations.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurology, Oslo University Hospital, Oslo, Norway",
        "Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Oslo, Norway"
      ],
      "name": "Tilde Harridsleff Rasmussen"
    },
    {
      "affiliations": [
        "Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Oslo, Norway",
        "Department of Neurology, Sørlandet Sykehus HF, Kristiansand, Norway"
      ],
      "name": "Stine Schikora-Rustad"
    },
    {
      "affiliations": [
        "Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Oslo, Norway",
        "Department of Neurology, Sørlandet Sykehus HF, Kristiansand, Norway",
        "The Norwegian National Advisory Unit on Tick-borne diseases, Sørlandet sykehus HF Arendal, Arendal, Norway"
      ],
      "name": "Åslaug Rudjord Lorentzen"
    },
    {
      "affiliations": [
        "Department of Immunology, Oslo University Hospital, Oslo, Norway"
      ],
      "name": "The Trung Tran"
    },
    {
      "affiliations": [
        "Department of Neurology, Oslo University Hospital, Oslo, Norway",
        "Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Oslo, Norway"
      ],
      "name": "Mathias H Øverås"
    },
    {
      "affiliations": [
        "Department of Neurology, Neuro Sys-Med, Haukeland University Hospital, Bergen, Norway",
        "University of Bergen Department of Clinical Medicine 1, Bergen, Norway"
      ],
      "name": "Kjell-Morten Myhr"
    },
    {
      "affiliations": [
        "Department of Neurology, Neuro Sys-Med, Haukeland University Hospital, Bergen, Norway",
        "University of Bergen Department of Clinical Medicine 1, Bergen, Norway",
        "Norwegian MS-Registry and Biobank, Haukeland University Hospital, Bergen, Norway"
      ],
      "name": "Stig Wergeland"
    },
    {
      "affiliations": [
        "Haukeland University Hospital, Bergen, Norway"
      ],
      "name": "Jan Aarseth"
    },
    {
      "affiliations": [
        "Department of Neurology, Neuro Sys-Med, Haukeland University Hospital, Bergen, Norway",
        "University of Bergen Department of Clinical Medicine 1, Bergen, Norway"
      ],
      "name": "Lars Bø"
    },
    {
      "affiliations": [
        "Department of Research, Innovation and Education, Oslo University Hospital, Oslo, Norway"
      ],
      "name": "Tone Berge"
    },
    {
      "affiliations": [
        "Department of Neurology, Oslo University Hospital, Oslo, Norway",
        "Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Oslo, Norway",
        "Department of Psychology, University of Oslo, Oslo, Norway"
      ],
      "name": "Einar August Høgestøl"
    },
    {
      "affiliations": [
        "Department of Neurology, Oslo University Hospital, Oslo, Norway",
        "Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Oslo, Norway"
      ],
      "name": "Hanne F Harbo"
    },
    {
      "affiliations": [
        "Diakonhjemmet Hospital Department of Rheumatology, Oslo, Oslo, Norway"
      ],
      "name": "Anne Therese Tveter"
    },
    {
      "affiliations": [
        "Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Oslo, Norway",
        "Department of Gastroenterology, Akershus University Hospital, Lørenskog, Norway"
      ],
      "name": "Kristin Kaasen Jørgensen"
    },
    {
      "affiliations": [
        "Centre for Biostatistics and Epidemiology (OCBE), Oslo University Hospital, Oslo, Norway"
      ],
      "name": "Celiné Cunen"
    },
    {
      "affiliations": [
        "Department of Neurology, Neuro Sys-Med, Haukeland University Hospital, Bergen, Norway",
        "University of Bergen Department of Clinical Medicine 1, Bergen, Norway"
      ],
      "name": "Øivind Torkildsen"
    },
    {
      "affiliations": [
        "Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Oslo, Norway",
        "Department of Neurology, Akershus University Hospital, Lørenskog, Akershus, Norway"
      ],
      "name": "Trygve Holmøy"
    },
    {
      "affiliations": [
        "Department of Neurology, Oslo University Hospital, Oslo, Norway",
        "Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Oslo, Norway"
      ],
      "name": "Elisabeth Gulowsen Celius"
    },
    {
      "affiliations": [
        "Department of Immunology, Oslo University Hospital, Oslo, Norway"
      ],
      "name": "John Torgils Vaage"
    },
    {
      "affiliations": [
        "Department of Neurology, Oslo University Hospital, Oslo, Norway",
        "Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Oslo, Norway"
      ],
      "name": "Gro Owren Nygaard"
    },
    {
      "affiliations": [
        "Department of Immunology, Oslo University Hospital, Oslo, Norway"
      ],
      "name": "Fridtjof Lund-Johansen"
    },
    {
      "affiliations": [
        "Department of Neurology, Oslo University Hospital, Oslo, Norway",
        "Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Oslo, Norway"
      ],
      "name": "Marton König"
    }
  ],
  "title": "Low risk of severe COVID-19 in vaccinated people with multiple sclerosis: a nationwide Norwegian study",
  "uid": "d9a06ba9-93ff-5843-addb-516282083d9a"
}