Neuroimmunological Clinic, Institute of Pediatric Neurology, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Brain Behav. 2024 Jul;14(7):e3587. doi: 10.1002/brb3.3587.
Examining the safety of theBNT162b2 mRNA vaccine in multiple sclerosis (MS) patients remains inconclusive, particularly regarding the potential for disease exacerbations. This study aims to assess the effects of BNT162b2 COVID-19 vaccination on disease activity in MS patients through sequential MRI imaging.
A retrospective study of 84 MS patients from five Israeli hospitals was conducted. MS lesion load was determined from three brain MRI scans, one postvaccination and two prevaccination scans. A post hoc analysis compared subgroups featuring vaccinated and unvaccinated patients respectively, with early onset MS.
The cohort included 70 women with early onset (mean age 16.4 ± 0.8 years) and adult onset (mean age 34.9 ± 1.1 years) MS. Among the early onset group, vaccinated patients showed an increased risk of new lesions (p = .00026), while there was no increased risk among adult-onset patients. Additionally, a comparison between early onset vaccinated and nonvaccinated groups revealed a higher risk of increased lesions in the vaccinated group (p = .024).
Overall, the study suggests that the BNT162b2 vaccine is generally safe in MS patients, with no association found between vaccination and new lesions in most patients. However, close MRI follow-up is recommended for early-onset MS cases to monitor lesion development.
评估 BNT162b2 mRNA 疫苗在多发性硬化症（MS）患者中的安全性仍无定论，尤其是在疾病恶化的潜在风险方面。本研究旨在通过连续 MRI 成像评估 BNT162b2 COVID-19 疫苗接种对 MS 患者疾病活动的影响。
对来自以色列五家医院的 84 名 MS 患者进行了回顾性研究。通过对 3 次脑部 MRI 扫描（1 次接种后，2 次接种前）来确定 MS 病灶的负荷。进行了一项事后分析，分别比较了接种组和未接种组、以及早发性 MS 亚组。
队列包括 70 名女性早发性 MS（平均年龄 16.4 ± 0.8 岁）和成年起病 MS（平均年龄 34.9 ± 1.1 岁）。在早发性 MS 组中，接种组出现新病灶的风险增加（p =.00026），而成年起病 MS 组则无此风险。此外，早发性 MS 接种组与未接种组之间的比较显示，接种组的病灶增加风险更高（p =.024）。
总体而言，该研究表明 BNT162b2 疫苗在 MS 患者中通常是安全的，大多数患者中接种与新发病灶之间无关联。然而，建议对早发性 MS 病例进行密切的 MRI 随访，以监测病灶发展。
