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Immunogenicity and Safety of a Third SARS-CoV-2 Vaccine Dose in Patients With Multiple Sclerosis and Weak Immune Response After COVID-19 Vaccination

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Approximately 80% of all patients with multiple sclerosis (MS) treated with anti-CD20 therapy or fingolimod have weak humoral immune responses after 2 doses of messenger RNA (mRNA) COVID-19 vaccines.13 The outcome and safety of a third vaccine dose in this group is largely unknown. We reported results from a study designed to assess the immunogenicity and safety of a third dose of mRNA COVID-19 vaccine in patients with MS who were treated with anti-CD20 therapy or fingolimod.

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Article Information

Accepted for Publication: November 29, 2021.

Published Online: January 24, 2022. doi:10.1001/jamaneurol.2021.5109

Corresponding Author: Marton König, MD, PhD, Department of Neurology, Oslo University Hospital, PO Box 4956, Nydalen, N-0424 Oslo, Norway (makoni@ous-hf.no).

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2022 König M et al. JAMA Neurology.

Author Contributions: Dr König had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Drs Lund-Johansen and Nygaard are co–last authors.

Concept and design: König, Vaage, Lund-Johansen, Nygaard.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: König, Lund-Johansen.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: König, Tran, Nygaard.

Obtained funding: Nygaard.

Administrative, technical, or material support: König, Tran, Holmøy, Vaage, Nygaard.

Supervision: Nygaard.

Conflict of Interest Disclosures: Dr König reported receiving speaker honoraria from Novartis, Biogen, and AstraZeneca outside the submitted work. Dr Holmøy reported receiving speaker honoraria from Merck, Biogen, Genzyme, Sanofi, Novartis, Roche, and Bristol Myers Squibb during the conduct of the study. No other disclosures were reported.

Funding/Support: This study was funded by the Coalition for Epidemic Preparedness Innovations and Oslo University Hospital.

Role of the Funder/Sponsor: The Coalition for Epidemic Preparedness Innovations and Oslo University Hospital had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Contributions: We thank Mathias Herstad Øverås, MD, Oslo University Hospital, Oslo, Norway; Adity Chopra, MD, PhD, Oslo University Hospital; Åslaug Rudjord Lorentzen, MD, PhD, Sørlandet Hospital; Siri Mjaaland, MD, PhD, Norwegian Institute of Public Health, Division of Infection Control, Oslo, Norway; Ingeborg Sundsvalen Aaberge, MD, PhD, Norwegian Institute of Public Health, Division of Infection Control; Kjell-Morten Myhr, MD, PhD, Haukeland University, Bergen, Norway; Stig Wergeland, MD, PhD, Haukeland University; Tone Berge, MD, PhD, Metropolitan University, Oslo, Norway; Hanne Flinstad Harbo, MD, PhD, Oslo University Hospital; Øivind Fredvik Torkildsen, MD, PhD, Haukeland University Hospital; Elisabeth Gulowsen Celius, MD, PhD, Oslo University Hospital; Ludvig Andre Munthe, MD, PhD, Oslo University Hospital; Randi Karlsen, MSc, Oslo University Hospital; Lars Skattebøl, MD, Oslo University Hospital; Einar August Høgestøl, MD, PhD, Oslo University Hospital; Rebecca Cox, MD, PhD, University of Bergen, Bergen, Norway; the Bergen COVID-19 Research Group, and the Coalition for Epidemic Preparedness Innovations for their cooperation and support. No one received financial compensation for their contribution.

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 credit toward the CME of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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