Reading the “T” Leaves of COVID-19 Vaccine Responses in Multiple Sclerosis

摘要

The view of the multiple sclerosis (MS) therapeutic landscape became clouded by the onset of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Previous strategies for explaining MS medication options to patients were challenged by the lack of knowledge about how MS therapies might affect acute coronavirus disease 2019 (COVID-19) infections. With the unprecedented capabilities of research laboratories and the worldwide biotechnology industry, we were able to offer COVID-19 vaccines to people who had a high risk of COVID-19 infection in just over a year from the emergence of the virus. There was still a brume over the therapeutic landscape, however, due to the uncertainty about vaccine efficacy in patients treated with lymphocyte-depleting and -sequestering medications. Early concerns focused on B-cell-depleting therapies (e.g., rituximab, ocrelizumab). Individuals with MS treated with ocrelizumab had previously demonstrated attenuated antibody responses to common vaccines.1 While it was appreciated that T-cell response to COVID-19 vaccines was going to be important, the ability to measure T-cell immune responses lagged behind antibody measurements in most clinical centers.