SARS-CoV-2 Vaccine Yields Positive T-Cell Response in Certain Patients With Multiple Sclerosis

Patients with multiple sclerosis (MS) treated with ocrelizumab can develop vaccine-specific T-cell responses to the SARS-CoV-2 messenger RNA vaccine, despite ocrelizumab being a B-cell-depleting agent, according to new research published in JAMA Neurology.

“Antibodies are believed to be a key component for an effective vaccine to provide protection. However, other arms of the immune system may contribute to vaccine efficacy. T cells are critical to generate antibody-producing plasma cells, long-lived memory cells, and for elimination of virus-infected cells,” wrote Livnat Brill, PhD, Faculty of Medicine, Hebrew University of Jerusalem, Department of Neurology and Laboratory of Neuroimmunology and the Agnes-Ginges Center for Neurogenetics, Hadassah Medical Center, Ein–Kerem, Jerusalem, Israel and co-authors.

Researchers aimed to understand the ability of patients with MS treated with B-cell-depleting therapy to have antibody and T-cell responses following SARS-CoV-2 vaccination.

A total of 112 participants including 49 patients with MS treated with ocrelizumab, 40 healthy controls, and 23 untreated patients with MS were included in this single-center study out of Hadassah Medical Center, Jerusalem, Israel. All participants were vaccinated with 2 doses of the Pfizer/BioNTech vaccine between December 2020 and April 2021. Antibodies and T-cell responses were assessed using blood donations performed 2 to 4 weeks and 2 to 8 weeks following participants second vaccination, respectively.

Of the patients with MS treated with ocrelizumab, 29 were evaluated for SARS-CoV-2-specific T-cell responses following vaccination. 89.7% (n=26 of 29) of patients treated with ocrelizumab had positive SARS-CoV-2-specific T-cell responses. This was a similar response rate to the healthy controls.

Researchers noted that patients with MS treated with ocrelizumab did have lower rates of antibody titers and positive antibody response when compared to the healthy controls and untreated patients with MS.

“In this study, patients with MS who were treated with ocrelizumab generated comparable SARS-CoV-2–specific T-cell responses with healthy controls and had lower antibody response following vaccination. Given the potential role of T cells in protection from severe disease, this is reassuring and will help physicians develop consensus guidelines regarding MS treatment in the era of the COVID-19 pandemic,” Dr Brill et al concluded.

Brill L, Rechtman A, Zveik O, et al. Humoral and T-Cell Response to SARS-CoV-2 Vaccination in Patients With Multiple Sclerosis Treated With Ocrelizumab [published online ahead of print, 2021 Sep 23]. JAMA Neurol. 2021;10.1001/jamaneurol.2021.3599. doi:10.1001/jamaneurol.2021.3599