Vol 58, No 1 (2024)
Research Paper
Published online: 2024-01-22

open access

Page views 780
Article views/downloads 644
Get Citation

Connect on Social Media

Connect on Social Media

Analysis of seroconversion following COVID-19 vaccination among multiple sclerosis patients treated with disease-modifying therapies in Poland

Aleksandra Podlecka-Piętowska1, Janusz Sierdziński2, Monika Nojszewska1, Jakub Stawicki1, Halina Bartosik-Psujek3, Beata Lech4, Małgorzata Popiel4, Adam Perenc4, Alina Kułakowska5, Agata Czarnowska5, Joanna Kulikowska5, Katarzyna Kapica-Topczewska5, Anna Jamróz-Wiśniewska6, Konrad Rejdak6, Jacek Zaborski7, Katarzyna Kubicka-Bączyk8, Natalia Niedziela8, Krzysztof Wierzbicki8, Monika Adamczyk-Sowa8, Jacek Zwiernik9, Beata Zwiernik10, Marta Milewska-Jędrzejczak11, Andrzej Głąbiński11, Elżbieta Jasińska12, Przemysław Puz13, Ewa Krzystanek13, Arkadiusz Stęposz13, Aleksandra Karuga13, Anetta Lasek-Bal13, Joanna Siuda14, Barbara Kściuk14, Anna Walawska-Hrycek14, Maja Patalong-Ogiewa14, Aleksandra Kaczmarczyk14, Katarzyna Siutka15, Waldemar Brola15, Beata Zakrzewska-Pniewska1
Pubmed: 38251955
Neurol Neurochir Pol 2024;58(1):112-119.


Clinical rationale for the study. The rapid spread of SARS-CoV-2 throughout the world has highlighted the importance of vaccinations to control the pandemic and to protect people at risk for severe disease courses. Disease-modifying therapies (DMT) in multiple sclerosis (MS), whether immunomodulatory or immunosuppressive, may affect the immune response. Therefore, the question arose as to whether these vaccinations would be effective.

Aim of the study. We planned a study to assess the immune response to SARS-CoV-2 vaccines by type of therapy.

Material and methods.
Participants were recruited from 14 Polish MS centres. The data was obtained by neurologists using a questionnaire. We collected data on 353 MS patients (269 females, 84 males) who received complete primary SARS-CoV-2 vaccination. All persons with MS (PwMS) were treated with disease-modifying therapies.

Results. 305 out of 353 PwMS (86.4%) were positive for IgG Abs against SARS-CoV-2 S domain S1 Ag after vaccination. A strong immune response was noted in 129 PwMS (36.5%). The rate of seroconversion after SARS-CoV-2 vaccination in PwMS who received immunomodulatory DMTs (interferon beta, glatiramer acetate, teriflunomide, dimethyl fumarate, natalizumab) was 91.5%, in PwMS receiving immune reconstruction therapy (alemtuzumab, cladribine) was 92%, and in immunosuppressive DMTs (fingolimod, ocrelizumab), the seroconversion rate was 59%.

Conclusions and clinical implications.
Our study shows that, in PwMS receiving immunomodulatory therapy, the immune response to vaccination is generally excellent. Even in immunosuppressive patients, seroconversion is satisfactory.

Article available in PDF format

View PDF Download PDF file


  1. Pugliatti M, Berger T, Hartung HP, et al. Multiple sclerosis in the era of COVID-19: disease course, DMTs and SARS-CoV2 vaccinations. Curr Opin Neurol. 2022; 35(3): 319–327.
  2. Czarnowska A, Tarasiuk J, Zajkowska O, et al. Analysis of Side Effects Following Vaccination Against COVID-19 Among Individuals With Multiple Sclerosis Treated With DMTs in Poland. Front Neurol. 2022; 13: 913283.
  3. Czarnowska A, Tarasiuk J, Zajkowska O, et al. Safety of Vaccines against SARS-CoV-2 among Polish Patients with Multiple Sclerosis Treated with Disease-Modifying Therapies. Vaccines (Basel). 2022; 10(5).
  4. Allen-Philbey K, Stennett A, Begum T, et al. Did it hurt? COVID-19 vaccination experience in people with multiple sclerosis. Mult Scler Relat Disord. 2022; 65: 104022.
  5. Michelena G, Casas M, Eizaguirre MB, et al. ¿ Can COVID-19 exacerbate multiple sclerosis symptoms? A case series analysis. Mult Scler Relat Disord. 2022; 57: 103368.
  6. de Figueiredo A, Larson HJ. Exploratory study of the global intent to accept COVID-19 vaccinations. Commun Med (Lond). 2021; 1: 30.
  7. Twardowska-Staszek E, Rostek I, Biel K. Sociodemographic and psychological variables and concerns related to COVID-19 vaccination among polish citizens. Int J Environ Res Public Health. 2022; 19(15).
  8. Nojszewska M, Kalinowska A, Adamczyk-Sowa M, et al. COVID-19 mRNA vaccines (Pfizer-BioNTech and Moderna) in patients with multiple sclerosis: a statement by a working group convened by the Section of Multiple Sclerosis and Neuroimmunology of the Polish Neurological Society. Neurol Neurochir Pol. 2021; 55(1): 8–11.
  9. Czarnowska A, Kapica-Topczewska K, Zajkowska O, et al. Symptoms after COVID-19 Infection in Individuals with Multiple Sclerosis in Poland. J Clin Med. 2021; 10(22).
  10. Reber AJ, Chirkova T, Kim JH, et al. Immunosenescence and Challenges of Vaccination against Influenza in the Aging Population. Aging Dis. 2012; 3(1): 68–90.
  11. Loebermann M, Winkelmann A, Hartung HP, et al. Vaccination against infection in patients with multiple sclerosis. Nat Rev Neurol. 2012; 8(3): 143–151.
  12. Mailand MT, Frederiksen JL. Vaccines and multiple sclerosis: a systematic review. J Neurol. 2017; 264(6): 1035–1050.
  13. Winkelmann A, Loebermann M, Barnett M, et al. Vaccination and immunotherapies in neuroimmunological diseases. Nat Rev Neurol. 2022; 18(5): 289–306.
  14. Kulikowska J, Czarnowska A, Gudowska-Sawczuk M, et al. Antibodies against SARS-CoV-2 S and N proteins in relapsing-remitting multiple sclerosis patients treated with disease-modifying therapies. Neurol Neurochir Pol. 2023; 57(1): 121–130.
  15. Bsteh G, Hegen H, Traxler G, et al. Comparing humoral immune response to SARS-CoV2 vaccines in people with multiple sclerosis and healthy controls: An Austrian prospective multicenter cohort study. Eur J Neurol. 2022; 29(5): 1538–1544.
  16. Krajnc N, Bsteh G, Berger T, et al. Monoclonal antibodies in the treatment of relapsing multiple sclerosis: an overview with emphasis on pregnancy, vaccination, and risk management. Neurotherapeutics. 2022; 19(3): 753–773.
  17. Satyanarayan S, Safi N, Sorets T, et al. Differential antibody response to COVID-19 vaccines across immunomodulatory therapies for multiple sclerosis. Mult Scler Relat Disord. 2022; 62: 103737.
  18. Achiron A, Mandel M, Dreyer-Alster S, et al. Humoral immune response to COVID-19 mRNA vaccine in patients with multiple sclerosis treated with high-efficacy disease-modifying therapies. Ther Adv Neurol Disord. 2021; 14: 17562864211012835.
  19. Sormani MP, Inglese M, Schiavetti I, et al. CovaXiMS study group on behalf of the Italian Covid-19 Alliance in MS. Effect of SARS-CoV-2 mRNA vaccination in MS patients treated with disease modifying therapies. EBioMedicine. 2021; 72: 103581.
  20. Wu Xi, Wang Lu, Shen Lu, et al. Response of COVID-19 vaccination in multiple sclerosis patients following disease-modifying therapies: A meta-analysis. EBioMedicine. 2022; 81: 104102.
  21. Brola W. Immune response to COVID-19 vaccines in patients with multiple sclerosis treated with disease-modifying therapies. Neurol Neurochir Pol. 2023; 57(1): 11–13.

Neurologia i Neurochirurgia Polska