TY - JOUR
T1 - A single-dose strategy for immunization with live attenuated vaccines is an effective option before treatment initiation in multiple sclerosis patients
AU - Carvajal, René
AU - Tur, Carmen
AU - Martínez-Gómez, Xavier
AU - Bollo, Luca
AU - Esperalba, Juliana
AU - Rodriguez, Marta
AU - Pappolla, Agustín
AU - Cobo-Calvo, Alvaro
AU - Carbonell, Pere
AU - Borras-Bemejo, Blanca
AU - Río, Jordi
AU - Castilló, Joaquín
AU - Braga, Nathane
AU - Mongay-Ochoa, Neus
AU - Rodrigo-Pendás, José Ángel
AU - Vidal-Jordana, Ángela
AU - Arrambide, Georgina
AU - Rodríguez-Acevedo, Breogán
AU - Zabalza, Ana
AU - Midaglia, Luciana
AU - Galán, Ingrid
AU - Comabella, Manuel
AU - Sastre-Garriga, Jaume
AU - Montalban, Xavier
AU - Tintoré, Mar
AU - Otero-Romero, Susana
N1 - Publisher Copyright:
© The Author(s), 2023.
PY - 2023/9/20
Y1 - 2023/9/20
N2 - Background: Mumps-Measles-Rubella (MMR) and Varicella zoster vaccines (VAR) are live attenuated vaccines, usually administered in a two-dose scheme at least 4 weeks apart. However, single-dose immunization schemes may also be effective and can reduce delays in immunosuppressive treatment initiation in patients with multiple sclerosis (pwMS) who need to be immunized. Objectives: To evaluate the immunogenicity of a single-dose attempt (SDA) versus the standard immunization scheme (SIS) with VAR and/or MMR in pwMS. Methods: Retrospective observational study in pwMS vaccinated against VAR and/or MMR. We compared seroprotection rates and antibody geometric mean titers (GMTs) between the two strategies. Results: Ninety-six patients were included. Thirty-one patients received VAR and 67 MMR. In the SDA group, the seroprotection rate was 66.7% (95% confidence interval (CI): 53.3–78.3) versus 97.2% (95% CI: 85.5–99.9) in the SIS (p < 0.001). For the seroprotected patients, GMTs were similar for both schemes. Conclusion: An SDA of VAR and/or MMR vaccines could be sufficient to protect almost two-thirds of patients. Testing immunogenicity after a single dose of VZ and/or MMR could be included in routine clinical practice to achieve rapid immunization.
AB - Background: Mumps-Measles-Rubella (MMR) and Varicella zoster vaccines (VAR) are live attenuated vaccines, usually administered in a two-dose scheme at least 4 weeks apart. However, single-dose immunization schemes may also be effective and can reduce delays in immunosuppressive treatment initiation in patients with multiple sclerosis (pwMS) who need to be immunized. Objectives: To evaluate the immunogenicity of a single-dose attempt (SDA) versus the standard immunization scheme (SIS) with VAR and/or MMR in pwMS. Methods: Retrospective observational study in pwMS vaccinated against VAR and/or MMR. We compared seroprotection rates and antibody geometric mean titers (GMTs) between the two strategies. Results: Ninety-six patients were included. Thirty-one patients received VAR and 67 MMR. In the SDA group, the seroprotection rate was 66.7% (95% confidence interval (CI): 53.3–78.3) versus 97.2% (95% CI: 85.5–99.9) in the SIS (p < 0.001). For the seroprotected patients, GMTs were similar for both schemes. Conclusion: An SDA of VAR and/or MMR vaccines could be sufficient to protect almost two-thirds of patients. Testing immunogenicity after a single dose of VZ and/or MMR could be included in routine clinical practice to achieve rapid immunization.
KW - Disease-modifying therapy
KW - Infections
KW - Live attenuated vaccine
KW - Multiple sclerosis
KW - Vaccination
UR - http://www.scopus.com/inward/record.url?scp=85173435995&partnerID=8YFLogxK
UR - https://www.mendeley.com/catalogue/669d3e4d-2042-3e69-ad6e-95148d452cfe/
U2 - 10.1177/13524585231200303
DO - 10.1177/13524585231200303
M3 - Article
C2 - 37728389
SN - 1352-4585
VL - 29
SP - 1841
EP - 1848
JO - Multiple sclerosis (Houndmills, Basingstoke, England)
JF - Multiple sclerosis (Houndmills, Basingstoke, England)
IS - 14
M1 - 13524585231200303
ER -
