Whether COVID-19 vaccines are associated with triggering disease flare-ups or disease activity in people with multiple sclerosis (MS) is the subject of several studies. According to the Disease Associated Multiple Sclerosis Network (KKNMS), there is no scientific argument that the benefits of vaccination against COVID-19 are much greater than the potential harm caused by the side effects of the vaccination. This is also or especially true for people with chronic diseases such as multiple sclerosis. Vaccinations have been shown to protect against or attenuate infection and thus provide “indirect” protection against MS activity, according to KKNMS.
Case-control studies of inactivated vaccines – these also include vaccines against COVID-19 – According to the Competence Network, several studies are available. No causal relationship was found between vaccination and disease activity in these. “Conversely, there is more evidence of reduced disease activity, because vaccines have been shown to protect against or attenuate infection, and thus provide ‘indirect’ protection against MS activity, which is often seen in connection with wild-type infections,” he explained. Professor Matthias Maurer of KKNMS.
study from israel
An Israeli study of COVID-19 vaccination of more than 500 people with multiple sclerosis showed that 2.1% of those vaccinated with MS experienced a relapse in connection with the first vaccination with the BioNTech/Pfizer vaccine. After the second vaccination, attacks of multiple sclerosis were documented in 1.6% of the group. This percentage is fully consistent with the proportion of people with MS with relapses in the comparative period of 2017-2020. And those numbers would make causation unlikely, according to KKNMS.
Study from Italy
This observation will also support another vaccination study from Italy. Two months after vaccinating 324 people with multiple sclerosis with vaccines from BioNTech/Pfizer and Moderna, an outbreak of multiple sclerosis was documented in 2.2% of the group, and two months before vaccination in 1.9% of an attack of multiple sclerosis was recorded in the group. According to KKNMS, these data also demonstrate that vaccination does not lead to changes in disease activity and cannot be considered a cause of MS relapses.
Individual reports of severe attacks
The individual case reports documented in the literature for severe episodes that occurred in connection with COVID-19 vaccination should be consistent with the individual experiences of neurologists and people with MS in recent months. But one has to be clear that “while thousands of people are vaccinated daily, a coincidental temporal relationship between vaccinations and various medical events can naturally be observed without assuming a direct causal relationship,” so that the KKNMS could. Questions about causation can only be answered through controlled studies.
Statement from KKNMS and the German MS Society
In light of this situation, both the KKNMS and the German MS Society feel compelled to issue the following statement, which, according to Professor Frauk Zip, complies with international vaccination recommendations:
- There is currently no scientific evidence that vaccination against COVID19 leads to increased activity or increased relapses in MS.
- Thus, MS is not an obstacle to vaccination against COVID19, the individual benefits of vaccination outweigh the individual risks of the MS patient.
- However, there may be individual (rare) astrocytic groups in which vaccination should be suspended or delayed in MS patients. However, this decision should be made in consultation with an experienced MS practitioner based on the individual medical history. We strongly advise against issuing public vaccination certificates if the only reason is a diagnosis of MS.
- The use of MS immunotherapy of any kind is not a contraindication for COVID19 vaccination. Thus, the vaccines used in Germany, which are not live vaccines, can also be used safely in immunosuppressed patients – and this should also be due to the advantages mentioned above. During treatment, a problem at most is poor vaccination response, which is why booster vaccinations can be taken into account.