Codirector, Elliot Lewis Center for Multiple Sclerosis Care, assistant professor, neurology, Tufts University School of Medicine, and chairman, Clinical Advisory Committee, New England Chapter, National MS Society

Joshua Katz, MD

“So far, what we've seen in our patients is that it doesn't appear to make a big difference which vaccine they received in terms of their likelihood of making antibodies, although, I'll tell you that the numbers between the different vaccines are small, so I can't say that with certainty. But the bigger issue is that certain medications clearly reduce the antibody response to the vaccine, and others don't appear to do that.”

A new study initiated by the National Institutes of Health will evaluate the efficacy of an additional COVID-19 vaccine in immunocompromised patients. Funded and sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), the phase 2 trial has been dubbed COVID-19 Booster Vaccine in Autoimmune Disease Non-Responders, including patients with multiple sclerosis (MS), pemphigus, rheumatoid arthritis, systemic lupus erythematosus, or systemic sclerosis.

Joshua Katz, MD, codirector, Elliot Lewis Center for Multiple Sclerosis Care, assistant professor of neurology, Tufts University School of Medicine, and chairman, Clinical Advisory Committee, New England Chapter, National MS Society, discussed existing data on the variation in vaccine response in patients with MS, based on specific disease-modifying therapies (DMTs), noting that experts have not seen large differences according to the vaccine received (Pfizer-BioNTech, Moderna, or Johnson & Johnson/Janssen). 

Although not directly affiliated with the trial, Katz shared his thoughts on its potential, as well as a recent pilot study conducted to check T-cell response in patients taking anti-B-cell therapies who did not have an antibody response to the vaccine. Also discussed was a general interest in more data on DMTs and the COVID-19 vaccine, due to experts’ desire to let patients know whether a booster will affect antibody response. 

NIH launches study of extra COVID-19 vaccine dose in people with autoimmune disease. News release. National Institutes of Health. August 27, 2021. Accessed September 9, 2021. https://www.nih.gov/news-events/news-releases/nih-launches-study-extra-covid-19-vaccine-dose-people-autoimmune-disease

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The chairman of the Clinical Advisory Committee of the New England Chapter of the National MS Society addressed the role DMTs play in patient response to the COVID-19 vaccine.

Disease-Modifying Therapies and COVID-19 Antibody Response: Joshua Katz, MD

“The good news for MS patients is that for the most part, they don't appear to be more susceptible to getting COVID, or having more severe infections if they do get COVID…But we don't really have a lot of experience with the breakthrough cases, so I'm sort of waiting with bated breath to find out if my patients who have been vaccinated, but who didn't have a good response to the first vaccine, are going to show signs that they're more susceptible to breakthrough infections.”

A phase 2 clinical trial has been initiated by the National Institutes of Health (NIH) to evaluate antibody response to a COVID-19 booster vaccine in immunocompromised patients who have not had a response to the original vaccine dosing regimen. Joshua Katz, MD, codirector, Elliot Lewis Center for Multiple Sclerosis Care, assistant professor, neurology, Tufts University School of Medicine, and chairman, Clinical Advisory Committee, New England Chapter, National MS Society, while not associated with the trial itself, offered commentary on what he hopes to learn from the trial as well as the importance of an effective booster for patients with multiple sclerosis (MS). 

The desired outcome from the trial is twofold in that experts hope to reduce infectivity and provide better levels of protection, as breakthrough cases and the Delta variant of COVID-19 continue to raise questions and concerns. The trial is sponsored and funded by a subsect of NIH, the National Institute of Allergy and Infectious Disease, and will evaluate patients with MS, pemphigus, rheumatoid arthritis, systemic lupus erythematosus, or systemic sclerosis. Katz addressed the patient population with MS specifically, noting that data does not show an increased risk of infection or more intense illness, despite a lack of understanding as to susceptibility to breakthrough infections. 

The codirector of the Elliot Lewis Center for Multiple Sclerosis Care discussed the prospective COVID-19 vaccination booster and its implication for patients with MS.  

Joshua Katz, MD

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Disease-Modifying Therapies and COVID-19 Antibody Response: Joshua Katz, MD

The Potential COVID-19 Booster for Patients With MS: Joshua Katz, MD