AUTHOR=Moser Tobias , Seiberl Michael , Feige Julia , Bieler Lara , Radlberger Richard F. , O’Sullivan Ciara , Pilz Georg , Harrer Andrea , Schwenker Kerstin , Haschke-Becher Elisabeth , Machegger Lukas , Grimm Jochen , Redlberger-Fritz Monika , Buchmann Arabella , Khalil Michael , Kvas Erich , Trinka Eugen , Wipfler Peter TITLE=Tetravalent Influenza Vaccine Is Not Associated With Neuroaxonal Damage in Multiple Sclerosis Patients JOURNAL=Frontiers in Immunology VOLUME=12 YEAR=2021 URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2021.718895 DOI=10.3389/fimmu.2021.718895 ISSN=1664-3224 ABSTRACT=Background

Efficacy of vaccines and disease activity linked to immunization are major concerns among people with multiple sclerosis (pwMS).

Objective

To assess antibody responses to seasonal influenza antigens and vaccine-associated neuroaxonal damage utilizing serum neurofilament light chain (sNfL) in pwMS receiving dimethyl fumarate (DMF).

Methods

In this prospective study, the 2020/2021 seasonal tetravalent influenza vaccine was administered to 20 pwMS treated with DMF and 15 healthy controls (HCs). The primary endpoints were responder rate of strain-specific antibody production (seroconversion or significant (4-fold) increase in influenza-antibody titers for ≥2/4 strains) at 30 days post-vaccination and changes in sNfL levels.

Results

All patients treated with DMF fulfilled the responder criteria for immunization compared with 53% of the controls. However, higher proportions of HCs already had influenza-antibody titers ≥1:40 at baseline (53% vs. 41%, p = 0.174). sNfL levels were comparable among both groups at baseline and did not increase 34 days after vaccination. In addition, no clinical or radiological disease reactivation was found.

Conclusion

DMF-treated patients mount an adequate humoral immune response to influenza vaccines. Within the limits of the small cohort investigated, our data suggest that influenza immunization is not associated with clinical or subclinical disease reactivation.