AUTHOR=Nistri Riccardo , Barbuti Elena , Rinaldi Virginia , Tufano Laura , Pozzilli Valeria , Ianniello Antonio , Marinelli Fabiana , De Luca Giovanna , Prosperini Luca , Tomassini Valentina , Pozzilli Carlo 

TITLE=Case Report: Multiple Sclerosis Relapses After Vaccination Against SARS-CoV2: A Series of Clinical Cases

JOURNAL=Frontiers in Neurology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.765954

DOI=10.3389/fneur.2021.765954

ISSN=1664-2295

ABSTRACT=<p><bold>Objective:</bold> To describe a temporal association between COVID-19 vaccine administration and multiple sclerosis (MS) relapses.</p><p><bold>Methods:</bold> This case series study was collected in four MS Centres in Central Italy, using data from 16 MS patients who received COVID-19 vaccination and presented both clinically and radiologically confirmed relapses between March and June 2021. We collected patients' relevant medical history, including demographics, MS clinical course, disease-modifying treatment (DMT) received (if applicable), and data from MRI scans obtained after the COVID-19 vaccination.</p><p><bold>Results:</bold> Three out of 16 patients received a diagnosis of MS with a first episode occurring after COVID-19 vaccination; 13 had already a diagnosis of MS and, among them, 9 were on treatment with DMTs. Ten patients received BNT162b2/Pfizer-BioNTech, 2 patients mRNA-1273/Moderna, and 4 patients ChAdOx1 nCoV-19/AstraZeneca. All MS relapses occurred from 3 days to 3 weeks after receiving the first dose of the COVID-19 vaccination or the booster. All patients had evidence of radiological activity on MRI.</p><p><bold>Discussion:</bold> Clinical and radiological findings in these cohort of MS patients confirmed disease re/activation and suggested a temporal association between disease activity and COVID-19 vaccination. The nature of this temporal association, whether causative or incidental, remains to be established.</p>