A single-dose strategy for immunization with live attenuated vaccines is an effective option before treatment initiation in multiple sclerosis patients

Mult Scler. 2023 Dec;29(14):1841-1848. doi: 10.1177/13524585231200303. Epub 2023 Sep 20.

Abstract

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.

Keywords: Multiple sclerosis; disease-modifying therapy; infections; live attenuated vaccine; vaccination.

Publication types

  • Observational Study

MeSH terms

  • Antibodies, Viral
  • Chickenpox Vaccine
  • Humans
  • Infant
  • Measles* / prevention & control
  • Multiple Sclerosis* / drug therapy
  • Mumps* / prevention & control
  • Rubella* / prevention & control
  • Vaccination
  • Vaccines, Attenuated

Substances

  • Chickenpox Vaccine
  • Vaccines, Attenuated
  • Antibodies, Viral