Antibody response to SARS-CoV-2 vaccination or infection in a prospective cohort of children with neuroinflammatory diseases

• Published in: European journal of paediatric neurology Vol. 46; pp. 30 - 34
• Main Authors: Kaufmann, Charlotte, Morris, Morgan, Gombolay, Grace Y.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.09.2023; European Paediatric Neurology Society. Published by Elsevier Ltd
• Subjects: COVID-19; Multiple sclerosis; Neuromyelitis optica spectrum disorder; Pediatric; SARS-CoV-2; Vaccination; COVID-19; SARS-CoV-2; Multiple sclerosis; Neuromyelitis optica spectrum disorder; Pediatric; Vaccination
• ISSN: 1090-3798; 1532-2130
• DOI: 10.1016/j.ejpn.2023.06.009

Immune medications affect antibody responses to SARS-CoV-2 vaccination in adults with neuroinflammatory disorders, but little is known about antibody responses in children with neuroinflammation and on immune treatments. Here we measure antibody levels in response to SARS-CoV-2 vaccination in children receiving anti-CD20 monoclonal antibodies, or fingolimod. Children under 18 years of age with pediatric-onset neuroinflammatory disorders who received at least two mRNA vaccines were included. Plasma samples were assayed for SARS-CoV-2 antibodies (spike, spike receptor binding domain-RBD, nucleocapsid) and neutralization antibodies. Seventeen participants with pediatric onset neuroinflammatory diseases were included: 12 multiple sclerosis, one neuromyelitis optica spectrum disorder, two MOG-associated disease, and two autoimmune encephalitis. Fourteen were on medications (11 on CD20 monoclonal antibodies-mAbs, one on fingolimod, one on steroids, one on intravenous immunoglobulin) and three were untreated. Nine patients also had pre-vaccination samples available. All participants had seropositivity to spike or spike RBD antibodies except for those receiving CD20 mAbs. However, this proportion was higher in children than in an adult MS patient cohort. The most significant contributor to antibody levels was duration of DMT. SARS-CoV-2 antibodies are decreased in children on CD20 monoclonal antibodies than on other treatments. Treatment duration associated with vaccination responses. •Disease modifying therapies (DMTs)affect immune responses to SARS-CoV-2 vaccination.•Limited data is available on immune responses to vaccines in children on DMTs.•Antibody responses to SARS-CoV-2 vaccination were assessed in children on DMTs.•Decreased antibody responses observed in CD20 monoclonal antibodies.•Preserved antibody responses in other DMTs.