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Damour A, Delalande P, Cordelières F, Lafon ME, Faure M, Segovia-Kueny S, Stalens C, Mathis S, Spinazzi M, Violleau MH, Wodrich H, Solé G. Anti-SARS-CoV-2 (COVID-19) vaccination efficacy in patients with severe neuromuscular diseases. Rev Neurol (Paris) 2023; 179:983-992. [PMID: 37633734 DOI: 10.1016/j.neurol.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/23/2023] [Accepted: 04/11/2023] [Indexed: 08/28/2023]
Abstract
INTRODUCTION Patients with severe neuromuscular disease (sNMD) are considered at high risk of severe COVID-19. Muscle tissue is often replaced by fibroadipose tissue in these diseases whereas the new mRNA-based vaccines are injected intramuscularly. We aimed at evaluating the efficacy of two injections associated with a booster injection of mRNA vaccine in these patients. METHODS We performed an observational, prospective, single-centre study to investigate the level of anti-S antibodies (Abs) and their neutralization activity at weeks 6 (W6) and 24 (W24) after two injections of mRNA-1273 vaccine and at weeks 12 (BW12) and 29 (BW29) after a booster injection of BNT162b2 vaccine in patients with sNMD. RESULTS Thirty-three patients with sNMD were included. At W6, 30 patients (90.1%) showed a protective serum level of specific anti-S Abs with a strong neutralization capacity. We observed a decline over time: only 12 patients (36.3%) retained anti-S Abs levels considered as protective at W24. The neutralization activity remained above the cut off in 23 (69.7%). The booster vaccination restored robust neutralization activity for all analysed 22 patients (100%) at BW12, which was maintained without any significant drop at BW29 (16). No severe adverse event was reported in this cohort and none of the 33 patients developed symptomatic COVID-19 over one year. CONCLUSIONS This study provides evidence that most sNMD patients receiving two injections of COVID-19 mRNA-based vaccines develop a strong humoral response after vaccination. A decline over time was observed but a single booster injection restores a long-term immunity. Moreover, no safety issues were observed.
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Affiliation(s)
- A Damour
- CNRS UMR 5234, Fundamental Microbiology and Pathogenicity, University Bordeaux, Bordeaux, France
| | - P Delalande
- MAS Yolaine-de-Kepper, Saint-Georges-sur-Loire, France
| | - F Cordelières
- Bordeaux Imaging Center, BIC, UMS 3420, US 4, University Bordeaux, CNRS, Inserm, Bordeaux, France
| | - M E Lafon
- CNRS UMR 5234, Fundamental Microbiology and Pathogenicity, University Bordeaux, Bordeaux, France; Virology Laboratory, Pellegrin Hospital, Bordeaux University Hospitals, Bordeaux, France
| | - M Faure
- CNRS UMR 5234, Fundamental Microbiology and Pathogenicity, University Bordeaux, Bordeaux, France
| | | | | | - S Mathis
- Neuromuscular Reference Center AOC, Neurology and Neuromuscular Diseases Department, Pellegrin Hospital, Bordeaux University Hospitals, Bordeaux, France
| | - M Spinazzi
- Neuromuscular Reference Center AOC, Neurology Department, Angers University Hospital Center, Angers, France
| | - M H Violleau
- Neuromuscular Reference Center AOC, Neurology and Neuromuscular Diseases Department, Pellegrin Hospital, Bordeaux University Hospitals, Bordeaux, France
| | - H Wodrich
- CNRS UMR 5234, Fundamental Microbiology and Pathogenicity, University Bordeaux, Bordeaux, France
| | - G Solé
- Neuromuscular Reference Center AOC, Neurology and Neuromuscular Diseases Department, Pellegrin Hospital, Bordeaux University Hospitals, Bordeaux, France.
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