Neurology and vaccinations: considerations in the context of COVID-19/SARS-COV-2

Abstract

As the world embarks on the largest vaccination program in history, it is worth reflecting on the huge logistical effort this will involve. Vaccination remains the strongest tool in the public health armamentarium for prevention of infectious diseases, but achieving herd immunity will require population vaccination rates of around 70%. Apart from the huge clinical delivery and manufacturing efforts required to achieve this, successful inoculation efforts will also depend on addressing vaccine hesitancy and misinformation. Some vaccines have previously been associated with the occurrence of rare, immune-mediated adverse events, although these can sometimes be difficult to separate from the overall infection burden at the time. However, we will need to remain vigilant for those events which may have occurred as a consequence of Covid-19 vaccination, as even very low-frequency events may have significant health burdens in the context of the number of anticipated vaccinations. It is important to note that study data available to date for the Covid-19 vaccination program remains reassuring. In this month’s journal club, we review some articles that explore the association of neurological complications associated with large-scale vaccination events, as well as immune response to vaccination in the context of a modern therapeutic agent. The first is a phase IIIb trial assessing the impact of ocrelizumab on vaccine response in people with multiple sclerosis (pwMS). The second is a case–control study that set out to investigate the hypothesis that vaccination is a risk factor for MS, and the last is a study reporting on the association between influenza vaccination and Guillain-Barré syndrome (GBS). Effect of ocrelizumab on vaccine responses in patients with multiple sclerosis: the VELOCE study