AUTHOR=Moser Tobias , Seiberl Michael , Feige Julia , Bieler Lara , Radlberger Richard F. , O’Sullivan Ciara , Pilz Georg , Harrer Andrea , Schwenker Kerstin , Haschke-Becher Elisabeth , Machegger Lukas , Grimm Jochen , Redlberger-Fritz Monika , Buchmann Arabella , Khalil Michael , Kvas Erich , Trinka Eugen , Wipfler Peter 

TITLE=Tetravalent  Influenza Vaccine Is Not Associated With Neuroaxonal Damage in Multiple Sclerosis Patients

JOURNAL=Frontiers in Immunology

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2021.718895

DOI=10.3389/fimmu.2021.718895

ISSN=1664-3224

ABSTRACT=Background: Efficacy of vaccines and disease activity linked to immunization are major concerns among people with multiple sclerosis (pwMS). 
Objective: To assess antibody responses to seasonal influenza antigens and vaccine-associated neuroaxonal damage utilizing serum neurofilament light chain (sNfL) in pwMS on dimethyl fumarate (DMF).
Methods: In this prospective study, the 2020/2021 seasonal tetravalent influenza vaccine was administered to 20 pwMS treated with DMF and 15 healthy controls (HCs). The primary endpoints were responder rate of strain-specific antibody production (sero-conversion or significant (4-fold) increase in influenza-antibody titers for ≥2/4 strains) at 30 days post-vaccination and changes in sNfL levels.
Results: All patients on DMF fulfilled the responder criteria for immunization compared to 53% of the controls. However, higher proportions of HCs had already influenza-antibody titres ≥1:40 at baseline (53% vs 41%, p=0.174). sNfL levels were comparable among both groups at baseline and did not increase 34 days after vaccination. In addition, no clinical or radiological disease reactivation was found.
Conclusion: DMF-treated patients mount an adequate humoral immune response to influenza vaccines. Additionally, our data suggest that influenza immunization is not associated with clinical or subclinical disease reactivation.