b'Case study nds no DMT eect on T-cells or antibody production. We do know,on COVID-19 vaccine eectivenesshowever that some people with MS can seeA Stanford University School of Medicine reductions in antibodies (IgG and IgM) and/orcase study reports on a 44-year-old female on reductions in certain types of T-cells like CD4rituximab for treatment of multiple sclerosis. and CD8 cells. So, what does this mean forThe patients MS was reported to be well- COVID-19 vaccine responses for people oncontrolled, and she had no symptoms of one of these drugs?respiratory infection or known SARS-CoV-2 Somestudieshaveshownadecreasedexposures.ThelastrituximabIVinfusion antibody response to COVID-19 vaccination.was 14 weeks prior to the rst dose of the Immunity after vaccination is about morePzer SARS-CoV-2 vaccine. The SARS-CoV-2 thanjustanantibodyresponse,however.IgG specific antibodies were undetectable Immunity can also be mediated through18 days after second dose of SARS-CoV-2 T-cell pathways that should be unaected byvaccine. Interferon-gamma release assay drugs such as Ocrevus, Rituxan, and Kesimpta.testing for SARS-CoV-2 was positive on day 19, Thats exactly what this case report found.demonstratingrobustT-cellmediated T-cell responses after vaccination in thisresponse despite lack of antibody-mediated individualwereunaectedbytheirB-cellresponse. A noted limitation by the authors treatment. is that it cannot be ruled out the patient had Id love to have more studies with morea prior undetected COVID-19 infection that individuals. If youre on B-cell therapy, speakproduced the positive IGRA. After evaluating with your medical team about the risks/this case the researchers suggest the IRGA benefits of vaccination, timing of theshould be studied as a possible correlate of vaccination and what labs are done routinelyprotection after COVID-19 mRNA vaccines in to monitor your immune status.patients with immunosuppressive medications.Dr. ThrowerNormally, I wouldnt commenton a single case report, but this is an importanttopic. Atthistime,itlookslikeCOVID-19could be poised to rear its ugly head againas the Delta variant. The MS communityhas had lots of questions about COVID-19,vaccinations and MS therapies. One of themost pressing questions is whether MS disease-modifying therapies alter the eectiveness ofCOVID-19 vaccinations. Therapies such asOcrevus, Rituxan and Kesimpta are anti-CD20monoclonal antibodies. They work by reducingthe number of B-cells that bear the CD20receptor. Ideally, their immune eect is limitedto the reduction of CD20 B cells with no eect61 msfocusmagazine.org'