Abstract
Background and purpose: During the COVID-19 pandemic, myasthenia gravis (MG) patients have been identified as subjects at high risk of developing severe COVID-19, and thus were offered vaccination with priority. The lack of direct data on the safety and tolerability of SARS-CoV-2 vaccines in MG have contributed to vaccine hesitancy. To address this issue, the safety and tolerability of SARS-CoV-2 vaccines were assessed in a large cohort of MG patients from two referral centers.
Methods: Patients with confirmed MG diagnosis, consecutively seen between October and December 2021 at two MG centers, were enrolled. Demographics, clinical characteristics, and information regarding SARS-CoV-2 infection/vaccination were extracted from medical reports and/or collected throughout telephonic or in-person interviews.
Results: Ninety-eight (94.2%) of 104 patients included were administered at least two vaccine doses 4 weeks before the interview or earlier, and among them, 63 of 98 (64.2%) have already received the “booster” dose. The most frequently used vaccines were BNT162b2-Pfizer-BioNTech and mRNA-1273-Moderna. Overall, only minor side effects were reported, most commonly local pain and fever. MG worsening after vaccination was observed in eight of 104 (7.7%) cases. The frequency of worsening among muscle-specific tyrosine kinase MG cases (3/9, 33.3%) was significantly higher compared to other serological subgroups. Spontaneous symptom regression was observed in six of eight cases. Twelve of 104 (11.5%) patients had SARS-CoV-2 infection, and none of the SARS-CoV-2-infected MG patients worsened after vaccination.
Conclusions: Our data support the safety and tolerability of mRNA COVID-19 vaccines, which should be strongly recommended in MG patients, who could be at higher risk of complications if exposed to SARS-CoV-2 infection.
Keywords: SARS-COV-2; myasthenia gravis; vaccination.
【저자키워드】 SARS-CoV-2, vaccination., myasthenia gravis, 【초록키워드】 Vaccine, vaccination, severe COVID-19, Clinical characteristics, SARS-COV-2 infection, COVID-19 pandemic, Diagnosis, Symptom, Vaccine hesitancy, SARS-CoV-2 vaccine, vaccine dose, Fever, Patient, Complication, large cohort, information, serological, patients, Frequency, dose, high risk, tyrosine, Support, Side effect, Tolerability, higher risk, subject, local pain, subgroups, worsening, mRNA COVID-19 vaccines, Administered, enrolled, lack, collected, reported, eight, significantly higher, contributed, Spontaneous, offered, were assessed, worsened, 【제목키워드】 vaccination, Safety, Patient, multicenter, Tolerability,