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People with MS at much higher risk of severe outcomes from Covid-19 even if fully vaccinated

People with multiple sclerosis (MS) have a much higher risk of being hospitalised and dying from Covid-19 than the general population, despite being more likely to be vaccinated, UK research suggests.

The analysis was done on data from the INvestigation oF cOvid-19 Risk among iMmunocompromised populations (INFORM) study which includes information on 12 million people aged 12 years and older in England.

Previous research from the study which was set up to investigate the impact of Covid-19 among people who are immunocompromised has shown substantially higher risk of severe outcomes in this population.

But until now people with MS had not been included in that category and not looked at in detail, the researchers said.

A comparison of Covid-19 infections in vaccinated people with MS and the general population across 2022 showed a seven-times greater risk of Covid-19 hospitalisation and four-fold increased risk of dying in those with the condition.

Overall, the researchers looked at health records from 16,350 people with MS and found three-quarters had received at least three doses of Covid-19 vaccine compared with half of those in the general population.

Among individuals with MS, there were 215 Covid-19 hospitalisations and 25 Covid-19 deaths, equating to incidence rates of 1.28 and 0.14 per 100 person-years, respectively.

This compared with rates of 0.24 and 0.06 per 100 person-years for hospitalisations and deaths in the general population.

Presenting at the European Society of Clinical Microbiology and Infectious Diseases congress, ESCMID Global, in Barcelona, the researchers will say this highlights the ‘urgent need’ for preventive measures for people with MS who are inadequately protected by vaccination alone.

However, the team did not look at what disease-modifying therapies patients might have been taking and the impact on risk.

Study lead Professor Jennifer Quint, professor of respiratory epidemiology in the School of Public Health at Imperial College London, said: ‘Having multiple sclerosis in itself doesn’t increase the risk of getting Covid-19, rather it’s the taking of immune-modifying medicine that can reduce the effectiveness of vaccines by preventing the immune system from mounting a robust protective response.‘

She added: ‘Some MS-specific factors, such as having underlying conditions or higher levels of disability can contribute to poor outcomes.

‘As a result, even after repeated doses of Covid-19 vaccines, some individuals with MS remain at high risk of serious outcomes.’

Professor Quint said she hoped the findings would raise awareness that the threat of Covid-19 is still very real for many individuals and that booster vaccines are inadequate to fully protect them.

‘With new variants constantly emerging, people living with MS should be considered an important high-risk group for Covid-19 hospitalisation and death for which additional preventive measures and multi-layered public health protections are urgently needed,’ she concluded.

A version of this article was originally published by our sister publication Pulse.