Abstract

The Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology (DCNI/ABN) and Brazilian Committee for Treatment and Research in Multiple Sclerosis and Neuroimmunological Diseases (BCTRIMS) provide recommendations in this document for vaccination of the population with demyelinating diseases of the central nervous system (CNS) against infections in general and against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19. We emphasize the seriousness of the current situation in view of the spread of COVID-19 in our country. Therefore, reference guides on vaccination for clinicians, patients, and public health authorities are particularly important to prevent some infectious diseases. The DCNI/ABN and BCTRIMS recommend that patients with CNS demyelinating diseases (e.g., MS and NMOSD) be continually monitored for updates to their vaccination schedule, especially at the beginning or before a change in treatment with a disease modifying drug (DMD). It is also important to note that vaccines are safe, and physicians should encourage their use in all patients. Clearly, special care should be taken when live attenuated viruses are involved. Finally, it is important for physicians to verify which DMD the patient is receiving and when the last dose was taken, as each drug may affect the induction of immune response differently.

Highlights

  • The Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology (DCNI/ABN) and Brazilian Committee for Treatment and Research in Multiple Sclerosis and Neuroimmunological Diseases (BCTRIMS) provide recommendations in this document for vaccination of the population with demyelinating diseases against infections in general and against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19

  • For some specific vaccines, there are already more robust clinical trials related to the use of some disease-modifying drugs (DMDs), which are discussed in more detail below

  • We emphasize the seriousness of the current moment in view of the progression of COVID-19 in our country, and refer to new variants of SARS-CoV-2, especially the P1 variant identified throughout the country, with the possibility of coinfection events occurring[1]

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Summary

Recommendations by the Scientific

The Brazilian Committee for Treatment and Research in Multiple Sclerosis and Neuroimmunological Diseases (BCTRIMS) on vaccination in general and against. Author’s contributions: JB, LCF, AD, DBB, PC, DG, MALP, NACS, SMA, TA, JSA, TJ, SLAP, ABAGRG, MP, RP: conceptualization, writing of original draft, methodology; JB, FG: project administration and supervision; JB, LCF, AD, DBB, PC, DG, MALP, NACS, SMA, TA, JSA, TJ, SLAP, ABAGRG, MP, RP: writing, review & editing; AKG, ACP, JAA, APGN, ACPO, BSO, CBT, CFV, DKM, DV, DS, EMLO, FRM, FEB, FFAF, FAAG, GRP, GDS, GSO, GACS, HHR, HKS, HRSN, LCC, MVMG, MCAV, MLVP, MCR, MB, MKFP, RBSM, RL, RBT, RK, RMD, SG, SAL, SAL, TF, TAGJR, TCAW, YF, OJMN, MLBF, MFM, DGB, FG: final approval by all participants of the Neuroimmunology Brazilian Study Group.

INTRODUCTION
Uses inactivated bacterial toxins
Safe and stable as it contains no active virus
Rituximab Satralizumab
Vaccine type
Live attenuated virus
Inactivated vaccine Recombinant vaccine
Inactivated vaccine
Inactivated vaccine Inactivated vaccine Conjugate vaccine Live attenuated virus
Considered safe
Considered safe Considered safe
Vaccine type Inactivated vaccine Live attenuated viruses
Interferons beta
Glatiramer Teriflunomide
Dimethyl fumarate
Mycophenolate mofetil
Treating multiple sclerosis and neuromyelitis optica spectrum
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