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Anti-CD20 – Vaccine Responses — SCE Neurology MCQ

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ModerateMultiple Sclerosis & CNS InflammationAnti-CD20 – Vaccine ResponsesSCE Neurology

MS patient on ocrelizumab has attenuated vaccine responses. What is the implication?

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Correct answer: B — Anti-CD20 significantly attenuates humoral vaccine responses — vaccinate BEFORE starting anti-CD20 where possible; time vaccines ≥12 weeks post-infusion and ≥4 weeks pre-infusion to optimise response

B-cell depletion reduces antibody responses to vaccines. Mitigation: complete vaccinations before starting, time relative to infusion cycles, household contacts should be vaccinated. T-cell responses may provide some protection. A: Significant attenuation. C: Responses reduced. D: All vaccines affected. E: T-cell may be preserved but humoral impaired.

Reference: ABN MS Guidelines; Achiron et al.