Table 1.
Summarized data on patients with MS or NMOSD who presented a relapse in close temporal relation to the AZD1222 vaccination for protection against COVID-19.
| Sex | Age (years) | Disease | Duration of controlled disease (years) | Medication in use | General AEs to first dose of AZD1222 | Days elapsed between vaccine and relapse | Clinical manifestation of relapse | Magnetic resonance | Treatment | Recovery* | General AEs to second dose of AZD1222 |
| F | 22 | RRMS | 5 | Fingolimod | Headache | 7 | Facial paralysis, hemiparesis, ataxia | Non-Gd tumefactive lesion (Fig 2) | Pulsotherapy methylprednisolone | Not yet recovered | Not done |
| F | 32 | RRMS | 2 | Dimethyl fumarate | Myalgia, fever | 10 | Loss of vision and papillitis in the left eye | New Gd+ lesions in the left eye | Pulsotherapy methylprednisolone Immunoglobulin | Partial recovery in 3 weeks | Not done |
| M | 35 | SPMS | 3 | Natalizumab | Myalgia, fever, fatigue | 7 | Worsening of disability, could not walk, severe weakness of both legs | High lesion load, new lesions | Oral prednisone | Not yet recovered | Not done |
| F | 30 | RRMS | 1 | Natalizumab | Myalgia, chills, fever | 25 | Right hemiparesis | New Gd+ lesions | Pulsotherapy methylprednisolone | Recovered in 3 weeks | Not done |
| F | 42 | RRMS | 3 | Fingolimod | Chills | 15 | Rapidly progressive weakness in both arms, grade III at its worst | New Gd+ lesions in spinal cord, T2 level | Pulsotherapy methylprednisolone | Recovered in 3 weeks | No adverse events |
| M | 35 | RRMS | 4 | Teriflunomide | Chills, pain on the site of injection | 20 | Incoordination of right arm and hand | New Gd+ lesions in brainstem | Pulsotherapy methylprednisolone | Not yet recovered | Not done |
| M | 51 | PPMS | 2 | No drug | Headache | 25 | Hypoesthesia in both arms | New Gd+ lesions in cervical cord | No treatment | Not yet recovered | Not done |
| F | 32 | RRMS | 6 | Glatiramer acetate | Headache | 7 | Motor and sensitive deficits in right leg and foot | New Gd+ lesions + new lesions | Pulsotherapy methylprednisolone | Not yet recovered | Not done |
| F | 62 | NMOSD | 8 | Azathioprine | Unspecific | 7 | Loss of vision in the left eye | New Gd+ lesions in left optic nerve | Pulsotherapy methylprednisolone | Recovered vision in 3 weeks | Not done |
Abbreviations: M: male, F: female; RRMS: relapse-remitting multiple sclerosis; SPMS: secondary progressive MS; PPMS: primary progressive MS; NMOSD: neuromyelitis optica spectrum disorders; AE: adverse event; Gd: gadolinium.
Recovery* - when “not yet recovered” is stated, it means that the patient is still with some degree of neurological disability after at least 40 days from the onset of the relapse.