Safety of COVID-19 Vaccines in Patients With Multiple Sclerosis: A Cross-Sectional Study From a Tertiary Rehabilitation Center in Saudi Arabia

Abstract

Background The safety and adverse effects (AEs) associated with approved COVID-19 vaccines in individuals with multiple sclerosis (MS) require further examination, particularly as there is limited information available for MS patients in Saudi Arabia. This study sought to investigate the reported AEs of COVID-19 vaccines among MS patients admitted to a major rehabilitation center in Saudi Arabia. Methods A cross-sectional analysis was conducted from January 2023 to March 2024 at Sultan Bin Abdulaziz Humanitarian City (SBAHC) in Riyadh. All MS patients registered in the electronic medical records were invited to participate in face-to-face or phone interviews. A total of 108 MS patients were surveyed, and data were collected on demographic information, MS-related history (including disease duration, presenting symptoms, and relapses), COVID-19 vaccination status (type, number of doses, and reported AEs), and exposure to disease-modifying therapies. Results Among the subjects, there were 58 males (53.7%) and 50 females (46.3%), with a mean age of 38.8 ± 9.7 years, ranging from 17 to 66 years. The relapsing-remitting type of MS was the most prevalent (n=53, 49%). The BNT162b2 mRNA COVID-19 vaccine from Pfizer-BioNTech was the most administered vaccine (n=58, 53.7%). Adverse events were reported by 56 (52%) participants, with the majority being mild (n=79, 73.3%). The ChAdOx1 nCoV-19 vaccine from Oxford-AstraZeneca showed a significantly higher incidence of AEs (n=76, 70%) compared to other vaccines (p < 0.001). Binary logistic regression indicated that the Oxford-AstraZeneca vaccine type was the most significant independent factor associated with COVID-19 vaccination AEs (odds risk 5.337, 95% confidence interval 0.022-18.980, p<0.001). Conclusions The safety profile of COVID-19 vaccines in this study is comparable to that of the general population, showing similar rates of mild and self-limiting AEs, with no serious or life-threatening reactions reported. The Oxford-AstraZeneca vaccine was notably linked to a higher incidence of AEs. These findings affirm the safety of COVID-19 immunization in MS patients and reinforce both local and international guidelines to promote vaccination during the COVID-19 pandemic.