COVID-19 Vaccination and Infection in Myasthenia Gravis: A Longitudinal Patient Survey

Introduction/AimsPatients with myasthenia gravis (MG) often receive immunosuppressive treatments. While approved COVID-19 vaccines effectively prevent severe infections, the impact of vaccination among immunocompromised MG patients remains unclear. This study explored vaccination status, adverse events, and post-vaccination outcomes among MG patients.MethodsA REDCap survey was conducted between September 21, 2021 and November 18, 2021 through the Myasthenia Gravis Foundation of America to collect data on demographic and disease characteristics, COVID-19 infections, vaccination status, and precaution strategies. A follow-up survey was available from January 11, 2022 to March 8, 2022.ResultsA total of 1205 participants [65.7% female, average age 59.6 +/- 15.4 years] completed the survey. Most were White or Caucasian (87.9%), 63.6% held a bachelor's degree or higher, and 41.9% were retired. Acetylcholine receptor (AChR) antibody positivity was reported by 47%, MuSK-Ab positivity by 6.1%, and 19.6% were seronegative. Most (75%) were on immunosuppressive therapy, and the vaccination rate was 91.5%. Among COVID-19 vaccine recipients, 61.5% reported adverse effects, while 8.5% of participants remained unvaccinated due to concerns about side effects (65%) and potential worsening of MG symptoms (70.9%). Post-vaccination COVID-19 infection rates dropped from 9.7% to 2.4%. Hospitalization decreased from 2.3% to 0.3%, and MG exacerbation rates from 5.5% to 1.4%.DiscussionCOVID-19 vaccination acceptance is high among MG patients. Reported side effects in MG patients were comparable to those in the general population, and vaccination was associated with a reduced COVID-19 infection rate. Addressing concerns about vaccine side effects and providing efficacy data specific to MG could aid unvaccinated individuals in decision-making.