Multiple Sclerosis after the COVID shots

This article discusses the multiple sclerosis cases that happened after COVID-19 jabs. Mindy, a reader, asked me to look into Multiple Sclerosis relapses after COVID injections after her daughter developed more MS lesions in her brain after her shots upon advice by her physicians.

Below are the search results from VAERS Data on how many Multiple Sclerosis cases were reported after the COVID-19 shot and its booster, COVID-19-2.

This is for all locations, all manufacturers, all ages and sex, and all events from 2021 to 2023.

There are 1,110 Multiple Sclerosis cases. Some cases are preexisting, but the symptoms worsened after the shots.

There are 816 Multiple sclerosis relapses. 

Myelin sheath

Nerve cells from the brain to the extremities are covered with myelin. Gaps separate the myelin sheaths called the Node of Ranvier, as shown below.

Unlike water that travels thru a pipe, signals from the brain to the farthest nerves jump from one Node of Ranvier to the next node. That process is called saltatory conduction.

Saltatory conduction allows sensory signals to reach the brain rapidly and split-second reflexes of the hand and feet. Thanks to saltatory conduction and healthy myelin sheaths, we can pull our hand immediately if we touch something hot before fully burning the skin.

Demyelinating diseases

A demyelinating disease is an autoimmune disease. The body’s immune system destroys the myelin, and the nerve loses its function when destroyed.

Multiple Sclerosis is the most common demyelinating disease. It is pretty debilitating.

Jacqueline du Pré is a British cellist who developed MS. Her career was cut short by multiple Sclerosis, which forced her to stop performing at 28; she died 14 years later at 42. You can’t help but feel sad when you see Jacqueline play her cello on some YouTube videos.

Types of Multiple Sclerosis

The clinical course of MS varies, and it can slowly progress or come and go (relapse) and get worse with time.

The image below shows the different clinical courses and types of MS.

Since myelin is found in the brain, spinal cord, and extremities, MS can happen in all body parts.

Published case reports of multiple Sclerosis after the COVID injections

Among all the complications after the COVID injections, MS case reports are the easiest to find. A whole page of search results popped out right away, and each study is linked to more. The relative ease of research agrees with the high number of MS cases in VAERS.

In their Neurological Manifestations associated with the COVID-19 vaccine, Castillo and Castrillo reported 868 cases of Guillain-Barré syndrome and 258 cases of central nervous system demyelination. Most reports are associated with the Pfizer shot, followed by Astra Zeneca.[3]

Mirmosayyeb et al. (Jan 2023) authored Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) following COVID-19 vaccines. They found:

• 19 cases
• 14 (73.6%) patients were female
• The average age was 37.8 (10.1) years.
• The mean (SD) of the interval time between injection of the COVID-19 vaccination and the first symptoms of MS or NMOSD (neuromyelitis optica spectrum disorder) 1st and 2nd doses were 7.5 (4.8) and 15.1 (12.8) days, respectively.
• 89.4% of patients received intravenous steroids, and 26.3% had plasma exchange (PLEX).
• Available data demonstrated that all patients recovered.

NMSOD is a demyelinating disease involving the nerves of the eyes and the spinal cord.

Rinaldi et al. Dec 2022. published a case series and systematic review, CNS inflammatory demyelinating events after COVID-19 vaccines.

• 91  CNS Inflammatory Demyelinating Events (CIDEs)
  • 24  Acute Transverse Myelitis (ATM) – spinal cord
  • 11 Acute Disseminated Encephalomyelitis (ADEM) – brain and spinal cord
  • 47 Multiple sclerosis
  • Nine NMOSD (neuromyelitis optica spectrum disorder) /Myelin Oligodendrocyte Glycoprotein Antibody Disease (MOGAD) – affects the optic nerve, spinal cord, brain, and brainstem.

Overall, inflammatory CNS demyelinating events occurred after both mRNA (n = 46), adenoviral-vectored (n = 37), and inactivated vaccines (n = 8).

Age was heterogeneous (19-88), and the female sex was prevalent.

Time from vaccine to symptoms onset was notably variable:

• ADEM and NMOSD/MOGAD had a longer median time of onset (12.5 and 10 days)
• ATM and MS (6 and 7 days)
• The demyelinating disease occurred earlier with mRNA vaccines than those following adenoviral-vectored ones (AstraZeneca, Janssen).

Lee et al. (Feb 2023) conducted an observational study, Acute central nervous system inflammation following COVID-19 vaccination.

It included patients with acute brain and spinal cord inflammatory events within 60 days after a COVID-19 vaccine from March 2021 to August 2022. The brain and spinal cord comprise the CNS.

They found thirty-eight patients (median age 39 (range: 20-82) years; 60.5% female) presented within 0-55 (median 15) days of receiving a COVID-19 vaccine. They were diagnosed with the following:

• Relapsing-remitting multiple Sclerosis (MS) (n = 16)
• Post-vaccine transverse myelitis (n = 7)
• Clinically isolated syndrome (n = 5)
• MS relapse (n = 4)
• Tumefactive demyelination (n = 2)- a locally aggressive form of demyelination, seen as a solitary lesion or sometimes a couple of lesions greater than 2 cm that may mimic a neoplasm on MRI.
• MOGAD (Myelin oligodendrocyte glycoprotein antibody disease) (n = 1)
• NMOSD (Neuromyelitis optica spectrum disorder) (n = 1)
• Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (n = 1)
• Primary autoimmune cerebellar ataxia (n = 1)

Twenty-two received acute treatment, and 21 started disease-modifying therapy. Sixteen received subsequent COVID-19 vaccination, of which 87.5% had no new or worsening neurological symptoms.

Multiple Sclerosis after COVID injections can be new-onset, an exacerbation, or a cause of death.

First Presentation of Multiple Sclerosis

A 40-year-old woman was diagnosed with cervical myelitis two weeks after receiving a second dose of a Pfizer COVID jab. After vaccination, she suffered from transient high-grade fever (38.5 degrees) without other symptoms.

Her history revealed that she was treated with steroids for left peripheral facial nerve palsy with full recovery four years ago.

Neurological examination revealed sensory disturbance in the right cervical 5th to 8th area dermatome. Her brain MRI showed asymptomatic MS lesions. Her neck MRI showed an MS lesion explaining her numbness.

She was diagnosed with Multiple Sclerosis and treated successfully with high-dose steroids. In this case, the authors think she might have underlying multiple Sclerosis uncovered by the Pfizer shot.

VAERS CASES of New MS after COVID shots

Case Number 1171952-1

 A 27-year-old non-pregnant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), dose one via intramuscular, administered in Arm Left on 08 Jan 2021 at 12:45 (Batch/Lot Number: EK4241) (at the age of 27-years-old) as a single dose, and dose two via intramuscular on 12Feb2021 (Batch/Lot Number: EL 1406) as a single dose for covid-19 immunization.

Medical history included none. The patient had no allergies to medications, food, or other products. Concomitant medications were not reported.

Since the vaccination, the patient has not been tested for COVID-19. On an unspecified date in Feb2021, the patient experienced multiple sclerosis and was hospitalized for three days.

The first presentation of the clinically evident demyelinating event five weeks after administration of the first dose, with symptoms beginning one day prior to the second dose.

Progressive symmetrical paresthesias to bilateral lower legs and impaired temperature sensation. The patient underwent lab tests and procedures, which included neuroimaging and lumbar puncture in 2021, which showed multiple sclerosis.

Treatment received for the event included high-dose prednisone. The outcome of the event was unknown.

Case number 1181703-1

Pt received the J&J covid vaccine on 3/15/21 in.presented to the ED on 3/29 for a few days of progressive weakness and urinary difficulty.

Recently took a trip and returned Thursday evening. That night, she noticed mild sensitivity to her left forearm. She developed an achy feeling on Friday under both arms and across her breasts. Her eyes felt painful as well.

Overnight Friday into Saturday, her feet began feeling cold and numb, and she developed a generalized sensitivity over her entire body that she describes almost as a burning sensation.

She also had trouble urinating and had pain, paresthesias, and weakness below mid-chest level, and urinary retention. MRI of the brain, Cervical, and Thoracic spinal Cord was consistent with demyelination.

Neuro consulted, and impression is acute demyelinating disease, unclear etiology but may be acute disseminated encephalomyelitis (ADEM) secondary to COVID vaccine vs. 1st presentation of multiple sclerosis.

Symptoms gradually improved s/p solumedrol IV bid x 5d in the hospital — > transitioned to oral prednisone taper per neuro (60 mg x2 days, then go down by 10 mg every two days until off) for discharge.

Pt to follow up with neuro post-discharge. For neurogenic bladder, PT had temporary foley. Removed April 2 and will require CIC QID (teaching done prior to discharge) at home. Outpatient follow-up with Urology.

There’s a lot more at VAERS.

Multiple Sclerosis Sudden Death after COVID shot

In South Korea, a 19-year-old with a history of epilepsy died suddenly. He was diagnosed with unilateral optic neuritis (ON) four years before death.

Optic neuritis is an inflammation of the eye’s nerve and could be an initial presentation of MS.

Six months before death, he received a second mRNA shot. Three months before dying, he experienced epileptic seizures for the first time.

Seventeen days before death, he was infected with mild COVID-19. Several days before dying, he complained of seizures again at night.

An autopsy revealed changes in the brain consistent with multiple Sclerosis. The other major organs, including the heart and lungs, were unremarkable. Based on the history and postmortem findings, the cause of death was determined to be multiple Sclerosis with suspected exacerbation.

The Connection between the SARS-CoV-2 Spike Protein and MS

HERV-W

The SARS-CoV-2 or its spike protein can elicit HERV-W (Human Endogenous Retrovirus-W) and triggers an autoimmune response.

HERV-W has been shown to contribute to causing multiple Sclerosis due to its ability to activate microglia and cause axon injury. The axon is part of the neuron covered with myelin that connects to other nerves. [9]

In January 2022, I published an article about spike proteins and HERV-W and their role in causing inflammation.

SARS-CoV-2 brings out an endogenous retrovirus protein to cause severe COVID-19 and Long COVID syndrome.

Inflammation

Bellucci et al. talked about the interplay between SARS-CoV-2 and MS.

In particular, there are three pivotal crossroads of MS and COVID-19 immunological substrates: the type-1 IFN (IFN-I) response, the TH-17 axis, and the inflammasome pathway.

An impairment in interferon-1 is a common denominator between MS and COVID-19 and its injection.

Bellucci et al. said, “The immune activation consequent to a microbial infection often embraces some grade of non-specific systemic inflammation known to enhance autoimmunity in people with MS and interfere with the disease course.”

A patient with MS can develop a relapse with an infection like a urinary tract infection.

Bellucci et al. offered some advice to prevent MS relapse

Caution should be taken when vaccinating people with MS with sustained disease activity and/or a recent clinical or radiological relapse, in which the threshold for inflammatory exacerbation concomitant to the immunization stimulus could be lower.

The same could be hypothesized for people with subclinical CNS inflammation (such as in radiological isolated syndromes, RIS) or genetically at-risk individuals during disease prodrome.

The case report about a 40-year-old  above exemplified that precaution.

Blood Brain Barrier Leak

The blood-brain barrier prevents toxic substances from entering the brain. In a SARS-CoV-2 infection, the spike protein the neuroinflammation can cause a leak in the BBB.

A study by Leech et al. showed that abnormalities in the BBB are present in secondary progressive and acute multiple Sclerosis and primary progressive multiple Sclerosis.

Molecular Mimicry

A study published in Jan 2023, Sequence similarity between SARS-CoV-2 nucleocapsid and multiple sclerosis-associated proteins, provides insight into viral neuropathogenesis following infection.

The study showed that the immune response developed during COVID-19 might lead to multiple sclerosis due to the similarities in the antigens of the nucleocapsid protein. Spike, membrane, NS7a, and envelope proteins from SARS-CoV-2 did not share significant overlap with the list of MS proteins.

However, Cuspoca et al. found that 39 proteins linked to the axon and myelin homeostasis shared the same sequence of pentapeptides with the SARS-CoV-2 spike protein. That means an immune response elicited by the SARS-CoV-2 spike protein can also attack the human nervous tissue.

In late 2020, before the vaccine rollout. I heard about a case of transverse myelitis in a subject injected with the AstraZeneca shot.  That made me research how safe the COVID shots are.

My readings led me to molecular mimicry between the SARS-CoV-2 proteins, the myelin sheath, and other human proteins. I wrote about them at

1. COVID-19, Autoimmunity and Vaccination, Part 1
2. COVID-19, Autoimmunity, and Vaccination Part 2
3. COVID-19, Autoimmunity, and Vaccination Part 3
4. Molecular Mimicry between the SARS-CoV-2 and the Breathing Center
5. Molecular mimicry between the spike protein and humans can shut down platelet production
6. Autoimmune antibodies and diseases after COVID-19 disease and injections
7. The SARS-CoV-2 spike protein cross-reacts with eleven human proteins to cause autoimmune diseases
8. VAERS Data: Neurodegenerative Diseases after COVID Jabs
9. Guillain-Barre Syndrome After Covid-19 Vaccination
10. UK Study of COVID-19 shots and Excess Rates of Guillain-Barré Syndrome

In summary, new and relapsing forms of multiple Sclerosis can happen after COVID shots. Talk to your doctor about whether the benefit of a COVID injection is greater than the risk.

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References:

1. United States Department of Health and Human Services (DHHS), Public Health Service (PHS), Centers for Disease Control (CDC) / Food and Drug Administration (FDA), Vaccine Adverse Event Reporting System (VAERS) 1990 – 03/17/2023, CDC WONDER On-line Database. Accessed at http://wonder.cdc.gov/vaers.html on Mar 24, 2023, 9:40:05 AM
2. United States Department of Health and Human Services (DHHS), Public Health Service (PHS), Centers for Disease Control (CDC) / Food and Drug Administration (FDA), Vaccine Adverse Event Reporting System (VAERS) 1990 – 03/17/2023, CDC WONDER On-line Database. Accessed at http://wonder.cdc.gov/vaers.html on Mar 24, 2023, 9:46:38 AM
3. Castillo RA, Castrillo JCM. MANIFESTACIONES NEUROLÓGICAS ASOCIADAS A LA VACUNA CONTRA COVID-19 [NEUROLOGICAL MANIFESTATIONS ASSOCIATED WITH COVID-19 VACCINE]. Neurologia. 2022 Oct 12. Spanish. doi: 10.1016/j.nrl.2022.09.005. Epub ahead of print. PMID: 36245941; PMCID: PMC9554338.
4. Mirmosayyeb O, Ghaffary EM, Vaheb S, Pourkazemi R, Shaygannejad V. Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) following COVID-19 vaccines: A systematic review. Rev Neurol (Paris). 2023 Jan 17:S0035-3787(22)00825-6. doi: 10.1016/j.neurol.2022.11.004. Epub ahead of print. PMID: 36658048; PMCID: PMC9844421.
5. Rinaldi V, Bellucci G, Buscarinu MC, Reniè R, Marrone A, Nasello M, Zancan V, Nistri R, Palumbo R, Salerno A, Salvetti M, Ristori G. CNS inflammatory demyelinating events after COVID-19 vaccines: A case series and systematic review. Front Neurol. 2022 Dec 1;13:1018785. doi: 10.3389/fneur.2022.1018785. PMID: 36530641; PMCID: PMC9752005.
6. Lee S, Muccilli A, Schneider R, Selchen D, Krysko KM. Acute central nervous system inflammation following COVID-19 vaccination: An observational cohort study. Mult Scler. 2023 Feb 25:13524585231154780. Doi: 10.1177/13524585231154780. Epub ahead of print. PMID: 36840605; PMCID: PMC9969223.
7. Fujimori J, Miyazawa K, Nakashima I. Initial clinical manifestation of multiple sclerosis after immunization with the Pfizer-BioNTech COVID-19 vaccine. J Neuroimmunol. 2021 Dec 15;361:577755. doi: 10.1016/j.jneuroim.2021.577755. Epub 2021 Oct 20. PMID: 34700047; PMCID: PMC8527738.
8. Jeon YH, Choi S, Park JH, Lee JK, Yeo NS, Lee S, Suh YL. Sudden Death Associated With Possible Flare-Ups of Multiple Sclerosis After COVID-19 Vaccination and Infection: A Case Report and Literature Review. J Korean Med Sci. 2023 Mar 13;38(10):e78. Doi: 10.3346/jkms.2023.38.e78. PMID: 36918031; PMCID: PMC10010908.
9. Kremer D, Gruchot J, Weyers V, Oldemeier L, Göttle P, Healy L, Ho Jang J, Kang T Xu Y, Volsko C, Dutta R, Trapp BD, Perron H, Hartung HP, Küry P. pHERV-W envelope protein fuels microglial cell-dependent damage of myelinated axons in multiple sclerosis. Proc Natl Acad Sci U S A. 2019 Jul 23;116(30):15216-15225. doi: 10.1073/pnas. 1901283116. Epub 2019 Jun 18. PMID: 31213545; PMCID: PMC6660731.
10. Bellucci G, Rinaldi V, Buscarinu MC, Reniè R, Bigi R, Pellicciari G, Morena E, Romano C, Marrone A, Mechelli R, Salvetti M, Ristori G. Multiple Sclerosis and SARS-CoV-2: Has the Interplay Started? Front Immunol. 2021 Sep 27;12:755333. doi: 10.3389/fimmu.2021.755333. PMID: 34646278; PMCID: PMC8503550.
11. Leech S, Kirk J, Plumb J, McQuaid S (February 2007). “Persistent endothelial abnormalities and blood–brain barrier leak in primary and secondary progressive multiple sclerosis.” Neuropathol. Appl. Neurobiol. 33 (1): 86–98. doi:10.1111/j.1365-2990.2006.00781.
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