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

Introduction/aims: Patients 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.

Methods: A 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.

Results: A 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%.

Discussion: COVID-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.