Author Response: Effect of Ocrelizumab on Vaccine Responses in Patients With Multiple Sclerosis: The VELOCE Study

We appreciate the comment on our article1 by Dr. Hahn, who asked about the vaccination sequence of Pneumovax 23 (PPSV23) followed by Prevnar (PCV13), as used in the OCR1 subgroup of the VELOCE study. The goal of VELOCE was to evaluate, in a research setting, the ability of MS patients—who were B-cell depleted after ocrelizumab treatment—to raise antibody (IgG) responses to a range of vaccines that act through different immune response pathways. VELOCE used Pneumovax (23-PPV), in all patients, to assess responses to the unconjugated S. pneumoniae capsular polysaccharide chains, described to reflect an immune response pathway that is T-cell independent (i.e., mainly dependent on the presence of B cells). The study then explored, in the OCR1 subgroup, the potential boosting effect of Prevnar (13-PCV), a polysaccharide/protein conjugate vaccine that acts through a T-cell dependent response pathway. The VELOCE design was not meant to suggest a particular order or timeframe for clinical vaccine use. We recommend that for clinical use, readers follow their country’s most current vaccination guidelines, such as the recently updated CDC recommendations for the use of pneumococcal vaccines in the United States: cdc.gov/vaccines/vpd/pneumo/hcp/recommendations.html.

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