A Case of Multiple Sclerosis Uncovered Following Moderna SARS-CoV-2 Vaccination

Multiple sclerosis is a demyelinating disorder of the central nervous system characterized by lesions disseminated in time and space. The diagnostic criteria for laboratory-supported definite multiple sclerosis involve two episodes of symptoms, evidence of at least one white matter lesion on MRI, and abnormal oligoclonal bands in cerebrospinal fluid. Patients usually present in their early 20s and on average have up to one flare-up per year. While vaccines play an important role in the prevention of many diseases, they have often been purported as a potential trigger of multiple sclerosis and multiple sclerosis relapses. The medical literature provides reliable information concerning the risk of developing multiple sclerosis and multiple sclerosis relapses following the administration of most vaccines, but not much is known about the novel Moderna severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) vaccine. We report the case of a 24-year-old male who presented with right-sided facial weakness, dizziness, and dysarthria two days after receiving his first dose of the Moderna coronavirus disease 2019 (COVID-19) vaccine. Imaging studies noted both acute and chronic central nervous system lesions. He met the diagnostic criteria for laboratory-supported definite multiple sclerosis. His acute flare was treated with intravenous corticosteroids and the patient was subsequently started on ocrelizumab. This case serves as an important example of the novel Moderna SARS-CoV-2 vaccine as a potential trigger of multiple sclerosis relapse. In addition, we review the literature for similar occurrences with the other COVID-19 vaccines and provide reliable guidance for COVID-19 vaccination for patients with multiple sclerosis.