The SARS-CoV-2 pandemic profoundly impacted people with multiple sclerosis (pwMS).
Disease-related aspects and demographic factors may influence vaccination rates, infection susceptibility,
and severity. Despite prior research, comprehensive real-world data obtained throughout the
pandemic remain limited. We investigated SARS-CoV-2 vaccination and infection patterns in a large
monocentric real-world cohort. We collected prospective data from medical visits at the MS Center
Dresden, Germany, from the pandemic’s beginning until 31 May 2022. Logistic regression and rank
correlation analyses were used to explore associations between SARS-CoV-2 outcomes and patient
characteristics. Of 2115 pwMS assessed (mean age 46.5, SD ± 12.9; median expanded disability
status scale 2.5), 77.9% were under disease-modifying treatment (DMT), primarily B-cell depletion
(25.4%). A total of 35.5% reported SARS-CoV-2 infections, and 77.4% were fully vaccinated. PwMS
with increased disability, older age, and comorbidities were associated with higher vaccination rates,
possibly due to the awareness of these populations regarding complications of SARS-CoV-2 infections.
Infections were more common in younger females, people with a lower degree of disability, those with
relapsing MS, and those who were not vaccinated. PwMS on B-cell depletion reported more infections
than untreated pwMS and those receiving other types of disease-modifying therapy, despite higher
vaccination rates. Most infections were mild, with no severity differences according to demographic
or disease-related factors, except for gender. Notably, all fatal cases occurred in unvaccinated pwMS.
Our studies suggest that demographic and disease-related factors, especially age and the use of B-cell
depletion, significantly influenced SARS-CoV-2 vaccination and infection rates in our cohort. These
factors may be considered in future preventive campaigns in further pandemics.