From the Guidelines
Yes, it is generally safe for individuals with multiple sclerosis (MS) to receive COVID-19 vaccines, as the benefits of vaccination in preventing severe Covid-19 infection, complications, and mortality outweigh the potential risks. According to a 2022 study published in Reviews in Medical Virology 1, patients with MS are at increased risk of severe Covid-19 infection, and vaccination is vital for this population. While there is some concern that vaccination against SARS-CoV-2 may exacerbate MS by inducing immunological responses and triggering immunological reactions, the study found that vaccines are generally safe in MS patients, with a low probability of acute relapse.
Some key considerations for MS patients receiving COVID-19 vaccines include:
- Timing of vaccination in relation to disease-modifying therapies (DMTs)
- Potential attenuation of vaccine response due to certain DMTs
- Delaying vaccination in patients on high-dose or long-term corticosteroids or immune-reconstitution therapies
- Coordinating vaccination with a neurologist, especially for patients on certain DMTs like ocrelizumab
The study 1 recommends that patients with a history of autoimmune conditions, including MS, receive mRNA Covid-19 vaccines if not contraindicated. Additionally, patients being treated with certain DMTs can be vaccinated at any time during their treatment, despite the likely vaccine response attenuation. However, in MS patients scheduled to start ocrelizumab therapy, the two-dose vaccine regimen should be administered at least 4–6 weeks before the initiation of their treatment course, or at least 4–6 months after the treatment course last ocrelizumab infusion.
Overall, the benefits of COVID-19 vaccination in preventing severe infection and mortality in MS patients outweigh the potential risks, and vaccination is recommended for all MS patients, with careful consideration of timing and potential interactions with DMTs.
From the Research
Covid-19 Vaccines and Multiple Sclerosis
- The safety and efficacy of Covid-19 vaccines in patients with multiple sclerosis (MS) have been evaluated in several studies 2, 3, 4, 5, 6.
- A retrospective observational study found that the Pfizer-BioNTech vaccine was safe for MS patients, with adverse events similar to those in the general population 2.
- Another study suggested that RNA, DNA, protein, and inactivated vaccines are likely safe for MS patients, while live-attenuated vaccines should be avoided whenever possible in treated patients 3.
Disease-Modifying Therapies and Vaccine Response
- Disease-modifying therapies (DMTs) can influence the safety and efficacy of Covid-19 vaccines in MS patients 3, 4, 5.
- Some DMTs, such as interferon-beta, glatiramer acetate, and teriflunomide, are not expected to impact vaccine efficacy, while others, such as cell-depleting agents and sphingosine-1-phosphate modulators, may attenuate vaccine responses 3, 4, 5.
- A review of vaccination studies in MS patients receiving DMTs found that teriflunomide appears to have minimal influence on the response to seasonal influenza vaccine 5.
Vaccine Safety and Immunogenicity in MS Patients
- A review of recently conducted studies on vaccine safety and immunogenicity in MS patients treated with DMTs found that vaccinations against various pathogens, including Covid-19, are generally safe and effective 6.
- The review also discussed the risks and benefits of vaccination against SARS-CoV-2 in MS patients and vaccination guidelines set forth by MS societies and organizations 6.
- Overall, the available evidence suggests that Covid-19 vaccines can be safely administered to MS patients, but the timing of vaccination and DMT dosing may need to be coordinated to optimize vaccine efficacy 2, 3, 4, 5, 6.