Our guidance currently relates to the mRNA vaccines (Pfizer-BioNTech and Moderna) only, as these have been through an assessment by our clinical and scientific experts. We know that other COVID-19 vaccines are in use in different countries, and our aim is to update our advice to cover these vaccines as soon as possible.

The mRNA vaccines work by using part of the coronavirus’ genetic code to prompt a response from the human immune system, which in turn will generate a human response to produce antibodies and T-cells cells (a special population of white blood cells) to fight the virus. All data regarding these mRNA COVID-19 vaccines come from clinical trials, which were carefully and thoroughly reviewed and then approved by regulatory authorities.

We do not know how many people in the mRNA vaccine clinical trials had MS, so data on the safety and effectiveness of mRNA COVID-19 vaccines specifically for people with MS are not yet available. Our guidance is therefore based on data from the general population in the vaccine clinical trials, and guided by prior experience regarding vaccination of people with MS. We will update our guidance as more data emerges.

People with MS should get a COVID-19 vaccine

The science has shown us that the COVID-19 mRNA vaccines (Pfizer-BioNTech and Moderna) are safe and effective. Like other medical decisions, the decision to get a vaccine is best made in partnership with your healthcare professional. You should get the mRNA vaccine (Pfizer-BioNTech or Moderna) if and as soon as it becomes available to you. The risks of COVID-19 disease outweigh any potential risks from the vaccine. In addition, members of the same household and close contacts should also get an mRNA vaccine (Pfizer-BioNTech or Moderna) when available to decrease the impact of the virus.

The Pfizer-BioNTech and Moderna COVID-19 vaccines require two doses. You need to get both doses for it to be fully effective. You should follow local, regional and national guidelines on the timing of the second dose. If you have had COVID-19 and recovered, you should also get the vaccine since it does not appear that prior infection protects from future COVID-19 infection indefinitely. Note that following full vaccination (both doses), it may take up to three weeks to reach maximal immunity.

We do not know how long a vaccinated person is protected from COVID-19, although clinical trial data indicates that protection is very high (ie; vaccinated persons have a very low, less than 5% risk, of having COVID-19 symptoms if exposed to the virus) for at least multiple months. Repeated doses of the COVID-19 vaccines may be required in future years.

People with progressive MS, those who are older, those who have a higher level of physical disability (e.g. limited walking distance), those with certain medical conditions (e.g. diabetes, high blood pressure, obesity, heart and lung disease), and Black people with MS and possibly South Asian people with MS, are among groups with the highest risk of hospitalisation due to COVID-19.

The mRNA vaccines (Pfizer-BioNTech and Moderna) are safe for people with MS

The mRNA vaccines (Pfizer-BioNTech and Moderna) do not contain live virus and will not cause COVID-19 disease. The mRNA vaccines (Pfizer-BioNTech and Moderna) are not likely to trigger an MS relapse or to worsen your chronic MS symptoms. The risk of getting COVID-19 far outweighs any risk of having an MS relapse from the vaccine.

The mRNA vaccines (Pfizer-BioNTech and Moderna) can cause side effects, including a fever or fatigue. A fever can make your MS symptoms worse temporarily, but they should return to previous levels after the fever is gone. Even if you have side effects from the first dose, it is important to get the second dose of the vaccine for it to be fully effective.

The COVID-19 mRNA vaccines (Pfizer-BioNTech and Moderna) are safe to use with MS medications

Continue your disease modifying therapy (DMT) unless you are advised by your MS healthcare professional to stop or delay it. Stopping some DMTs abruptly can cause severe worsening of the disease. Based on data from previous studies of other vaccines and DMTs, getting the mRNA vaccines (Pfizer-BioNTech or Moderna) while on any DMT is safe. Some DMTs may make the vaccine less effective but it will still provide some protection. For those taking ofatumumab, alemtuzumab, cladribine, ocrelizumab, or rituximab – you may need to coordinate the timing of your vaccine with the timing of your DMT dose. Work with your MS healthcare professional to determine the best schedule for you.

All of us have a personal responsibility to slow the spread of the pandemic and eliminate the virus as quickly as possible

The authorisations of safe and effective vaccines for COVID-19 bring us one step closer to eliminating this pandemic. In areas where there is ongoing local transmission of COVID-19, in addition to getting vaccinated, you should refer to your local guidelines about transmission mitigation strategies, which are likely to include wearing a face mask, social distancing and washing your hands.