Visitor Monitoring

COVID Vaccine Guidance: Patients with MS

Noran Neurological Clinic and your care team would like to provide you with information regarding COVID-19 vaccination and MS. Please see the below information from the MS Society which offers guidance regarding COVID-19 vaccination (Pfizer and Moderna) as well as specific timing guidelines for COVID-19 vaccination dependent upon your current therapy. 

If you have any questions, please feel free to call at 612-879-1000.

Vaccine Guidance from the MS Society

Original Publication: COVID-19 Vaccine Guidance for People Living with MS 
Updated: February 24, 2021

COVID-19 Vaccine Guidelines for People Living with MS (Printable PDF)

The Pfizer BioNTech and Moderna vaccines are safe for people with MS and they are safe to use with MS DMTs1. Most DMTs are not expected to affect the responses to the Pfizer BioNTech or Moderna vaccines, though some (see details below) may make the vaccines less effective and coordinating the timing of vaccine administration with these DMTs may provide the best vaccine response2.

Given the potential serious health consequences of COVID-19 disease, getting the vaccine when it becomes available to you may be more important than optimally timing the vaccine with your DMT.
The decision of when to get the COVID-19 vaccine should include an evaluation of your risk of COVID-19, including your occupation, and the current state of your MS. Work with your MS healthcare provider to determine the best schedule for you. If the risk of your MS worsening outweighs your risk of COVID-19, do not alter your DMT schedule and get the vaccine when it is available to you.

If your MS is stable, consider the following adjustments in the administration of your DMT to enhance the effectiveness of the vaccine:

  • Avonex, Betaseron, Copaxone, Extavia, glatiramer acetate, Glatopa, Plegridy, Rebif, Aubagio, Bafiertam, dimethyl fumarate, Tecfidera, Tysabri and Vumerity
    If you are about to start one of these DMTs for the first time, do not delay starting it for your vaccine injection. If you are already taking one of these DMTs, no adjustments of your DMT administration are needed2.
  • Gilenya, Mayzent, Zeposia
    If you are about to start Gilenya, Mayzent or Zeposia, consider getting the Pfizer BioNTech or Moderna COVID-19 vaccine so that the second vaccine injection is done 4 weeks or more prior to starting Gilenya, Mayzent or Zeposia.  If you are already taking Gilenya, Mayzent or Zeposia, continue taking as prescribed and get vaccinated as soon as the vaccine is available to you.
  • Lemtrada and Mavenclad
    If you are about to start Lemtrada or Mavenclad, consider getting the Pfizer BioNTech or Moderna COVID-19 vaccine so that the second vaccine injection is done 4 weeks or more prior to starting Lemtrada or Mavenclad. If you are already taking Lemtrada or Mavenclad, consider administering the vaccine injections starting 12 weeks or more after the last Lemtrada or Mavenclad dose, with the optimal timing of the vaccine 24 weeks or more after the last DMT dose2. When possible, resume Lemtrada or Mavenclad 4 weeks or more following the second vaccine injection. This suggested scheduling is not always possible and getting the vaccine when it becomes available to you may be more important than timing the vaccine with your DMT. Work with your MS healthcare provider to determine the best schedule for you.
  • Ocrevus and Rituxan (and biosimilars)
    If you are about to start Ocrevus or Rituxan, consider getting the Pfizer BioNTech or Moderna COVID-19 vaccine so that the second vaccine injection is 4 weeks or more prior to starting Ocrevus or Rituxan. If you are already taking Ocrevus or Rituxan, consider getting the vaccine injections 12 weeks or more after the last DMT dose3. When possible, resume Ocrevus or Rituxan 4 weeks or more following the second vaccine injection. This suggested scheduling is not always possible and getting the vaccine when it becomes available to you may be more important than timing the vaccine with your DMT. Work with your MS healthcare provider to determine the best schedule for you.
  • Kesimpta
    If you are about to start this DMT, consider getting the Pfizer BioNTech or Moderna COVID-19 vaccine so that the second vaccine injection is 4 weeks or more prior to starting your DMT. If you are already taking Kesimpta, consider getting the vaccine injections 4 weeks after your last Kesimpta injection. When possible, resume Kesimpta injections 4 weeks or more following the second vaccine injection. This suggested scheduling is not always possible and getting the vaccine when it becomes available to you may be more important than timing the vaccine with your DMT. Work with your MS healthcare provider to determine the best schedule for you.
  • High-dose steroids
    Consider getting the vaccine injections 3-5 days after the last dose of steroids.

Vaccine Timing Recommendation

Recommendations on timing of vaccines can vary between some of the disease modifying therapies used to treat MS. Below are the timing recommendations for the COVID-19 vaccines based on the MS medication you are being treated with and currently available information. This guidance is based upon the Pfizer and Moderna vaccines, which are not live viruses. Guidelines may differ for other vaccines, especially if they contain live virus.

Vaccine Timing Recommendations (Printable PDF)

Therapy

Vaccine Timing Recommendation

No Therapy

Anytime

Injections

 

Including (Avonex, Betaseron, Copaxone, Extavia, Glatopa, Glateramer Acetate, Plegridy, Rebif): Can receive the vaccine at any time once available.

Oral Therapies

Gilenya: Anytime.

Mayzent: Anytime.

Tecfidera: Anytime.

Aubagio: Anytime.

Mavenclad: 3 months after your last treatment. If you are due for your next round of therapy, please contact your MS provider for guidance.

Infusion Therapies

Tysabri: No timing modification required; continue with current infusion schedule.

     Rationale:

· The timing of the two vaccine doses would make it so that you would need to go 7 weeks between infusions.

· Tysabri does not affect the circulating immune system enough that you would need to wait any length of time before or after vaccination to receive Tysabri, or wait any length of time after receiving Tysabri before getting the vaccine.

Ocrevus: 3 months after your last treatment.

Rituxan: 3 months after your last treatment.

Lemtrada: 3 months after your last treatment. If you are due for your next round of therapy, please contact your MS provider for guidance.

IV Solumedrol: 3-5 days after your last dose of steroids.

 

Note:  The above recommendations from your Neurologist are based upon an MS standpoint. If you have other medical conditions, please consult with your primary care provider/other specialists regarding their recommendations.

Some disease modifying therapies may make the vaccine less effective, but it will still provide some protection.