Guidance on COVID-19 Vaccines for Patients With MS

EP: 1.Innate vs Adaptive Immunity in MS Management

EP: 2.Innate and Adaptive Immunity and BTK Inhibitors for Multiple Sclerosis

EP: 3.Role of Inflammation in MS

EP: 4.Role of High Efficacy Therapy for MS

EP: 5.Use of High-Efficacy Therapy in MS in Clinical Practice

EP: 6.Considerations for Using High-Efficacy Therapy in MS

EP: 7.Updates From ACTRIMS 2022 for Relapsing MS

EP: 8.Treating Smoldering Inflammation in MS

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EP: 9.Guidance on COVID-19 Vaccines for Patients With MS

EP: 10.Response to COVID-19 Vaccines in Patients Treated With High Efficacy DMTs

EP: 11.VELOCE Study in Relapsing MS

EP: 12.Managing MS in the COVID-19 Era

EP: 13.Future of MS With BTK Inhibitors

EP: 14.MS Diagnosis and Management Going Forward

EP: 15.Clinical Pearls for the Management of MS

Ahmed Z. Obeidat, MD, PhD: We’ll transition to talking about the COVID-19 vaccine and MS [multiple sclerosis] treatment. None of these talks go without mentioning COVID-19. Sadly, we’re still in a pandemic. It’s improving, but it may be coming back also, so we don’t know. We’re always hopeful that one day we’ll go back to normal life and feel some normalcy. But when we talk about COVID-19 and MS treatment, vaccination in particular is a very important topic. Dr Hendin, I’m going to talk to you a little about the positions of the AAN [American Academy of Neurology], the National MS Society, and maybe even the MS Coalition. What’s the position on MS and vaccination for COVID-19? That’s a question that comes up all the time in the clinic.

Barry A. Hendin, MD: I’ll try to simplify it. One can get granular or at least a bit general. There’s a lot of consensus. The American Academy of Neurology, the Multiple Sclerosis Association of America [MSAA], the Consortium of MS Centers [CMSC], and the National MS Society have all had a consistent message. That is, No. 1, that with people with MS, just like the general population, we encourage vaccination. That means that with the FDA-approved groupings age-wise, we encourage vaccination. No. 2, it’s unlikely that the vaccinations will lead to a negative effect in MS relapse, etc. On the other hand, getting COVID-19 is a serious and too often fatal problem. All of these groups, including the American Academy of Neurology, the National MS Society, the Consortium of MS Centers, and the MSAA have all said to encourage vaccination, but that isn’t the end of it. Encourage vaccination, boosters, hand washing, masking, and avoidance of crowds.

What about the MS population in particular? Although having MS doesn’t in and of itself create a substantial risk difference, we know that MS with progressive disability, aging, and other comorbidities, like uncontrolled diabetes or kidney disease, can lead to worse outcomes. That’s all the more reason to be vigilant, vaccinated, and boosted after discussion with your clinician.

All of these discussions state that this is still ultimately a discussion between patients and clinicians. I agree with that, but it’s also a strong endorsement of vaccination, and I thoroughly agree. It also states that they took a dive into timing, and there’s some interest in the guidelines as to potential timing with B-cell depletion therapies and S1P [sphingosine-1-phosphate receptor] modulators. I understand the interest of timing. I’d love to have people vaccinated before they start their medications, but that isn’t always the case. I encourage vaccination. I tip my hat to timing, but much more so to getting the agent when it’s available.

Ahmed Z. Obeidat, MD, PhD: Yes. Thank you very much. This is very helpful. To your point, the message is that vaccination and the booster are recommended. All these organizations agreed on this, which speaks to the importance of this public health issue and the importance of fighting this infection and hopefully getting rid of it one day.

Transcript Edited for Clarity