Multiple Sclerosis Society of Canada

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COVID-19 Vaccine Guidance for People Living with MS

  • Announcement

Last updated – January 19

People living with multiple sclerosis (MS) are seeking peace of mind on the safety and effectiveness of the currently approved Pfizer-BioNTech and Moderna COVID-19 mRNA vaccines. In response, MS Society partner organizations convened a group of international expert researchers and medical professionals to review the available science and make fact-based recommendations. The Canadian Network of MS Clinics and the MS Society of Canada’s Medical Advisory Committee have revised and endorsed the guidance for Canadians living with MS.

We do not know how many people in the vaccine clinical trials had MS, so data on the safety and effectiveness of COVID-19 vaccines in those with MS is not yet available. The guidance is based on data from the general population in the vaccine clinical trials and data from studies of other vaccines in MS. This guidance will be updated and become more detailed as more is learned from scientific studies of the vaccines.

People with MS should consider getting the COVID-19 vaccine

The science has shown us that the approved COVID-19 vaccines are safe and effective. Like other medical decisions, the decision to get a vaccine is best made in partnership with your healthcare provider. Most people with relapsing and progressive forms of MS should consider receiving vaccination. The risks of COVID-19 disease likely outweigh any potential risks from the vaccine. This is particularly true for patients who are at high risk (see below) of contracting COVID-19 because of their work or living conditions and whose co-morbidities are those that have been noted to pose a higher risk of contracting or suffering from COVID-19. In addition, members of the same household and close contacts should also get a COVID-19 vaccine when available to decrease the impact of the virus.

Most COVID-19 vaccines require two doses. You need to get both doses for it to work. If you’ve had COVID-19 and recovered, you should also get the vaccine in consultation with your healthcare provider. We don’t know how long someone is protected from getting COVID-19 again.

On January 12, the National Advisory Committee on Immunization (NACI) updated its COVID-19 vaccine recommendations for persons with an autoimmune condition (link to recommendations). NACI recommends that the COVID-19 vaccine may be offered to individuals with an autoimmune condition if a risk assessment deems that the benefits outweigh the potential risks for the individual, and there is informed consent regarding insufficient study in people with autoimmune diseases.

Despite the lack of study in people with autoimmune diseases, the Canadian Network of MS Clinics (CNMSC) feels strongly that immunization should be considered in all persons with MS. The CNMSC position is that immunization should be considered for all persons with MS, since the risks of COVID-19 appear to outweigh the potential risks of the vaccine. We encourage persons with MS to discuss the vaccine with their physicians, to determine the right decision for them.

People with MS at highest risk for severe COVID-19 should consider vaccination as soon as the vaccine is available to them

People with progressive MS, those who are older, those who have a higher level of physical disability, those with certain medical conditions (e.g., diabetes, high blood pressure, obesity, heart and lung disease, pregnancy), and Black, Hispanic and Indigenous populations are among groups with the highest risk for hospitalization due to COVID-19. If you are at high risk, you should consider getting the vaccine as soon as it becomes available to you. Refer here for information related to the vaccination rollout across the country.

The COVID-19 vaccines are believed to be safe for people with MS

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

Like other vaccines, COVID-19 vaccines can cause side effects, including a fever. A fever can make your MS symptoms worsen temporarily, but they should return to prior levels after the fever is gone or with acetaminophen. Even if you have side effects, it’s important to get the second dose of the vaccine for it to be effective.

The vaccines are believed to be safe to use with MS medications

The effectiveness of COVID-19 vaccination in people with MS and DMT is thus far unknown. Continue your disease modifying therapy (DMT) unless you are advised by your MS healthcare provider to stop or delay it. Stopping some DMTs abruptly can cause severe increase in disability with new lesions on MRI. Based on data from previous studies of other vaccines and DMTs, getting the COVID-19 vaccine while on any DMT is safe. Some DMTs may make the vaccine less effective but it will still provide some protection. For those taking Kesimpta*, Lemtrada, Mavenclad, Ocrevus, or Rituxan (rituximab) —you may need to coordinate the timing of your vaccine with the timing of your DMT dose. Work with your MS healthcare provider to determine the best schedule for you. We are in the process of developing considerations for providers to use when making these decisions with you.

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

The authorization of safe and effective vaccines for COVID-19 bring us one step closer to eliminating this pandemic. In addition to getting vaccinated, the science is settled that wearing a face mask, social distancing and washing your hands are the best ways to slow the spread of the virus and should be continued even if you get a COVID-19 vaccine.

Learn more about the safe and effective COVID-19 vaccines from the Government of Canada and the Centers for Disease Control and Prevention

*not yet licensed or available in Canada

The following individuals were consulted in the development of this guidance:

MS neurologists and experts

Nancy Sicotte, MD, FAAN—Chair, National MS Society’s National Medical Advisory Committee, Cedars-Sinai Medical Center, USA
Brenda Banwell, MD—Chair of MS International Federation International Medical and Scientific Advisory Board (IMSB) – University of Pennsylvania, USA
Amit Bar-Or, MD, FRCPC—University of Pennsylvania, USA
Jorge Correale, MD—Raul Carrea Institute for Neurological Research, FLENI, Buenos Aires, Argentina
Anne Cross, MD—Washington University and Secretary of Board of Governors of the Consortium of MS Centers, USA
Jaime Imitola, MD, FAAN—University of Connecticut, UConn Health, USA
Dorlan Kimbrough, MD—Duke University, USA
Avindra Nath, MD—National Institutes of Health/National Institutes of Neurological Disorders and Stroke, USA
Scott Newsome, DO, MSCS, FAAN, FANA—Johns Hopkins University and President of the Board of Governors of the Consortium of MS Centers, USA
Penny Smyth, MD, FRCPC—University of Alberta, Canada
Rachael Stacom, MS, ANP-BC, MSCN—Independence Care System, USA

MS Partner Organizations

Julie Fiol, RN, MSCN—National MS Society, USA
Pamela Kanellis, PhD—MS Society of Canada
Julie Kelndorfer—MS Society of Canada
Hope Nearhood, MPH, PMP—National MS Society, USA
Leslie Ritter—National MS Society, USA

The Canadian Network of MS Clinics Vaccine Working Group

Jodie Burton, University of Calgary MD, MSc, FRCPC
Virginia Devonshire MD, FRCPC, University of British Columbia, President Canadian Network MS Clinics
Mark Freedman HBSc, MSc, MD, CSPQ FANA FAAN FRCPC, University of Ottawa
Francois Grand’Maison, MD, FRCPC, Université de Sherbrooke
Penny Smyth MD, FRCPC, University of Alberta

MS Society of Canada Medical Advisory Committee

For more information on approved COVID-19 mRNA vaccines:

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