What to Know About Your MS Treatment and Getting the COVID-19 Vaccine

Joy P. Marko, MS, APN-C, CCMEP Disclosures Published on Jul 6, 2021

This article is for anyone who is living with multiple sclerosis (MS) and wants to learn more about the COVID-19 vaccine. The goal of this patient education activity is to help people living with MS and their care partners engage in shared decision-making with their doctor about MS treatment and getting the COVID-19 vaccine.

You will learn about:

How COVID-19 can affect your body
Getting the COVID-19 vaccine for people living with MS
MS treatments and when to get your vaccine
Possible side effects of COVID-19 vaccines
Questions to ask your doctor

Medicines listed in this activity have either a US Food and Drug Administration (FDA) approval or have been given an Emergency Use Authorization (EUA) by the FDA to treat or prevent COVID-19.

The information on COVID-19 is continually changing. The content in this activity is accurate based on the information that was available at the time of its publication. This resource is provided for educational and informational purposes only. We do not provide medical advice, diagnosis, or treatment.

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How COVID-19 Affects Your Body

Most people who get COVID-19 will have mild or no symptoms. But for others, COVID-19 can be severe and even deadly.

COVID-19 is especially dangerous for the elderly. Being pregnant, smoking, using corticosteroids (steroids) or other immunosuppressive medicines, or having certain medical conditions such as diabetes or obesity could also put adults of any age at a higher risk for severe illness.

COVID-19 can damage many different organs and systems in your body. This can lead to complications (additional problems) that can be serious and long-lasting.

COVID-19 Vaccines

The COVID-19 vaccines currently used in the United States have an Emergency Use Authorization (EUA) from the FDA because their known and potential benefits outweigh the known and potential risks. The vaccines are safe and effective and reduce your risk of severe illness from COVID-19. You can't get COVID-19 from the vaccine because it doesn't contain the live virus.

Depending on which vaccine you get, it can be used in people 12 or 18 and older and is given as 1 shot, or 2 shots a few weeks apart. It usually takes a few weeks for your body to build up enough immunity (protection) after your final shot. When you get your vaccine, be sure to ask when you will be fully protected.

Getting the COVID-19 Vaccine if You're Living With MS

Living with MS does not make you more likely to get COVID-19. But because the risks of COVID-19 outweigh any potential risks of the vaccine, it's recommended that most people 12 and older who are living with relapsing and progressive types of MS should get the vaccine.

If you've had COVID-19, you should still get the vaccine. If you currently have COVID-19 symptoms or had treatment for COVID-19, ask your doctor when you should get your vaccine.

COVID-19 Vaccines and Your MS Treatment

The COVID-19 vaccines are considered safe to use with disease-modifying therapy (DMT) as treatment for MS.

Most DMTs are not expected to affect how well the COVID-19 vaccine works. And while it's thought that certain DMTs may make it less effective, getting the vaccine will still provide you some protection against COVID-19. It's important that you do not stop, delay, or change the way you take your DMT unless you talk to your doctor first.

When to Get Your Vaccine

For certain DMTs, your doctor may recommend scheduling your COVID-19 vaccine to coordinate with the timing of your DMT dose in order to get the most protection from the vaccine that you can.

But because COVID-19 can seriously affect your health, getting the vaccine as soon as possible may be more important than timing the vaccine with your DMT. Be sure to talk to your doctor about the best DMT dosing and COVID-19 vaccine schedule for you.

If You're About to Start a DMT

Your doctor may recommend you get your final COVID-19 vaccine shot at least 2 to 4 weeks before you start certain DMTs, such as:

Sphingosine 1 phosphate receptor modulators
Anti-CD20 monoclonal antibodies
Oral cladribine (Mavenclad®)

For alemtuzumab (Lemtrada®), your doctor may recommend your final vaccine shot be at least 4 weeks before you start.

If You're Already Taking a DMT

If MS is stable, your doctor may recommend you consider certain timing for your COVID-19 vaccine and/or your DMT dose, such as:

Alemtuzumab
• Getting the vaccine at least 24 weeks after your last dose

• Restarting at least 4 weeks after your final vaccine shot
Anti-CD20 monoclonal antibody infusions
• Getting the vaccine at least 12 weeks after your last dose

• Restarting at least 4 weeks after your final vaccine shot
High-dose steroids
• Getting the vaccine at least 3 to 5 days after your last dose
Oral cladribine and ofatumumab (Kesimpta®)
• Restarting 2 to 4 weeks after your final vaccine shot

These suggested changes may not always be possible. Talk to your doctor so you can find the best timing and schedule together.

Are the COVID-19 Vaccines Safe?

COVID-19 vaccines are not likely to affect how MS progresses or trigger a relapse.

But all vaccines can have side effects. Some that may happen with COVID-19 vaccines can include:

Pain, redness, or swelling where the shot was given
Muscle aches, headache
Tiredness
Fever
Nausea
Inflammation (swelling) of the heart muscle or lining outside the heart, depending on which vaccine you get

There is a very small chance that some people may develop:

A severe allergic reaction
Blood clots in vessels in the brain, abdomen (belly), and legs, depending on which vaccine you get

Not all side effects are listed here. Ask your doctor, pharmacist, or the person giving you your vaccine for a full list and when to seek medical attention because of side effects.