Multiple Sclerosis Centers of Excellence
Coronavirus (COVID-19) and Vaccine Information
February 2022: Evusheld for Pre-Exposure Prevention of COVID-19
Evusheld has received emergency use authorization from the US Food and Drug Administration (FDA) for use in vaccinated people who are not expected to mount an adequate response to COVID-19 vaccination. This medication may be useful to people with MS taking B cell depleting therapies (ocrelizumab, rituximab, ofatumumab, and their biosimilars), S1P modulators (fingolimod, siponimod, ponesimod, ozanimod, and their generics), and alemtuzumab. Evusheld consists of intramuscular injections of tixagevimab and cilgavimab administered at the same time. The purpose of Evusheld is to provide prevent COVID-19 infection. The protection is expected to last about 6 months. Evusheld does not treat active COVID-19 infection. Importantly, Evusheld is not a substitute for the COVID-19 vaccination series. Evusheld is in limited supply and is available on a per facility basis. Read more about Evusheld at the National MS Society (NMSS) and the Centers for Disease Control and Prevention (CDC).
February 2022: Updated CDC Guidance on Timing of Booster Shots for Immunocompromised People
The CDC updated guidance on the timing of booster shots in the 4 shot series for immunocompromised people receiving mRNA COVID-19 vaccines (Pfizer and Moderna) by shortening the interval between the 3rd and 4th shot from 5 months down to 3 months. This guidance applies to people with MS taking B cell depleting therapies (ocrelizumab, rituximab, ofatumumab, and their biosimilars), S1P modulators (fingolimod, siponimod, ponesimod, ozanimod, and their generics), and alemtuzumab. There are no changes to the timing of the 3 shot series for people taking the Johnson & Johnson vaccines. Table 3 on the CDC website outlines the current eligibility and timing for vaccines for immunocompromised people. People with MS who are not taking the therapies listed above and do not have other conditions causing immunodeficiency (such as being a transplant recipient) follow the schedule of COVID-19 vaccinations for the general population in Table 2.
December 2021: Updates on the COVID-19 Booster
The MS Centers of Excellence (MSCoE) recommend booster shots for all people with MS, their family members over 18 years of age, and caregivers per CDC and NMSS. Logistics for Veterans obtaining these doses occurs at the local facility level. Community resources for access to COVID-19 vaccination can be found through State Health Department websites.
August 2021: Updates on 3rd COVID-19 Shots for Immunocompromised Populations and the COVID-19 Booster
Supplementing the information from the CDC and NMSS, below are clarifications and recommendations from MSCoE:
- A 3rd vaccination is different from a “booster”. A 3rd vaccination is advised for people who may not have mounted a full immune response to the initial COVID-19 vaccination due to an immunocompromised state.
--People with MS taking B cell depleting therapies (ocrelizumab, rituximab, ofatumumab), S1P modulators (fingolimod, siponimod, ponesimod, ozanimod), and alemtuzumab fall into this category of immunocompromised people. Note that vaccines work best in people on B cell depleting therapies if they are given at least 3 months after an infusion.
- Booster vaccines are given to people who have completed their initial COVID-19 vaccination to prevent their immune response from waning naturally over time. Boosters are commonly used to maintain the beneficial effects of some kinds of vaccines.
--People with MS who are not on the MS therapies listed above, or are not on any MS therapy fall into this category and should follow CDC recommendations for the general public.
- Currently 3rd vaccinations and boosters are recommended only for those who received the Pfizer or Moderna mRNA vaccination series. Follow the websites below for evolving recommendations for those having initially received the Johnson & Johnson COVID-19 vaccine.
- MSCoE strongly encourages all eligible people to get vaccinated for COVID-19 for their own health and their communities’ safety.
- MSCoE strongly recommends continued masking, handwashing, and social distancing for all people regardless of vaccination status until the COVID19 pandemic is over.
The NMSS expert guidance on COVID-19 3rd vaccines and boosters for people with MS: National MS Society: Additional COVID-19 Vaccine Dose (Booster) and MS
The CDC statement on COVID-19 vaccines for immunocompromised people: COVID-19 Vaccines for Moderately to Severely Immunocompromised People
The CDC statement on mRNA Covid-19 vaccine boosters: Joint Statement from Health and Human Services Public Health and Medical Experts on COVID-19 Booster Shots
In June, the NMSS issued further guidance on the use of MS disease modifying therapies and the timing of the COVID-19 vaccines. The NMSS Medical Advisory Panel noted that some disease modifying therapies may be linked to a more severe form of COVID-19 and the use of corticosteroids for relapses should be carefully considered during the pandemic. All people with MS are encouraged to receive one of the US FDA-approved COVID-19 vaccines. A recent article from two MSCoE leaders reviewed the current COVID-19 vaccines and their safety profiles. Please bring up questions you have about the COVID-19 vaccine or MS therapies during the pandemic with your MS health care provider.
VA is working closely with the CDC and other federal partners to provide COVID-19 vaccines to Veterans and VA health care personnel. We know you have a lot of questions, and information is changing quickly. VA will continue to update the webpage COVID-19 vaccines at VA as we have new information to offer. Please check back often for updates.
The NMSS recently released guidance regarding timing MS medications with COVID-19 mRNA vaccines. The guidance was developed by a team of researchers and medical professionals with expertise in MS, immunology, neurovirology, vaccines, B-cell depleting therapies, and special populations in MS (progressive, late onset, pediatric and people of color). The team was led by Dr. Nancy Sicotte, chair of the NMSS’s National Medical Advisory Committee. This information is in addition to their webpage on COVID-19 vaccine guidance for people living with MS.
The NMSS has officially announced COVID-19 vaccine guidance for people living with MS. Highlights are below.
- People with MS should be vaccinated against COVID-19.
- The COVID-19 vaccines are safe for people with MS.
- The vaccines are safe to use with MS medications.
- All of us have a personal responsibility to slow the spread of the pandemic and eliminate the virus as quickly as possible.
- Best Practices: COVID-19 Vaccine in Veterans with MS: Protect the Vulnerable
- Centers for Disease Control: COVID-19
- National MS Society: COVID-19 Vaccine Guidance for People Living with MS
- VA: COVID-19 Vaccines at VA
- VA Public Health: Novel Coronavirus Disease (COVID-19)
- Wheelchair and Assistive Technology Users: Precautions for COVID-19
- World Health Organization
Disclaimer: Links are provided as a convenience and for informational purposes only. They do not constitute an endorsement or an approval by MSCoE of any of the products, services, or opinions of the organization. MSCoE bears no responsibility for the accuracy, legality, or content of the external site or for that of subsequent links. Contact the external site for answers to questions regarding its content.