UPDATED APRIL 11, 2022 -- Vaccines and Booster Guidance for MS Patients on Disease Modifying Therapies

If you haven’t already received your initial COVID-19 vaccination, please get vaccinated as soon as possible. We continue to strongly recommend all individuals receive the COVID-19 vaccination unless you have a known allergy to a component of the vaccine. This information was updated on April 11, 2022.

To see this information in an easy to read, downloadable PDF format, please click here.

For individuals on anti-CD20 disease modifying therapy (Ocrevus, Rituxan, or Kesimpta) or S1P disease modifying therapies, (Gilenya and its generics, Mayzent, Zeposia, or Ponvory), Lemtrada, Mavenclad, or any chemotherapy drugs, below is our guidance:

COVID Vaccine: Frequently Asked Questions

We suggest you read our updated list of frequently asked questions with answers provided by the medical team at the Rocky Mountain MS Center at University of Colorado.
Read our FAQ

 

Recommendation
& Eligibility:
If you received Pfizer/Biontech If you received Moderna If you received Johnson & Johnson
Initial Doses
- Age 5+
- 2 doses, 3 weeks apart
- Age 18+
- 2 doses, 4 weeks apart
- 1 dose
Additional Dose
- Age 5+
- 1 dose, 3 weeks after second shot
- If on Ocrevus or Rituxan, one month prior to your next infusion OR at least one month after your last infusion, preferably and if possible, 5 months.
- If on Kesimpta, 4 weeks after your last dose of Kesimpta. When possible, resume Kesimpta injections 4 weeks after getting vaccine. If you wait 4 weeks after the last dose of Kesimpta, and then get the vaccine dose, then wait 4 more weeks, that potentially means missing a single dose of Kesimpta. Discuss with your doctor.
- Age 18+
- 1 full dose, 4 weeks after second shot
- If on Ocrevus or Rituxan, one month prior to your next infusion OR at least one month after your last infusion, preferably and if possible, 5 months.
- If on Kesimpta, 4 weeks after your last dose of Kesimpta. When possible, resume Kesimpta injections 4 weeks after getting vaccine. If you wait 4 weeks after the last dose of Kesimpta, and then get the vaccine dose, then wait 4 more weeks, that potentially means missing a single dose of Kesimpta. Discuss with your doctor.
- 1 additional vaccine dose of an mRNA vaccines (Pfizer or Moderna)
- This additional dose should be administered 4 weeks after the J&J vaccine
Booster
- Age 12+
- 1 dose, 3 months after 2nd or additional 3rd shot
- If on Ocrevus or Rituxan, one month prior to your next infusion OR at least one month after your last infusion, preferably and if possible, 5 months.
- If on Kesimpta, 4 weeks after your last dose of Kesimpta. When possible, resume Kesimpta injections 4 weeks after getting vaccine.  If you wait 4 weeks after the last dose of Kesimpta, and then get the vaccine dose, then wait 4 more weeks, that potentially means missing a single dose of Kesimpta. Discuss with your doctor.
- Age 18+
- 1 half dose, 3 months after 2nd or additional 3rd shot
- If on Ocrevus or Rituxan, one month prior to your next infusion OR at least one month after your last infusion, preferably and if possible, 5 months.
- If on Kesimpta, 4 weeks after your last dose of Kesimpta. When possible, resume Kesimpta injections 4 weeks after getting vaccine.  If you wait 4 weeks after the last dose of Kesimpta, and then get the vaccine dose, then wait 4 more weeks, that potentially means missing a single dose of Kesimpta. Discuss with your doctor.
- Age 18+ should get an mRNA booster ( Pfizer or Moderna), 2 months after the second dose (of Pfizer or Moderna, as noted above)
Second Booster
- Age 12+ 
- 1 dose 4 months after receiving first booster dose.
- If on Ocrevus or Rituxan, one month prior to your next infusion OR at least one month after your last infusion, preferably and if possible, 5 months.
- If on Kesimpta, 4 weeks after your last dose of Kesimpta. When possible, resume Kesimpta injections 4 weeks after getting vaccine.  If you wait 4 weeks after the last dose of Kesimpta, and then get the vaccine dose, then wait 4 more weeks, that potentially means missing a single dose of Kesimpta. Discuss with your doctor.
- Age 18+ 
- 1 half dose least 4 months after receiving first booster.
- If on Ocrevus or Rituxan, one month prior to your next infusion OR at least one month after your last infusion, preferably and if possible, 5 months.
- If on Kesimpta, 4 weeks after your last dose of Kesimpta. When possible, resume Kesimpta injections 4 weeks after getting vaccine.  If you wait 4 weeks after the last dose of Kesimpta, and then get the vaccine dose, then wait 4 more weeks, that potentially means missing a single dose of Kesimpta. Discuss with your doctor.
- No additional booster recommended at this time.
TOTAL NUMBER OF DOSES
- If you are age 5-11: 3 doses total
- If you are age 12+: 5 doses total
- If you are age 18+: 5 doses total (3 doses and 2 half doses)
- If you are age 18+: 3 doses total

 

For individuals taking any other DMT, including fumarate therapies (Tecfidera and its generics, Bafiertam, and Vumerity); Aubagio; Tysabri; Copaxone and its generics; or interferons (Avonex, Rebif, Betaseron, and Plegridy), OR if you are NOT taking a disease modifying therapy, below is our guidance:

Recommendation
& Eligiblility:
In you received Pfizer/Biontech If you received Moderna If you received Johnson & Johnson
Initial Vaccine Doses
- Age 5+
- 2 doses, 3 weeks apart
- Age 18+
- 2 doses, 4 weeks apart
- Age 18+
- 1 dose
Additional Dose
None
None
None
Booster
- Age 12+
- 1 dose, 5 months after 2nd shot
- Age 18+
- 1 half dose, 5 months after 2nd shot
- Age 18+ should get Pfizer or Moderna booster
- 1 dose, 2 months after 1st shot
Second Booster
- Age 50+: 1 dose at least 4 months after receiving first booster
- Age 50+: 1 half dose, 5 months after 2nd shot or additional 3rd dose
- No additional booster recommended at this time
TOTAL NUMBER OF DOSES
- Age 5-11: 2 doses total
- Age 12-49: 3 doses total
- Age 50+: 4 doses total
- Age 18+: 3 doses total (2 full doses and 1 half dose)
- Age 50+: 4 doses total (2 full doses and 2 half doses)
- Age 18+: 2 doses total

 

What is the difference between an additional third dose and a booster?

An additional dose is intended to improve the response to the first and second dose of the vaccine in immunocompromised people. A booster is given when the immune response to the first, second dose, and any additional dose is likely to have decreased over time. People who are immunocompromised who received the Pfizer or Moderna vaccine may receive a total of five COVID-19 vaccine doses (the first two doses, an additional dose, and two boosters). The additional third dose of the Moderna vaccine is a full dose, the boosters of the Moderna vaccine are half dose. Pfizer doses are all the same strength.

Please Note:

It is most important to get fully vaccinated as soon as possible. All three vaccines approved for use in the United States are safe and effective. If you have the choice, we encourage individuals to get either the Pfizer/Biontech or the Moderna vaccines. Data shows the mRNA vaccines are more effective than the Johnson & Johnson vaccine. Additionally, the Pfizer/Biontech and Moderna vaccines do not have the same risk of blood clots as the Johnson & Johnson vaccine.

It is okay to mix and match the vaccines for additional dose and booster.

While we are recommending people space out their infusion and vaccine, there is not a safety concern about getting them closer together. Recommendations are based on increasing the efficacy and tolerating the vaccinations better.

These recommendations assume that you did not have a severe reaction to your first doses of the vaccine, and that you don’t have another medical reason for not taking a third dose (for example, a known allergy to components of the vaccine).

As always, talk to your own provider before making any decisions that you have questions about.

>> We recognize that this is a substantial number of vaccine doses. If you have had a significant reaction to prior doses of the vaccine, please discuss getting an additional booster with your doctor.  And, as always, talk to your own provider before making any decisions that you have questions about.

>> We suggest you also read our new list of frequently asked questions with answers provided by the medical team at the Rocky Mountain MS Center at University of Colorado.

 

If on Kesimpta, 4 weeks after your last dose of Kesimpta. When possible, resume Kesimpta injections 4 weeks after getting vaccine. If you wait 4 weeks after the last dose of Kesimpta, and then get the vaccine dose, then wait 4 more weeks, that potentially means missing a single dose of Kesimpta. Discuss with your doctor.