COVID-19 Vaccine Update – June 22, 2021

Our medical team at the Rocky Mountain MS Center at University of Colorado is recommending that all individuals receive the COVID-19 vaccine, unless there is a specific reason to not get vaccinated, such as a known allergy to a component of the vaccine.

All U.S. adults over the age of 12 are now eligible for COVID-19 vaccination. Individuals who are 12 and older are eligible to receive the Pfizer BioNTech vaccine, and individuals 18 and older are eligible to receive the Moderna and Johnson & Johnson vaccines.

The latest data as of June 22 says that about 319 million vaccine doses had been given in the United States with an estimated 150 million individuals fully vaccinated. That means that more than half of adults in the U.S. have received at least one vaccine dose and about 45% of adults are fully vaccinated. In Colorado, more than 6 million doses have been given and about 2.9 million people are fully vaccinated — just about half of the eligible population of people 12 years of age and older. Source: Our World in Data.

Vaccines and Disease Modifying Therapies (DMTs)

We recommend that everyone who can get the COVID vaccine, including people with MS, should get the vaccine.  Continue your disease modifying therapy (DMT) unless you are advised by your MS healthcare provider to stop or delay it.

It is most important to note that getting the vaccine when it is available to you is more important than timing the vaccine perfectly with your DMT. Please work with your MS healthcare provider to determine the best schedule for you.

Although B-cell therapies do reduce the efficacy of vaccines, patients on B-cell therapies have still mounted some antibody response in studies with the flu and pneumococcal vaccines. Preliminary data show that this is also true for the COVID vaccine. Further studies will be done to see if additional vaccine boosters or other strategies will be needed for patients on B-cell therapies.

For people with MS, especially those in high-risk groups and those taking a DMT that might reduce the effectiveness of the vaccines, the safest approach is to continue wearing masks, practicing social distancing, and performing regular handwashing after receiving the COVID vaccine.

We do not have any real world data that adjusting the timing of the vaccination relative to the timing of your MS medications will have any positive benefit in terms of improving your response to the vaccine. And, the risk of contracting COVID-19 is still very high for unvaccinated individuals. Therefore, early vaccination will provide more benefit to you than trying to time the vaccine to possibly gain somewhat higher immune responses to the vaccine.

For more details about timing your vaccine with your DMT, please see the National MS Society’s suggestions here. Keep in mind that these recommendations from the NMSS are based on expert opinion as there is no real world data available regarding effectiveness relative to adjusting the timing of your MS medications.  If you take Ocrevus or Rituxan, IF possible, try to wait at least 4 weeks until after last vaccine injection to get your next infusion.

DMT Impacts on COVID Vaccines: Study Underway

The MS Center’s Dr. Amanda Piquet recently joined researchers at New York University in an effort to investigate the efficacy of immune response to COVID vaccines in MS patients on ocrelizumab (Ocrevus). This study will look at how a patient’s immune system responds to the vaccine after being treated with ocrelizumab, one of several MS DMTs that depletes the immune system’s B-cells.

A previous study measuring ocrelizumab patients’ response to several other vaccines — including tetanus, pneumococcal and flu vaccines — showed that patients mount a decreased immune response, and preliminary data shows that to be the case with COVID vaccines as well. But those results may not show the whole story.

“It’s important to note that this study was following only Immunoglobulin G (IgG) antibody levels to measure immune response,” says Piquet. “We know that there are other important immune response factors beyond IgG antibody levels, including your neutralizing antibodies and your T-cell response. Therefore, an essential part of this new study is that we will examine the vaccine response by following all of these factors: IgG antibody levels, T cell response, and neutralizing antibodies. Theoretically, T cell responses should not be significantly affected in patients treated with ocrelizumab, thus protective immunity via the cellular immune response may still exist.”

Recent data presented from New York University in COVID-19 infected, unvaccinated patients with MS demonstrated T-cell immune memory to SARS-CoV-2 up to 10 months following infection even in B-cell depleted patients with MS. These findings suggest that ocrelizumab-treated patients are able to fight off COVID-19 infection despite depressed antibody levels.

Without all the data in, vaccines are still recommended for those on B-cell therapies, because even a reduced immune response is still providing them some level of protection against COVID.

At this point, there’s no suggestion that vaccines can affect the efficacy of the DMTs themselves.

Receiving Your Vaccine – Eligibility Information and How to Get Your Vaccine Appointment

All Coloradans 12 and older are now eligible to receive the COVID-19 vaccine. Individuals who are 12 and older are eligible to receive the Pfizer vaccine and individuals 18 and older are eligible to receive the Moderna and Johnson & Johnson vaccines.

If you live in Colorado, here are some helpful resources to help navigate signing up for a vaccine appointment. Finding an appointment isn’t always easy, so be persistent and try all options to secure your vaccine appointment.

Additional Vaccine Information Resources