#MSCOVID19 Viral Vaccines


We have heard about the RNA vaccines and today MEDCRAM (118) will tell you about the Oxford/Astrazeneca Vaccine. This is the vaccine that the UK has purchased the most of. I think it is unlikely that it will be offered to people on immunosuppressive DMT, although it is replication deficient and so should not be able to cause an infection.

This week we had a nice email from Dr Seheult

“Dear Sirs.
It was great interest that I read your recent article entitled COVID-19 vaccine-readiness for anti-CD20-depleting therapy in autoimmune diseases (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7405500/

On behalf of Kyle Allred and the rest of the MedCram team, I wanted to thank you for acknowledging our work in your publication.  We are honored and humbled that we could provide invaluable insights regarding pulmonary medicine and during the COVID-19 pandemic.
We also salute your invaluable work in the important area of vaccine response in those patients on medication such as rituximab, oblinutuzumab and ofatumumab.  
Roger Seheult, M.D.”

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  • But can people with MS who are not currently on on disease-modifying therapies but who have had alemtuzumab 5 years ago receive the Oxford vaccine?

      • MD will you kindly consider providing a post on the vaccines and the various DMTs as to where you anticipate they’ll stand regards who gets what.

        Having had Alemtuzumab in 2016/17 and still with low level lymphocytes I’d presumed I won’t be eligible for the Oxford vaccine being as how it’s live.

        I’d understood receiving Alem meant no live vaccines and your posts to date had simply confirmed this.

        Or so I though until this reply to Anon.

        You’ve mentioned the neuros erring on the side of caution, but will the decision be more likely to lie with our GP?

        I was intending to raise the matter with mine – as in tell him about not being able to receive the Oxford ‘model’ – that I require the Pfizer or Moderna.

        Having your view on this, backed as it is with the benefit of your scientific expertise will be very helpful for all of us with MS so as to know how to engage with the relevant clinicians about the issue.

        • I think with alemtuzumab as it was three years ago it would generally be considered not to be a problem but it depends what you mean by low. NO live vaccines are the recommendation until you replete.

          I have no idea who will made the decision I would have thought the ABN will take a stance..whether it is based on known science is another issue:-)

          If terms of getting vaccines there is no Oxford vaccine until the regulators say its safe, this may happen but it dpends on where we are in the queue amybe if you are Health care worker you may get the option

          • Thanks MD.
            Not sure whether I’m correct in thinking to be replete I’d need a normal lymphocyte level ie: above 1.

          • I cant answer that as I dont know I think 0.8-1 would be such a level but we both know this number is a composite however there is a post on alemtuzumab and that may offer insight

          • Could prof g please define what definitive test and result would be needed post alemtuzumab to allow for safe vaccination thank you

          • ProfG is on leave.
            This cannot be properly answered because you have to define what is needed from the vaccination it could be T cells, but generally people only look and monitor antibody responses as it is easy.

  • Thanks. Like everyone, I am thrilled about the Covid-19 vaccine news – but I am confused to what this means for those of us on Ocrevus and Rituximab. Above you write it is “unlikely that it will be offered to people on immunosuppressive DMT”. Do you suspect we will be offered the Pfizer vaccine – or we will have to wait until just before our next six-monthly infusion before getting the vaccine – or should be put off our next dose?
    Rachel Horne

    • It needs to be tested.

      Unlikely….this is the live vaccine. However I stand to be corrected. I think studies need to be done.

      Offer Pfizer vaccine…possibly but only enough for 2.5 million people in fist batch so it depends on how they allocate it

      Get it one month after infusion one can expect the antibody levels to be low (but this is currently unknown)…based on other vaccines. However maybe T cells are unaffected and it is all that you need.
      Get infusion at 5 month, got to be higher chance of a response at least in some people, put off dose…but for how long without information, it is shooting in the dark and risk of MS worsening.

  • What are MS experts saying about the general risks of the AstraZeneca vaccine for pwMS? There were cases of transverse myelitis in the trials and one of those went on to be diagnosed with MS so there are big questions about whether the AZ vaccine can trigger MS activity.

    I am fearful of it for test reason. Plus with tecfidera lymphocyte counts drop so live vaccines are not recommended.

    • For most DMT live vaccines have not been studied with DMT and therefore it is recomended that you avoid or dont use them, certainly until lymphocytes recover.
      The adenoviral vaccines either need to shown to be safe in a proper study or I suspect they will not be offered

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