COVID-19 What does the MS Society say

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https://www.mssociety.org.uk/what-we-do/news/ms-society-medical-advisers-release-consensus-statement-covid-19-vaccines

The main message is that the COVID-19 vaccine should not cause harm in people with MS, but there may be a reduced efficacy, meaning social distancing and other measures should continue.

Until the Oxford-Astra vaccine is licensed it is unclear whether it will be classed as a live vaccine due to the adenovirus vector (which if caused a viral infection would be similar to the common cold, not COVID-19)

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  • Moring MD – I’m due to have a full infusion of Ocrelizumab tomorrow and all set to go. I’m going to try and gather some info from the nurse to see if they’ve given any instructions as to, if what and when. I’m not holding out much hope (a bit negative I know) as my questions will be directed to my Neuro, who I’m not sure will be in the hospital tomorrow as his clinic is usually on a Thursday! I could try and ask them to email him (why this isn’t an option for me to do – as I’m no stalker, I don’t know and my last job, used to have 24 hr email contact, I just didn’t answer until office hours :))

    My ideal would be… a leaflet produce by your Neuro (ish) could be their whizzy-wig depart, to list all the meds and best options for pwMS to have the vaccine. How they would roll it out to their patients and a rough idea – if the ‘live’ vaccine isn’t an option – which one! Then you are monitored – MS Nurse calls/emails/Zoom/Teams/F/time or arranges an old fashioned appointment face to face and asks how you are doing and have you had an side effects and is your MS okay!

    It’s only an ideal… so “Don’t Panic Mr. Mainwaring”

    I hope you are well and stay safe too!

    Thanks Jane

    • The problem is the lack of information and lack of option, until others are approved there is only one option in the UK and that is the Pfizer BNTech variant..in the pipeline we Moderna vaccine, the UK didnt purchase much of this. It works in the same way but is logistacally easier to use.

      However there is a limited supply of the drug

      The Oxford/Astrazeneca vaccine has completed part of phase III programme, but can enough sense from the “slive and Dice ” trials be found. China has approved two variants, one being approved in the Middle East

  • Is the AstraZeneca vaccine not using a chimpanzee adenovirus vector that has been modified in such a way that it can not replicate? I thought it was only used as an envelope to harbor DNA that encodes for the spike-protein of sars-cov2?
    To my understanding it could therefore not replicate and thus should not be classified as a ‘live vaccine’.

    Did I misunderstand?

    • That is entirely correct. I have a feeling that the main problem with the AZ vaccine is that a strong immune response is also generated against the adenoviral vector limiting its use long-term. I suspect that is why I saw reported a proposed trial with the Russian Sputnik vacccine, where you get one dose AZ followed by one dose Sputnik, which is a different adenoviral vector to presumably try to limit this.

      • MD2, is this why the AZ vaccine has efficacy “only” in the 70s? Part of the immune response is being divided from the Covid protein spike to the adenoviral vector? Also couldn’t you have some prior immunity to the adenovirus and would that interfere with obtaining the desired immune response?

        • Hi Devin
          It may account for the fact that 2 full doses of the AZ vaccine only confers 62% immunity. The 70% figure is a conflation of the 90% in the mis-dosed subgroup and the 62% figure in the larger full dose cohort.I suspect that cross-reactive immune responses to other adenoviruses in some individuals is a distinct possibility, again potentially blunting the vaccine’s efficacy. It’s interesting that despite the technology being untried, the mRMNA vaccines so far seem to be the class leaders. I think I saw that the more conventional protein-based vaccine from GSK was pulled due to lack of efficacy, though I might have dreamt that in these fevered times!

        • Prior immunity to adenovirus can be a problem and that is a reason why chimpanzee adenovirus is used. I agree adenovirus is immunogenic a hell

    • Yes it will not replicate. But it is a live virus but can only infect once, So the UK Green book takes your view of it not being live, however other people talk about it as if it is a live virus

  • Is it not too soon to make such general assessments? Especially since auto-immune or inflammatory responses to RNA-vaccines are still mostly unknown?

    • Well unless you look you’ll never know and apart from some allergic responses, which I suspect is due to other components of the vaccine these problems have not been reported.

    • You are perhaps correct but in the circumstances this is a considered view, but if no none is willing to take a vaccine then in it has no merit.

      • Hopefully more trials in subgroups to come. I recently saw A scientist on U.S. news show and he said trials are starting for RNA Covid vaccine in pregnant woman. And when I applied to be a volunteer for moderna trials, the form specifically asked if I had MS and if immune compromised. 🤞Hope this means a trial with MSers is planned.

  • I am using Ocrelizumab. My neurologist advised me to get a vaccine in the middle of an Ocrelizumab series, so not almost at the end of the 6 months and not just after another cycle.

    What do you think about this?

    • Sounds reasonable, but in the NHS I am not sure how flexible the system will be in terms of choosing your vaccine time and date. We have to hear about how this will work.

    • My neurologist’s view is 6 weeks before or after ocrelizumab. I’m scheduled my next infusion in early Jan. If I get the vaccination this month (unlikely tho I am NHS staff) I’ll push the infusion back. If I don’t get it before 5th, I’ll have my treatment as planned and then delay being vaccinated for at least 6 weeks although I’m inclined to leave it a bit longer.

  • What are your thoughts of how safe the vaccines are for people who have been treated with Lemtrada? I don’t understand the science but I know Lemtrada reduces T cells to prevent relapses. I am concerned that if the vaccines increase T cell activity could that increase chances of relapses?

  • I have a similar concern with DMF, which causes dramatic decrease of CD8 T cells. Especially when a patient comes off of DMF (without switching to another DMT). Is there not an increased risk of relapse by the vaccine in those particular circumstances?

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