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Prof G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.

19 comments

  • In the ‘pre-covid’ literature on mRNA-vaccines, some concerns have been raised that mRNA-vaccines may result in autoimmune reactions, in particular in individuals at increased risk of autoimmune reactions (e.g. Pardi et al, mRNA vaccines – a new era in vaccinology; Liu, A Comparison of Plasmid DNA and mRNA as Vaccine Technologies).
    In the discussions of the Covid19-mRNA vaccines, that risk is not mentioned. Are there specific arguments (as opposed to just lack of data) as to why that would not be an issue with the covid19 mNRA vaccines?
    For pwms under treatment, it stands to reason to assume that that risk is covered sufficiently by their treatment. Quid for patients without treatment? This is not a question about whether or not to take the vaccine. It could, for instance, tip the balance for patients in favour of starting treatment again.

  • Good morning Prof G

    Thank you for this post and to all the team for keeping us up to date and well informed in relation to the vaccines for COVID.

    All the questions I had have been answered by the guidance given and a great reminder of all the issues with health in the past! I know you can’t give your recommendation as to which one would you prefer 🙂 I’m just relieved we can now go ahead with ‘a’ vaccine (I think the Government are not telling us which one for a reason :)) and at least give ourselves a bit of resistance to the virus. I would be extremely interested to know, how many pwMS caught the virus when on immune suppressed treatment and how they fared. My only pearl of wisdom as someone with the condition that worked in a large school/college and on Tecfidera for 18 months – was that I never caught any of the bugs on offer around my department or from the students therein! Could there be some superhuman pwMS folk, flying around that are COVID resilient!?! :~)

    Once again, many thanks and I hope they contact everyone with a neurological condition very soon.

    All the best and I hope you are recovering well too!

    Jane

  • no word about medication. I wonder how long one have to wait for next infusion of Tysabri or Ocrevus after vaccination?

  • I wonder is this guidance will change given the recent deaths in Denmark associated with the Pfizer vaccine. 13 associated with the vaccine. All elderly with underlying health complications. Let’s see what the EMA make of it.

    • I think it is Norway and the deaths have been in eldery . apparent 400 people a week die i their carehomes

      • Norway, I stand corrected. Perhaps this will change each country’s vaccination strategy. Start by immunising 18-35 year olds. They are the ones who have the potential to become super spreaders (like Indonesia is doing). Norway elected to immunise elderly and vulnerable first. Perhaps this needs to be re-considered. Don’t get me wrong, I’m a strong advocate for vaccines for all. But perhaps immunising elderly patients first who have multiple underlying health conditions isn’t the best approach. It will be interesting to watch how different countries roll out their programs. I’ll be getting my jab the moment it becomes available in Australia (big debate here over the AZ vaccine efficacy vs Pfizer and Moderna and which should be implemented). Any vaccine is better than nothing.

        Stay safe everyone.

  • What about the incidents of transverse myelitis after the Astra-Zeneca-Oxford vaccine?
    For someone on anti-CD20 treatment, is that reason enough to avoid that vaccine and take another one (if possible)?

    Asking because most of us in India will probably be offered the Oxford vaccine (made in India)

    • One case of TM in vaccine group (the other was MS before vaccine) one was in the placebo arm.

      (A) The cases are fluke and nothing to worry about
      or (B) There is a very small risk of TM with adenoviral vectors, but this is unproven
      or (C) You select RNA vaccine over adenovirus but there is a very small risk of something else from RNA vaccine (Anti-vaxers suggesting it causes autoimmunity
      eg anti-nucleic antibody response like lupus…agin unproven
      or (D) You do nothing and have risk of hospitalisation and maybe death from COVID
      or (E) You do nothing catch the virus, pass it on to your neighbour’s gran who dies
      or (F) You live in a place where RNA vaccines are not available and you go for Covaxin inactivated virus vaccine which has some unknown effect
      or (E) Adenoviral vectors work really well in immunosuppressed people because they dont clear the adenovirus as fast as other people so it provides a strong amount of antigen making a very strong anti-COVID-19 response, which protects you fantastically well.

      At the present we dont have the data…the UK, india, UK, India, Argentina, Dominican Republic, El Salvador, Mexico, Morocco are the current testing ground to see how safe the AZ vaccine is. In the UK the hospital based vaccines are the RNA based and the nightingales and hubs will be Astrazeneca.
      these choices
      (E) A very small risk of death from RNA vacine…if you are in a care house and over 90 or this is a fluke and
      care homes are the risk factor as 400 people a week die in them in Norway.

      (C)

      • Australia has placed its money behind the AZ vaccine and this is the one most here will end up receiving. There are some concerns around efficacy compared to the other vaccines and whether heard immunity can be achieved with 60% efficacy. Like most main stream news outlets, they only give you a piece of the argument. The NSW government is now saying no vaccination = no entry into restaurants, pubs etc (presumably you’ll need to carry an immunisation card). Let’s see how that goes and survives high court challenges.

        • Don’t see why it would be a problem since you can be refused entry to a pub in Australia for wearing thongs (flip flops for those from the UK 😄) don’t seem why you can’t be refused entry for not having the vaccine.

          • Because there isn’t to my knowledge a big anti-footwear movement in Australia. Sadly, there is a big anti-vax movement. If vaccination is required to enter populated areas, it will be challenged by civil libertarians, just like the move to exclude children from daycare that have not revived their MMR etc. vaccinations. Again, this is not an argument against getting vaccinated. I’m simply predicting the outcome of excluding those that refuse from pubs, clubs, restaurants etc.

          • This is actually a response to Mighty Mouse below, but for some reason I’m not getting a reply link at the end of his post.

            In Australia the “no jab, no play” stopping unvaccinated children from attending daycare has held in most states. That being said, despite being very pro-vax I’m not sure I agree with it since it penalises children for something they have no control over. But quite happy to restrict the voluntary social activities of adults who have the choice 😁.

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