#MSCOVID19: Vaccine Q&A page is now live


Barts-MS rose-tinted-odometer: ★★★★★

Just to let you know that the I have answered all the reasonable questions that have come in via the COVID-19 decision aid. To keep it simple and to allow me to be more responsive I will simply update the online document every day or so. This is similar to what I did with the MS-Selfie Microsite I ran for at the beginning of the pandemic.

CoI: multiple

Twitter: @gavinGiovannoni                                              Medium: @gavin_24211

About the author

Prof G

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


  • I’m rapidly declining with secondary progressive ms with relapses. My neurologist wants to try me on Siponimod. This affects the immune system so I’m wondering when I should start it. I got 1st dose of Pfizer vaccine on the 12th.

    • Quickesst 12th + 3 weeks secod dose + 4 weeks according to lable but I am not a neurologists

      Label: Following which initiation of treatment should be postponed for 1 month to allow the full effect of vaccination
      Vaccinations may be less effective if administered during siponimod treatment.

  • I am confused about why you say Covid infection is unlikely to lead to relapse in one of your answers. I thought one third of relapses are precipitated by infection?

  • Sorry how do I access the online document to check for answers to questions? I can’t seem to work it out 🤦🏼‍♀️

  • Prof g if not yet vaccinated is it safe for someone with MS to stay with a relative who is fully vaccinated and if so what If any precautions should be taken? Data about whether or not those who have been vaccinated can spread it seems to be conflicting and confusing.

    • There is insufficient data and safest to assume that vaccinated can be infected and infect, however the vaccine should limit this. Obviously we success that people follow government guidelines

    • The government is saying that even if you are vaccinated you should still obey all their social distancing guidelines etc. However, this position will un untenable as the data comes in showing the vaccine reduces infections and shedding.

  • Something I wanted to point out is that no one is counting vaccinations given to clinically vulnerable people, only clinically extremely vulnerable:
    This concerns me – they are counting age group vaccinations and I’ve heard they have already moved on to over 55s in some areas. But how do they know it’s time to move on to over 55s (or over 60s even) if they don’t know how many clinically vulnerable people have been vaccinated? Maybe this creates more incentive to carry on with age group vaccinations as this produces a headline figure that can be reported.
    Clinically vulnerable are left right out of the statistics.

  • About fumarates, the chart says:
    “Provided there is no severe lymphopaenia it is likely to have no impact on vaccine responses.”

    Well, what if there IS severe lymphopaenia? The person has about 400 white blood count.

  • On Ocrevus and trying to balance delaying my next dose and getting a COVID-19 vaccine. I have the ability to be vaccinated 190 days after last Ocrevus infusion. Assuming I wait 2 to 4 weeks after a second vaccine dose for my next Ocrevus infusion, this will extend my Ocrevus doses to 225 to 240 days. The alternative is to delay the vaccine until after the Ocrevus dose, which would take place at 190 days. In an area of high community spread. Trying to understand risk of extending Ocrevus to 230 days. Advice?

    • My advice in this situation would be to get vaccinated and delay the next dose by 15 days. A 15-day delay is really not a problem with ocrelizumab.

  • Dear prof G, I understand you’re COVID-ed out, but I hope you find time to answer this question.
    I’m currently having a (pseudo-)relaps, for which I don’t plan to take steroids. My first covid-vaccination shot is next Friday. I’m worried this may cause my (pseudo-)relaps to worsen. Should I try to delay the shot (by making a new appointment)?

By Prof G



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