So, six weeks ago we said this:
However, in the COVID19 era, the life cycle of evidence emerging, and us reflecting on it, has shrunk. Hence, another update on our vaccine advice was overdue:COVID-vaccines-DMT_BartsMS-guidance_March-update_final
There are two changes to the previous version:
Firstly, we’ve adapted our advice about vaccination in the context of cladribine by removing the “3 month-rule”, i.e. the advice that after a treatment cycle, one should wait for at least 3 months before undergoing vaccination. This was based on the theoretical concept that B & T cell depletion induced by the treatment would alter people’s immune responses such that they become unable to mount an effective response if given the vaccine earlier. However, no convincing evidence supporting this claim has emerged, and what’s more data from an, admittedly limited, sample of n=15 pwMS treated with cladribine and receiving vaccinations against Influenza and Herpes zoster at various time points prior to and after treatment did not reveal any relationship between the time point of vaccination, the degree of lymphocyte depletion, and effective antibody titres. @profb reported on the results of the study a little while back:
Secondly, to reduce any aches and pains associated with the vaccination, we added some simple advice regarding paracetamol (generally, 1g for adults) to be taken after the vaccination, and regularly (up to four times/day) for 48 hours, unless you are unable to take paracetamol for other health related reasons. Ibuprofen 400mg at the same dosing intervals as above would be an alternative.
Do I think this was our last word on #SARS-CoV2 #vaccination? – Highly unlikely, and I’m very pleased to report BartsMS have made significant headway with their vaccination programme. Over 570 pwMS have now been contacted, and 450 have had at least their first dose. If you are one of them, please remember to fill in your questionnaire so we can learn and share (anonymously, of course) your experience of the SARS-CoV2 vaccination; this could prove really valuable for our colleagues and your fellow MSers in the rest of the World, where vaccine experience & confidence are lower, particularly with the AstraZeneca vaccine, which is what most pwMS in our service receive. If you have lost your questionnaire, you can download it here; just send it back to the email provided:COVID19-patient-questionnaire
We also remain keen on your blood… So, if you are as eager as we are to find out what the impact of DMTs on SARS-CoV2 vaccine antibody responses is, ping us an email on firstname.lastname@example.org and the team will send you some collection cards & return envelope. Whenever and wherever you had your vaccine (with your GP, at a vaccination centre, or through BartsMS), you can participate as long as you have a patient record at Barts Health NHS Trust.