MS and the COVID-19 vaccines
Can I get a COVID-19 vaccine? Are the coronavirus vaccines made by Pfizer-BioNTech, Oxford-AstraZeneca or Moderna ‘live’ vaccines?
We’ve spoken to leading healthcare professionals to help answer your questions about COVID-19 vaccines and MS.
Your own MS team can give you more advice based on your circumstances, treatments, and whether getting a COVID-19 vaccine is right for you.
Our medical advisers have published a consensus statement about COVID-19 vaccines and disease modifying therapies (DMTs) - updated on 12 March.
Recent updates to this page:
- Wednesday 7 April with the updated information about possible AstraZeneca vaccine side effects
- Tuesday 6 April with new details about getting the vaccine in England if you're the main carer for someone
- Thursday 1 April with more details of the new vaccine priority group for families of people with MS
- When can I get a COVID-19 vaccine?
- Can I have a COVID-19 vaccine if I'm having an MS relapse or take steroids?
- Will a COVID-19 vaccine interfere with my other medications?
- Do I need to prepare anything before my COVID-19 vaccination?
- What about COVID-19 vaccine side effects?
- Are the Pfizer-BioNTech and Oxford-AstraZeneca coronavirus vaccines ‘live’ vaccines?
- Which COVID-19 vaccine is best for someone with MS?
- Will my partner or carer be eligible for a COVID-19 vaccine?
- Can I get the COVID-19 vaccine if I’m pregnant?
- How is the vaccine being distributed?
- Why are there different COVID-19 vaccines being developed?
- How do the COVID-19 vaccines work?
- Do any of the COVID-19 vaccines contain egg or animal products?
- Have the COVID-19 vaccines been tested in people with MS?
- How do we know that the COVID-19 vaccine will be safe and effective for people with MS?
- Will the vaccine be available on the NHS, or can I pay for a COVID-19 vaccine?
- Will health and social care professionals be given the COVID-19 vaccine?
The COVID-19 vaccine is available to groups of people on the UK government’s priority list. People with MS who are shielding will already be in group 4. Everyone with MS who’s not in groups 1-5 is in group 6.
The UK government announced on 16 February that another 1.7 million people in England will be added to the shielding (also known as clinically extremely vulnerable) list and will move into vaccine group 4. If you're added to the shielding list the government will contact you to let you know.
To arrange your vaccine, the NHS will phone, text or write to you. They might contact you by phone and by letter. A genuine contact from the NHS won’t ask for payment or for you to send personal documents to prove your identity.
In England, if you’re registered with a GP and you have MS you can book online with the NHS or call 119.
In Scotland, if you’ve got MS you should already have been invited for the vaccine. If you haven't, you can visit the NHS Inform website for advice on who to contact in your area.
In Wales, some NHS local health boards are asking people in the top priority groups to get in touch if they haven’t been invited for the vaccine yet. For some areas this includes people with MS in priority group 6. Find your local NHS health board.
In Northern Ireland, if you’ve got a shielding letter or if you’re 50 or older, you can book online. Find out more and book on the Health and Social Care Northern Ireland website.
Do you provide care and support for a family member or friend with MS? Read more about getting the COVID-19 vaccine
Even though vaccines have been approved, it will take many months for everyone to be vaccinated. In preparation, the UK government pre-ordered millions of COVID-19 vaccines so they’re ready as soon as possible.
There’s a UK-wide plan to prioritise certain groups to be vaccinated first.
Vaccine priority groups
- Group 1: Residents in a care home for older adults and their carers
- Group 2: People 80 years of age and over and frontline health and social care workers
- Group 3: People 75 years of age and over
- Group 4: People 70 years of age and over and ‘clinically extremely vulnerable' people
- Group 5: People 65 years of age and over
- Group 6: Everyone aged 16 to 64 with underlying health conditions which put them at higher risk of serious disease and mortality and unpaid carers (friends or family). Group 6 includes everyone with MS who’s not already in groups 1-5. In England, it also includes people who live with someone with MS taking certain DMTs.
- Group 7: People 60 years of age and over
- Group 8: People 55 years of age and over
- Group 9: People 50 years of age and over
But there might be exceptions to this, based on advice from your MS team. They could say a vaccine isn’t right for you at this time.
Our medical advisers recommend not having the vaccination while you're having a relapse.
They also advise waiting 2 weeks after completing a course of steroids to treat a relapse, before being vaccinated.
Our medical advisers say you should wait 2 weeks after completing a course of steroids to treat a relapse, before being vaccinated.
Our medical advisers don’t think the COVID-19 vaccine will stop DMTs from working. They say this because of what we know about the way these vaccines work, and evidence from studies of other vaccines and MS. At the moment, we’re not sure if a COVID-19 vaccine will interfere with any other medications you might be taking.
No one should stop their MS therapy unless specifically requested to do so by their MS team.
Your MS team can answer specific questions about your own circumstances.
You'll need to bring a face covering, unless you don’t wear one because of your MS or another condition. And if your appointment is at a vaccination centre you’ll need your booking reference numbers.
You can have someone with you as a carer if you usually would.
When you go for your vaccination, you’ll be asked to read the patient safety leaflet. This is normal for any kind of vaccination.
With some DMTs – though not all – your MS team might have specific advice about the timing of the vaccine. That’s to make the vaccine as effective as possible.
Some people report no side effects at all from the COVID-19 vaccines.
When people do notice something, the most common reactions are headaches, arm pain, body aches, chills or fever lasting a few hours to a few days. Over-the-counter painkillers, like paracetamol, can help with this.
Some of the possible side effects are similar to MS symptoms, including tiredness and muscle pain. A fever can make your MS symptoms worse temporarily, but they should return to how they were, after the fever is gone. But if you’re worried about any symptoms, you should contact your doctor or MS team as you usually would.
We know about these possible side effects because thousands of people taking the vaccines were monitored during the clinical trials. And when people report new side effects to a doctor or nurse (or use the Yellow Card scheme) this is recorded and the information about the vaccine is updated. That way, there’s ongoing monitoring for side effects in the months and years after the vaccine is given.
We also have information from the MS Register, where people with MS have answered questions about vaccine side effects they might have noticed.
Because none of the licensed vaccines are ‘live vaccines’ it’s impossible to catch the coronavirus from the vaccine.
Oxford-AstraZeneca for the under 30s
On 7 April, the government vaccine advisers (the JCVI) announced new advice for people aged 18-30 who don’t have an underlying condition (such as MS). This could include family, partners or carers of people with MS.
If these people are going for their first jab, they should be offered an alternative to the Oxford-AstraZeneca vaccine, when possible.
This is because of extremely rare side effects of blood clots.
If you’re due for your second Oxford-AstraZeneca jab, the JCVI says you should still have it, even if you’re under 30 and have no underlying conditions. There have been no cases of blood clots reported after the second jab.
The chances of having a blood clot after the first dose of the AstraZeneca vaccine are very small, and a link between the vaccine and the blood clots hasn’t been proven. But they’ve been reported in about 4 people in every 1 million who’ve had this vaccine.
The JCVI has not given the new advice for people under 30 because they are likely to develop blood clots. They are taking a very cautious approach and weighing up the small risk of blood clots against the benefits of taking the vaccine.
For people with underlying conditions, they say the benefits of the vaccine outweigh the risk.
People under 30 without underlying conditions are less at risk from COVID-19 complications. So the JCVI has decided that at the moment they should be offered an alternative vaccine where possible.
The approved Pfizer-BioNTech and Oxford-AstraZeneca coronavirus vaccines are not ‘live’ vaccines. Neither is the third vaccine that’s approved, made by Moderna.
A ‘live’ vaccine contains a weak version of the virus or bacteria they prevent. Many neurologists would suggest you avoid 'live' vaccines if you’ve recently taken certain DMTs or high-dose steroids. This is because although the virus or bacteria that the vaccine contains is weakened, there is still a small chance that it can cause disease in people with immune systems that have been weakened by DMTs.
The approved vaccines for COVID-19 work in a different way.
It’s too soon to compare the 2 available COVID-19 vaccines and say if one might be better than the other for people with MS.
But the research information we have already confirms that the best way to stay out of hospital with COVID-19 is to get either of the vaccines now on offer (made by Pfizer-BioNTech and Oxford-AstraZeneca).
If you’ve got MS, some of those closest to you might also be in the priority list for the COVID-19 vaccine, including:
- anyone 16 or older who lives with you, if you take certain DMTs – this was added to the priority list for England on 29 March. We’ll update when we know about the other nations
- partners and unpaid carers who provide care and support
People might also be on the priority list because of their own age, job or health condition.
Anyone 16 or older who shares your home
Anyone 16 or older who shares your home on most days is now in priority group 6 in England, if you:
- have taken alemtuzumab (Lemtrada) within the last 4 weeks (or longer if specified by a clinician)
- have had HSCT treatment in the last 12 months
- have taken cladribine (Mavenclad), ocrelizumab (Ocrevus) or alemtuzumab (Lemtrada) within the last 6 months AND have 2 or more other risk factors in this list
GPs and neurologists will identify people who take a relevant treatment. They might also include people taking treatments not in our list.
GPs will then send you a letter confirming your household is eligible. If you get that letter, people who live with you can book their vaccine through the GP practice.
When they go for the vaccination, they’ll need to have evidence they live at the same address as you (like a bank statement or a utility bill).
This group was added to the priority list because there’s evidence that the vaccines can reduce the chances of someone passing on the virus. So even if people have a reduced response to the vaccine themselves, there could be extra protection from vaccinating people in the same home.
These DMTs might reduce a person’s response to the vaccine. But our medical advisers’ advice is that even if you get a reduced response to the vaccine, this is better than none. So they say it’s still worth getting vaccinated even if on these DMTs. And no one should stop their MS therapy unless specifically requested to do so by their MS team.
Partners and unpaid carers who provide care and support
If you’re the main carer for someone, you’re in group 6 on the list alongside people aged 16 to 64 who have underlying health conditions.
The 4 UK governments have slightly different ways to identify unpaid carers who are eligible for the vaccine.
In England, you can book your vaccine online with the NHS or call 119 if:
- you get Carer’s Allowance
- or you get other support following an assessment by your local council
- or your GP record shows you’re a carer
- or you’re supported by a local carer support organisation
If none of these apply, but you’re the main carer for someone, contact your GP. They might be able to update your record.
When you go for your vaccination, you might be asked to prove your identity, but you won’t be asked to prove you’re an unpaid carer, or that you receive Carer’s Allowance.
You might be able to get the vaccine at the same time as the person you care for. If you’re registered at the same GP practice, let them know in advance of the appointment. If you’re eligible for the vaccine, they can add you to the record and you’ll get a letter from the NHS to take along to the appointment. This might depend on availability of vaccines on the day or staff capacity at the vaccination centre or GP surgery.
In Scotland, from Monday 15 March, unpaid carers can register for the vaccine online with the NHS or by calling 0800 030 8013. You can use this service if you’re aged 16 to 64 and provide regular face-to-face care for a family member of friend who has MS (or another condition).
In Wales, if you’re the main unpaid carer for someone with MS, you could be eligible for the COVID-19 vaccine. The full eligibility guidance is explained on the Welsh government website
If you’re already registered as an unpaid carer with your GP, the practice will get in touch with you to invite you for the vaccination.
If you’re not registered with your GP as a carer, you’ll need to fill in an online form for your local NHS health board – or the health board where your GP is based, if that’s different. Once you have completed the form, you’ll be invited for the vaccine.
The licensed COVID-19 vaccines aren’t generally recommended if you’re pregnant. But you might want to discuss having the vaccine with your doctor or nurse if:
- you’re at very high risk of catching COVID-19 (for example, you’re a frontline health or social care worker)
If you have MS but these don’t apply, you wouldn’t usually be advised to have the vaccine if you're pregnant.
Some people had the COVID-19 vaccine as early as December 2020. But the distribution depends where people are on the priority list, and it will take time to vaccinate all the priority groups.
We can't say exactly when someone will get the vaccine, but there are local and national plans to make it available.
In England, this involves hospital ‘hubs’ and special GP vaccination centres. The hospital will get in touch with you by letter or phone if you have been identified as priority for the vaccine (by using your medical records). In the coming weeks, the vaccines will also be rolled out to care homes and to bigger vaccination centres across the country. The government are hoping to vaccinate the most vulnerable groups by spring 2021.
In Wales, the government plan to deploy the vaccine in phases – starting with hospitals and then in community settings, which will include mobile vaccination centres. People will be sent appointments depending on where they are on the schedule and their risks.
In Northern Ireland, the first phase of vaccination roll-out started with care home residents and staff, as well as front-line healthcare workers. The plan is now for everyone over 80 to get their first dose of the vaccine by the end of January and other priority groups after that.
In Scotland the vaccine is being given through hospitals, mass vaccination centres and smaller local ones, pharmacies and GPs. The government hopes to offer the vaccine to everyone in the 9 priority groups by May 2021.
These plans are being reviewed regularly and they could change if new vaccines are approved and as more information is collected.
Different COVID-19 vaccines are being developed to give us the best chance of finding effective ones. There are lots of ways to make a vaccine for a virus. What they all have in common is getting our immune system ready to fight off the virus. They make sure our system recognises the virus if it gets in.
Researchers from around the world are all working to develop vaccines for COVID-19. And at the start of the race to find it, no-one knew for sure what approach would work best.
There seem to be several different types that work well, and it could mean we have different vaccines for different groups of people. For example, older people’s immune systems might respond best to one, while teenagers find another more effective.
Having lots of different approaches also makes it more likely we’ll find better ways to store and deliver the vaccine. Some need super-cold storage, others can be kept in a household fridge for months on end. The first vaccines to report results – including the approved vaccines – need 2 jabs. It’s possible that others might need only one, or be given as a nasal spray.
The Pfizer-BioNTech vaccine is what’s known as a ‘messenger RNA (mRNA) vaccine’. The Moderna vaccine also works in this way. The Oxford-AstraZeneca vaccine has a different way of working - it’s known as a ‘viral vector vaccine’.
Messenger RNA - using the genetic code
The messenger RNA (mRNA) vaccines don’t contain any pieces of the actual coronavirus. Instead, they contain part of the genetic code of the virus, carried by the mRNA. These vaccines work by injecting this part of the coronavirus's genetic code, which trains the body’s immune system to attack coronavirus if it’s exposed to it.
The Oxford vaccine – a ‘viral vector vaccine’
The other vaccine has been developed by the University of Oxford and drug company AstraZeneca. It’s known as a ‘viral vector vaccine’. It uses a weak version of the virus that causes the common cold in chimpanzees. This helps it get into the body like an actual virus would. But in the vaccine, this virus has had its genetic code changed so that it can’t actually cause disease in humans.
The change also means it’s got the genetic code for one particular part of the coronavirus - the ‘spike protein’. It’s just that, a spike on the outside of the virus that it uses to get inside our cells.
The vaccine makes the same spike so our immune system can recognise it if the actual coronavirus gets in - and then fight it off.
None of the 3 licensed COVID-19 vaccines contain egg or animal products.
The Oxford-AstraZeneca vaccine was made using human kidney cells.
We don’t know yet how many people with MS might have taken the COVID-19 vaccines during the clinical trials. That detail about who was on the trials hasn’t been published yet.
But we do know they looked at whether the vaccines worked on people with certain medical conditions and in older people. They did this because the immune responses for these people can work less effectively and therefore give them less protection through vaccines.
The 3 vaccines which have shared their initial results show the vaccine is between 70-95% effective in people involved in the trial as a whole.
Pfizer-BioNTech plan to check how effective the vaccine is for people with weakened ('compromised') immune systems - for example if you use certain DMTs. They’ll do this through a clinical trial and through their ongoing monitoring of people in the months and years after taking the vaccine.
All new medicines have to go through rigorous safety tests in clinical trials – including vaccines. This includes 3 stages of clinical trials where people who take the vaccine are very closely monitored. Researchers constantly check the safety and side effects through these trials.
Although the trials for the coronavirus vaccines have been accelerated, safety processes have still been carried out as normal.
The process can take up to a few months, but the process has so far been quicker for COVID-19 because the experts are prioritising and checking data as it’s produced - rather than waiting until after everything is completed as they usually would. So they can speed up the process while keeping it thorough.
Any COVID-19 vaccine is only approved once it meets these robust standards of effectiveness, safety and quality.
The Association of British Neurologists (ABN) say they don’t expect that COVID-19 vaccines will worsen someone’s MS – for example, by causing a relapse. And they have no reason to believe these will be dangerous in people with MS, including people taking immunosuppressive drugs.
We don't know for sure that the vaccines will work for everyone with MS. It’s possible that people on some MS treatments might have a reduced response to the vaccines.
This could happen because vaccines work by triggering an immune response and DMTs work by dampening down the immune system. This effect from the DMT might change over time. So you may have a reduced response for some time after an infusion, for example, but this might not be permanent.
Our medical advisers say that even a reduced response is likely to be better than none, so you should still get vaccinated if you’re on a DMT that might affect the vaccine like this.
Your own MS team can give you more advice, based on your circumstances, any treatments you take, and on whether getting a COVID-19 vaccine is right for you.
The UK government has said that adults who have a weakened immune system ('immunocompromised') should get a COVID-19 vaccine as a matter of priority. They say this includes people having stem cell transplants, and adults receiving alemtuzumab, ofatumumab or rituximab. This doesn’t guarantee the vaccine will be completely effective if you take these treatments, but you will get priority if you and your MS team agree it’s right for you.
Now a vaccine has been approved, there will be lots more information coming out about possible side effects and anyone who should avoid or delay taking that particular vaccine. We’ll keep up to date with any changes.
The vaccines developed by Pfizer-BioNTech, Oxford-AstraZeneca and Moderna will be available on the NHS and free of charge to those who are eligible. At first, this will be for people on the priority list. So a vaccine might not be available to you on the NHS straight away.
We don’t know yet if other vaccines being developed will also be available on the NHS.
At some point, people might be able to buy the vaccine, but this isn’t certain to happen and you can't at the moment.
To arrange your vaccine, the NHS will phone, text or write to you. They might contact you by phone and by letter. A genuine contact from the NHS won’t ask for payment or for you to send personal documents to prove your identity.
Many health and social care professionals will be given the COVID-19 vaccine.
Health and social care staff are at risk of contracting COVID-19, but also of passing it on to the people they care for. The UK government have made it clear that the NHS and social care system needs to be protected so services can continue as normal.
Care home staff and their residents are considered highest priority for vaccination, with health and social care workers following them.
We updated this page on Wednesday 7 April.