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 2021.
- When can I get a COVID-19 vaccine?
- Do I need a third COVID-19 jab because I’m immunosuppressed?
- Can children and teenagers get the 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 coronavirus vaccines ‘live’ vaccines?
- Which COVID-19 vaccine is best for someone with MS?
- Can I get the COVID-19 vaccine if I’m pregnant?
- 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?
COVID-19 vaccines are available now across the UK. We’ve summarised how you and those close to you can get the jabs in each nation.
If you’ve already had your full vaccination (usually 2 jabs), you might be offered a booster jab to keep the protection strong. ;
Some people with MS are also being offered a third jab for a different reason. This is because they were taking certain disease modifying therapies (DMTs) when they had their first or second doses. Read more about who might be contacted by the NHS for this third jab
If the NHS gets in touch to arrange your vaccine it could be by phone, letter or both. A genuine contact from the NHS won’t ask for payment or for you to send personal documents to prove your identity.
If you use a disease modifying therapy (DMT), you might also want to read our medical advisers' statement on vaccines and DMTs
Vaccines in England
In England, if you’re 18 or over and registered with a GP you can book online with the NHS or call 119.
If you're 16 or 17 you can find your nearest walk-in vaccination centre one the NHS website. If you'll be 18 in 3 months or less, you can book a COVID-19 vaccine appointment on the NHS website.
To book, and for a full list of who can get the vaccine now, visit the NHS website.
Vaccines in Scotland
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.
Anyone aged 16 or 17 living in mainland Scotland can book a vaccine appointment at NHS Inform. In Shetland, Orkney and Western Isles, the local health boards will get in touch.
For a full list of who can get the vaccine now, visit NHS Inform website.
Vaccines in Wales
In Wales, if you're 16 or older, you should have already been offered a COVID-19 vaccine. If you haven't, you can contact your local NHS health board.
For a full list of who can get the vaccine now, visit the Welsh government website.
Vaccines in Northern Ireland
In Northern Ireland, anyone 16 or 17 with a shielding letter, or anyone 18 or older can book online. Find out more and book on the Health and Social Care Northern Ireland website.
Other 16 and 17-year-olds can now get the jab at a walk-in centre. Find your nearest vaccination walk-in centre
Across the UK, people with MS who’ve already been fully vaccinated will be offered a booster jab. This will be timed for at least 6 months after your second jab.
The NHS will get in touch to arrange it. You might be invited to have the annual flu jab at the same time.
Friends, family and colleagues might also be able to get a booster jab. It’s also being offered to everyone over 50 and adults who live with someone who is immunosuppressed.
A booster could help keep up the protection that vaccines give against COVID-19, which decreases over time. That extra protection could be particularly important as we go into the winter months.
When will I get the booster jab?
The first booster jabs are expected from 20 September, but it’ll take several weeks or months to offer the vaccine to everyone who’s eligible.
Boosters will be offered in the same order as the UK government's original vaccine priority list. But local areas will have flexibility, to make sure people get the booster as quickly as possible. For example, that could depend on when someone had their second dose.
Some people with MS are being offered a third dose of the COVID-19 vaccine because they were severely immunosuppressed when they had the first or second jab. This is not part of the booster jab scheme. Read more about the third dose vaccine if you were severely immunosuppressed
The government vaccine advisers (the JCVI) recommend some people who have a weakened immune system get a third dose of a COVID-19 vaccine.
In England, Scotland and Wales, your GP, neurologist or NHS health board should let you know if you are eligible for a third dose of a COVID-19 vaccine.
I Northern Ireland, the government hasn’t yet approved the plan. We expect to hear about their decision in the next few days.
The JCVI has recommended it for anyone 12 or over who had a ‘severely weakened immune system’ around the time of their other jabs. This is to try to increase your level of vaccine protection.
It’s likely to include you if you've:
- had HSCT treatment in the last 2 years
- recently been treated with ocrelizumab, rituximab, ofatumumab, fingolimod, or siponimod. This would usually be if you've had the treatment within the last 3 to 6 months
You might also be offered this third jab if you’ve recently taken high-dose steroids (for example to manage a relapse).
Unfortunately we can't say for sure who'll be offered this third dose. Each person's risk is different, so everyone needs an individual decision.
Your neurologist will give advice about when you should get your third jab. It could depend on how the vaccine might interact with your medications.
The JCVI recommends either the Moderna or the Pfizer-BioNTech vaccine for this third dose. But if these aren’t available, the Oxford-AstraZeneca jab can be used.
A third dose of a COVID-19 vaccine doesn’t guarantee everyone who has a weakened immune system will get a good level of protection from the virus. But the JCVI expects many people will increase their immunity. They’ve said that a ‘large minority’ is likely to get this benefit.
Children and teenagers aged 12 to 15 will be offered a first dose of the Pfizer-BioNTech vaccine for COVID-19.
In England, Wales and Northern Ireland these will be offered at schools in the coming weeks.
In Scotland, 12 to 15-year-olds will get letters from the NHS inviting them to get the vaccine at a drop-in centre or vaccination clinic. These letters will start arriving from 27 September.
Some other children and teenagers have been eligible for the jab for some time. The Joint Committee on Vaccination and Immunisation (JCVI) already recommends:
- a first dose of the Pfizer-BioNTech vaccine for 16 and 17-year-olds. JCVI guidance about the second dose will come later. Read more about how to get the COVID-19 vaccine in your nation if you're 16 or 17
- the Pfizer-BioNTech vaccine for children aged 12 and over who have an increased risk of serious COVID-19 or who live with an immunosuppressed person
Can children with MS get the COVID-19 vaccine?
Children over 12 with MS can get the COVID-19 vaccine along with everyone else. We agree with an MS International Federation recommendation that young people with MS should be offered the vaccine.
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 40s
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). On 7 May this was extended to people up to the age of 39. 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 40 and have no underlying conditions. There have been very few cases of blood clots reported after the second jab.
The chances of having a blood clot after 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 10 people in every 1 million who’ve had this vaccine.
The JCVI has not given the new advice for people under 40 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 40 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 available COVID-19 vaccines and say if one might be better than another 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 the vaccines now on offer.
The Joint Committee on Vaccination and Immunisation has said that, when it comes to being pregnant, there are no specific safety worries about any of the types of coronavirus (COVID-19) vaccines. Their advice is that pregnant women should be offered the COVID-19 vaccine at the same time as the rest of the population. When they’re offered it will depend on how old they are and what, if any, clinical risk group they are in.
If you’re pregnant, the advice is you should be offered the Pfizer-BioNTech or Moderna vaccines if these are available. That’s because 90,000 pregnant women in the US have had these two vaccines without any problems. There’s no evidence that other vaccines are unsafe for pregnant women, although more research is needed.
Women should talk to their doctor or nurse about the risks and benefits of vaccination. They’ll know the latest evidence on safety, which vaccines to have, and whether you’re in any special clinical risk group.
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 available 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.
One small study has looked at how effective the Pfizer-BioNTech vaccine might be for people taking cladribine, fingolimod or ocrelizumab. Read about this Pfizer-BioNTech vaccine research
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.
One small study has looked at how effective the Pfizer-BioNTech vaccine might be for people taking cladribine, fingolimod or ocrelizumab. Read about this Pfizer-BioNTech vaccine research
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.
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