MS and coronavirus care and support

We’ve been talking to people across the UK about multiple sclerosis and COVID-19. These are some of the questions that crop up the most.

We've worked closely with our medical advisers and the Association of British Neurologists (ABN) to keep this page updated through the COVID-19 pandemic. And we'll keep this information updated to answer your questions about coronavirus.

Follow these links for MS and COVID-19 information:

  1. MS and coronavirus (COVID-19) – what are the risks?
  2. Are people with MS "clinically extremely vulnerable" to COVID-19?
  3. What’s the latest COVID-19 guidance if I’ve got MS?
  4. Can I still get tested for coronavirus (COVID-19)? 
  5. I have MS, what should I do if I catch COVID-19 or someone I live with does?
  6. Carers, family and COVID-19
  7. How can I get COVID-19 treatments like Paxlovid, sotrovimab, remdesivir or molnupiravir?
  8. Can people with MS get Evusheld to stop COVID-19?
  9. DNARs, critical care and your rights
  10. Work, employers and COVID
  11. MS, finance, benefits and coronavirus
  12. COVID-19, MS and schools
  13. What research is happening into MS and COVID-19?
  14. Coronavirus vaccines
  15. Long COVID and MS
  16. MS treatments (steroids and disease modifying therapies)

1. MS and coronavirus (COVID-19) – what are the risks?

Research indicates that having multiple sclerosis (MS) in itself doesn’t increase your risk of getting COVID-19.

But some people with MS could be at greater risk of getting coronavirus, or of complications if they catch it. For example, that could be because of certain disease modifying therapies (DMTs), frailty or having long-term conditions besides MS.

Studies so far indicate that in general being on a DMT for MS doesn’t increase your risk of getting COVID-19 or having worse symptoms. But there are some specific cases where a DMT is likely to increase risk.

You should follow your MS team's advice about treatments and any extra social distancing measures they recommend.

Research presented in October 2021 also suggests that people with MS who do get COVID-19 could be more likely to experience 'long COVID'.

Read advice from our medical advisers on calculating risk

Can COVID-19 cause an MS relapse?

We don’t have much evidence about the risk of COVID-19 in particular causing relapses. But we know infections (including viral infections) can increase the risk of relapses. You can read more on page 17 of our 'Managing your relapses' booklet.

Are people with MS in the "higher risk" or “vulnerable” group?

Everyone with MS is technically in the "higher risk" group (or “vulnerable” group in Northern Ireland). This used to be called the "clinically vulnerable" group.

The four UK governments defined this group as being more vulnerable to COVID-19 than the average person, but not as much as people in the "highest risk" (or “clinically extremely vulnerable”) group. It's very similar to the group of people eligible for the free annual flu jab.

Everyone with MS is technically in this group because MS can be associated with increased risks, depending on your symptoms, treatment or other factors. And the government's data doesn't hold that level of detail about each person.

Sometimes there’s been separate guidance for everyone in this group. At other times, the government advice has been the same as for the population as whole.

Read about government COVID-19 guidelines in your nation

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2. Are people with MS “clinically extremely vulnerable” to COVID-19?

Some people with MS have been considered "extremely clinically vulnerable" or in the "highest risk" group for COVID-19. This could be because of a particular treatment or the way your MS affects you. Or it could be a combination of things.

Earlier in the pandemic, you might have received a shielding letter saying you’re clinically extremely vulnerable. Shielding programmes have stopped across the UK, and the shielding and “highest risk” lists aren’t used anymore. But it’s still important to bear in mind you have higher underlying risks from COVID-19.

Your doctor should consider you to be clinically extremely vulnerable if you:

  • have significant difficulties with breathing or swallowing (for instance if you need artificial feeding)
  • 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 (speak to your MS team to understand at what point your risks will reduce)
  • have taken cladribine (Mavenclad), ocrelizumab (Ocrevus) or alemtuzumab (Lemtrada) within the last 6 months AND have 2 or more other risk factors listed below

You might also be considered clinically extremely vulnerable by your consultant or GP if 2 or more of the main extra risk factors below describe your situation.

What are the main risk factors for COVID-19 if I have MS?

Early research indicates that having multiple sclerosis (MS) in itself doesn’t increase your risk of getting COVID-19.

But some people with MS could be at greater risk of getting coronavirus, or of complications if they catch it. There is also some evidence that vaccines may not have worked as well for some people with MS as for others.

You might also consider the number of coronavirus cases in your local area, when that information is available. If these are significantly higher than the national average, it may be best to take extra precautions regardless of your risk level.

Making decisions around risk

We need more evidence to know for sure. But based on what we know our medical advisers have estimated the risks for people with MS in different situations.

We hope this will help you make decisions about what situations you’re comfortable with.

Main extra risk factors

The main extra risk factors are:

  • you’re over 70
  • you have trouble with things like preparing meals and housework because of frailty
  • your frailty or MS symptoms mean you usually need an aid for walking, or you use a wheelchair (score 6.0 or higher on the Expanded Disability Status Scale)
  • you have another long-term health condition besides MS, especially obesity, high blood pressure (also called hypertension), or diabetes. See a fuller list of long-term conditions that also apply on the US National Library of Medicine website
  • you're pregnant
  • you’ve had a course of alemtuzumab (Lemtrada) or cladribine (Mavenclad) in the last 6 months
  • you’ve had a course of ocrelizumab (Ocrevus) or rituximab in the last 12 months

Your MS team will be more familiar with your personal circumstances. So if they tell you to take precautions for any other reason it's very important you follow their advice.

How does my risk change if I’ve been vaccinated?

Vaccination reduces the risks from COVID-19 for people with MS and is generally very safe. Booster jabs can help keep up the protection that vaccines give against COVID-19.

However, some DMTs might reduce the effectiveness of any vaccine because they prevent the immune system from mounting a complete immune response to the vaccine.

3 categories of vaccine protection

Evidence around how effective vaccines are for different groups of people with MS is still emerging. Based on what we know right now, we think there are three categories of vaccine protection:

Vaccine category A

You're fully vaccinated (you've had all primary doses, at least 2 weeks ago, and a booster if that's due) and you're treated with

  • glatiramer acetate (Copaxone and Brabio)
  • teriflunomide (Aubagio)
  • dimethyl fumarate (Tecfidera)
  • beta interferons
  • natalizumab (Tysabri)
  • cladribine (Mavenclad)
  • alemtuzumab (Lemtrada) more than 12 months ago
  • no treatment (not on a DMT)

People in this category with 0 - 1 extra risk factors are at similar level of risk as everyone else in the UK. If you have 2 or more extra risk factors, you’re at increased risk so should be extra careful to follow precautions.

Vaccine category B

You're fully vaccinated (you've had all primary doses, at least 2 weeks ago, and a booster when that's due) and around the time you were vaccinated you were treated with

  • ocrelizumab (Ocrevus)
  • alemtuzumab (Lemtrada) less than 12 months ago
  • ofatumumab (Kesimpta)
  • rituximab
  • fingolimod (Gilenya)
  • ozanimod (Zeposia)
  • siponimod (Mayzent)

If this is you, even if you have 0 extra risk factors you are at increased risk, so should be extra careful.

If you have 1 or 2 extra risk factors, you’re at higher increased risk, so should be even more careful to follow precautions.

Read more about these DMTs and COVID-19 vaccines

Vaccine category C

You are partially vaccinated (you haven't had all your primary doses or you had the final one within the last two weeks), or you're not vaccinated.

Until you’ve had all your primary doses of the vaccine and the recommended boosters, you're at higher increased risk than anyone who's fully vaccinated. So you should take full precautions. We know some people can’t have the vaccine for medical reasons. Unfortunately this does mean higher increased risk (unless you are in the very specific situation explained in the next section).

Generally we expect the vaccine will give at least some protection from COVID-19 for everyone with MS, so we encourage people to get it if possible, though we know it comes down to personal choice.

I have MS, but no recent relapses or symptoms

If you have MS, but you

  • have no other risk factors
  • are not taking a DMT

Your risk is similar to everyone else in the UK’s. This means if you have been vaccinated your risk is similar to another vaccinated person. And if you haven’t your risk is similar to another unvaccinated person.

As with everyone, getting vaccinated reduces risks from COVID-19 both for you and those around you.

Precautions for people who have increased or higher increased risk

People who have increased or higher increased risk could consider additional precautions like:

  • wherever possible requesting to work from home, if this is not possible asking your employer to include COVID-19 in their workplace risk assessment in light of your higher risks
  • avoiding crowded places, especially indoors (for example shops or public transport at peak times)
  • if possible asking friends and family to undertake home COVID tests before social gatherings
  • more generally following the advice for people at higher risk set out by your government and the NHS, or their advice for immunosuppressed people if that applies to you

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3. What’s the latest COVID-19 guidance if I've got MS?

The latest COVID-19 guidance for people with MS, family and friends, depends on where you live. Each nation has its own guidelines.

Read the latest COVID-19 guidance for your nation:

COVID guidance if you’re at higher risk

Not everyone with MS is at higher risk from COVID-19. But you might be if you take certain disease modifying therapies (DMTs), or because of how your MS affects you. The UK Government and Scottish Government both have further guidance for people who are “immunosuppressed” or at “highest risk”.

Read the UK Government COVID guidance for people who are immunosuppressed 

Read the Scottish Government COVID guidance for people at greatest risk

Social distancing

Social distancing rules have been relaxed. We’re all comfortable with different levels of risk. If you’re worried about people not social distancing, you might want to carry a "Give me space" card. It's a card, lanyard or badge that encourages other people to keep their distance.

If you’re anxious about COVID you can call our MS Helpline to talk to someone: 0808 800 8000

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4. Can I still get tested for coronavirus (COVID-19)?

Automatic and widespread testing for COVID-19 has stopped. But everyone can still buy tests, and some people can get free tests in certain circumstances.

For example, some testing still happens in hospitals and care homes. That includes when anyone has symptoms, but also for people going to live or stay in a care home. If you're eligible for early COVID treatment assessment, you can get free COVID tests. The systems vary between UK nations:

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5. I have MS, what should I do if catch COVID-19 or someone I live with does?

The exact government guidance if someone catches COVID-19 varies across the UK. But across the UK, most people are not usually advised to get a test anymore.

Free tests are still available for anyone eligible for early COVID-19 treatment assessment. You should test as soon as possible if you think you might have COVID-19, to arrange early treatment if it's appropriate.

If anyone has COVID-like symptoms, they should try to avoid contact with others, except for essential care.

Read the UK government guidance for people with COVID-19 symptoms in England

Read the NHS Inform guidance for people with COVID-19 symptoms in Scotland

Read the government guidance in Wales for people with COVID-19 symptoms

Read the niDirect guidance in Northern Ireland for people with COVID-19 symptoms

If you take a DMT and get COVID-19

With most DMTs, you can usually carry on taking them if you have mild COVID-19 symptoms. Don't stop taking a DMT without medical advice. Read more about DMTs if you get COVID-19

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6. Carers, family and COVID-19

If you’re caring for someone with MS, you might choose to take extra steps to protect you and them from COVID-19. For example, getting COVID vaccine boosters and checking what measures any paid carers are taking.

Not everyone with MS has an increased risk of COVID-19. The person’s MS team can explain more about their particular COVID-19 risk.

There’s government guidance for staff in care homes, and those who provide care at your own home. Some of it’s written for care workers and their employers. But you might find it helpful so you know what to expect from paid carers.

Find support and COVID information for carers on the Carers UK website

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7. How can I get COVID-19 treatments like Paxlovid, sotrovimab, remdesivir or molnupiravir?

If you have MS and you test positive for COVID-19 you might be offered a COVID-19 treatment - like Paxlovid, sotrovimab, remdesivir or molnupiravir.

These and other COVID-19 treatments are usually offered for people with MS who take certain disease modifying therapies (DMTs) or had recent use of steroids.

For example, you might be offered the COVID treatments if you take a DMT which more strongly suppresses the immune system, such as ocrelizumab, rituximab or HSCT.

Read Roseanne's story about COVID-19 treatment and MS in our community blog

If you have COVID-19 symptoms

Even if you’re don’t think you’ll qualify for these COVID-19 treatments, contact your MS team if you test positive or you think you might have COVID-19. They can advise on how to manage it and whether you should access these treatments.

Changes in England - June 2023

In England, the way to get these treatments has changed. From 27 June 2023, the NHS won't contact anyone automatically about these treatments.

So if you test positive you'll need to contact your GP, NHS 111 or your neurologist as soon as possible. Then they can consider referring you for an assessment for treatment.

Taking the treatments

Some of the treatments are taken as tablets. So someone can collect them for you or you can have them delivered to your home.

Others are given as an infusion (a drip) at a clinic. When the NHS contact you to discuss your treatment option, they should also discuss how you can get safely to and from the clinic. 

Keeping tests at home

If you’re eligible for COVID-19 treatments, you can get free COVID tests to keep at home. That way you can get a result quickly if you test positive, and start the treatment sooner when it’s needed.

Each nation has information about how to get free tests and how to access COVID-19 treatments.

Read NHS information about accessing COVID-19 treatments in England

Read NHS information about accessing COVID-19 treatments in Scotland

Read government information about accessing COVID-19 treatments in Wales

Read government information about accessing COVID-19 treatments in Northern Ireland

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8. Can people with MS get Evusheld to stop COVID-19?

Evusheld was licensed in March 2022 to prevent COVID-19 symptoms. It’s available privately, but not on the NHS to anyone in the UK, including people with MS.

Evusheld is the brand name for a combination of two drugs, tixagevimab and cilgavimab.

Why isn’t Evusheld available on the NHS?

Evusheld isn’t available on the NHS because the government says it’s unlikely to work against Omicron and other newer variants of coronavirus.

In May 2023, NICE announced its guideline on the use of Evusheld on the NHS. That guideline says Evusheld should not be used on the NHS.

This decision is being applied in all four nations of the UK.

Read more about the NICE guideline for Evusheld

Does Evusheld work?

Early research showed it reduced the risk of getting COVID symptoms. And no one who took Evusheld in the study got seriously ill from COVID. That research involved mostly people at higher risk from COVID-19.

The study was before the Omicron variant. More recent research in 2023 suggested that Evusheld wasn’t as effective against some newer variants of COVID. That included those likely to become common in the UK.

NICE and the Scottish Medicines Consortium (SMC) have decided they can't recommend Evusheld on the NHS because of this research.

The UK Government was hoping to run a large research trial to test Evusheld with different variants. But they've said this isn’t possible ay more because Evusheld is unlikely to stop so many of the variants now in the UK. There might still be a trial in future, depending on the variants that emerge.

Researchers might find alternatives to Evusheld through a trial called PROTECT-V. That’s an ongoing trial for different drugs that might treat and prevent COVID-19.

NICE also make research recommendations. Those include quicker Evusheld research when there are new variants. NICE also aim to be quicker at responding to COVID care and treatment themselves, so they can react to changes.

How can I get Evusheld privately?

From 19 October 2022, Evusheld might be available privately through:

  • Private health insurance that you already have
  • Private healthcare companies who might sell the treatment even if you don’t have their insurance
  • Private medical centres
  • NHS hospital departments which offer private treatment

We don’t know how many clinics offer Evusheld. You should check with any clinic directly to find out if it’s available, the care they provide and the cost.

You might find the NICE guidance helpful if you’re thinking about paying for Evusheld. They explain the evidence they have taken into account when they came to their decision.

Read the NICE guidance for Evusheld (tixagevimab plus cilgavimab)

Getting the Evusheld jab will cost over £1,000. Prices will vary, but each dose of the drug costs the doctor that much. That's before any costs for their time.

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9. DNARs, critical care and your rights

In the earliest months of the COVID-19 pandemic, some people with MS and other long-term had letters or calls from their doctors about signing Do Not Attempt Resuscitation (DNAR or DNR) documents. These are documents people can choose to sign to refuse certain treatments like ventilators – machines to help people breathe.

At that time, the NHS was preparing for the worst case scenario of running out of ventilators. This isn’t the case now.

We understand that the idea of being denied treatment is extremely worrying for anyone. Having MS in itself does not mean you’ll be denied critical care. And signing a DNAR or refusing treatment should always be a choice.

The only criteria that should ever be applied to a critical care decision is the chances a person will recover and return to a good quality of life. Many people with MS have a strong chance of recovery from COVID-19.

Read more about DNARs, critical care and your rights

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10. Work, employers and COVID

Each UK nation has its own guidance and rules around work, employers and COVID-19. There is also equality and employment law which applies across the UK.

ENGLAND COVID-19 and work

Employers don't all have to consider COVID-19 in particular in their risk assessments any more. But if you’ve got MS you’re still covered by employment, health and safety, and equality law to keep you safe at work. And employers still have to protect people who come into contact with coronavirus at work.

Read the Health and Safety Executive COVID-19 guidance for employers

SCOTLAND COVID-19 and work

The government encourages more working from home than before the pandemic, where it's possible and appropriate. That can include "hybrid working" - some time spent at home and some at the workplace.

Employers still have to make workplaces safe and to conduct risk assessments. And they emphasise this is particularly important for those at higher risk. Guidance for employers and employees has been updated by the Scottish government, to help minimise risks

WALES COVID-19 and work

The Welsh Government has specific COVID-19 guidance for employers, including risk assessment tools and checklists.

Read the Welsh Government COVID-19 guidance for employers

Northern Ireland COVID-19 and Work

The guidance is for employers and employees to discuss what's an appropriate balance of working from home and at the workplace.

Read the Northern Ireland government COVID-19 workplace guidance

UK law and work

Everyone with MS is covered by the disability provisions of the Equality Act (Disability Discrimination Act in Northern Ireland).

Your employer may be required to make reasonable adjustments so you're not put at a substantial disadvantage compared to someone who isn't disabled. If your employer doesn’t agree to make reasonable adjustments, you can complain. You might be able to show they’ve discriminated against you.

You might be able to get help from the government Access to Work scheme for adjustments so you can keep working.

If you don’t think your employer is keeping you safe, you should discuss this with your employer and contact your trade union if you have one.

You can report specific issues to your local authority or the Health and Safety Executive online or on 0300 790 6787.

Read more about reasonable adjustments and what you can do if you think you've been treated unfairly

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11. MS, finance, benefits and coronavirus

During the height of the COVID-19 pandemic there were some changes to financial support and benefits. For example, furlough, Test and Trace payments and changes to Statutory Sick Pay. Those changes have now ended, but it’s still worth checking you’re getting what you’re entitled to. Especially if your circumstances have changed since the pandemic.

Find out about finances and benefits if you’ve got MS or you’re a carer

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12. COVID-19, MS and schools

There are still some COVID-19 guidelines for schools. But these are not laws anymore. So if you have specific concerns, check with the school directly or find your local council and check with them.

Is it safe for children with MS to be in school?

In September 2020, a group of leading neurologists in childhood MS agreed that children with MS are not a high risk group for coronavirus. And that almost all children should return to school full time when they're open.

In a statement they said:

  • Nothing can be 100% safe. But their experience across the UK over the past 6 months hasn’t shown that their patients are at high risk - even when they've been exposed to COVID-19
  • Children with MS rarely have other conditions as well as MS, or ongoing physical symptoms like problems with walking. These are two factors that could put people with MS at higher risk
  • The academic and social benefits of going to school and socialising outweigh the risk from the virus
  • Unless your child’s neurologist suggests taking extra precautions, they should follow government guidance for all children at school

Read a government blog about the COVID-19 guidance for schools in England 

Read the Scottish government COVID-19 guidance for schools

Read the Northern Ireland Department of Education COVID-19 guidance for schools 

Read the Welsh government COVID-19 guidance for schools

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13. What research is happening into MS and COVID-19?

There has been research to help us learn more about multiple sclerosis and coronavirus. But this coronavirus is still new, so we don’t fully understand how it affects people with MS.

Lots of people with MS have filled in the MS Register survey on coronavirus and MS. That’s helping us understand how COVID and the effects of the pandemic have affected our community.

Find out what we’ve already learned from responses to the MS Register survey

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14. Coronavirus vaccines

COVID-19 vaccines are available across the UK. We answer some of the big questions for people with MS, friends, family and carers.

Find out more about coronavirus vaccines and MS

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15. Long COVID and MS

‘Long COVID’ symptoms can be similar to MS symptoms. Our information explains more about long COVID and MS.

Read about long COVID and MS

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16. MS treatments (steroids and disease modifying therapies)

Working with our medical advisers, we answer questions you might have about MS treatments and COVID-19.

Read about your MS treatment and coronavirus

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You’re not alone we can help

Talk to someone on the phone

We're here for you. If you’re worried about your MS and coronavirus and want to chat to someone, call our MS Helpline on 0808 800 8000. We’re here Monday to Friday, 9am to 7pm except bank holidays.

Chat online

If you'd like to talk your worries through online with other people who know MS, visit our Online Community Forum today.

Or join one of our Virtual Wellbeing sessions and connect online with other people living with MS across the UK.

Ask an MS health expert

Or you could sign up for an information webinar. We've got plenty to choose from, take a look at our online sessions and see what suits you.

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