It’s that time of year again, and we would like to remind all individuals living with MS of the importance of getting the new updated COVID vaccine and your annual Flu Shot. If you are over the age of 60, we encourage you to also get the Respiratory Syncytia Virus (RSV) vaccine which is now available. Further details are below.
COVID-19 Updated Vaccine for Fall/Winter Season
The Rocky Mountain MS Center’s medical team continue to strongly recommend all individuals receive the COVID-19 vaccination, including the most recent updated COVID-19 vaccination now available, unless you have a known allergy to a component of the vaccine.
The Centers for Disease Control (CDC) recommends that everyone 6 months and older get an updated COVID-19 vaccine. Updated COVID-19 vaccines from both Pfizer-BioNTech and Moderna are now available. If you have not received a COVID-19 vaccine in the past 2 months, we urge you to get an updated COVID-19 vaccine.
Our team’s guidance on timing of your updated COVID vaccine based on your Disease Modifying Therapy is below:
For individuals on anti-CD20 disease modifying therapy (Ocrevus, Rituxan, Kesimpta, or Briumvi) or S1P disease modifying therapies, (Gilenya and its generics, Mayzent, Zeposia, or Ponvory), Lemtrada, Mavenclad, or any chemotherapy drugs, below is our guidance:
- If on Ocrevus, Rituxan, or Briumvi, try to get your updated vaccine one month prior to your next infusion OR at least one month after your last infusion, preferably and if possible, 5 or more months.
- If on Kesimpta, guidance is a bit less clear. In general we recommend to try to get your updated vaccine 4 weeks after your last dose of Kesimpta, and then, use the next Kesimpta injection 4 weeks after the vaccine. Thus, this means missing a single dose of Kesimpta. Discuss with your doctor.
- For Gilenya, its generics, Mayzent, Zeposia, and Ponvory, there is no way to hold dosing, so we suggest the regular schedule to get your updated vaccine if you have not received a COVID-19 vaccine in the past 2 months.
- We do not have specific timing guidance for Lemtrada and Mavenclad. Thus, we would suggest taking a dose anytime 3 months or more after last DMT dose and at least 4 weeks prior to next dosing.
If the specific timing doesn’t work out, it is better to get an updated shot rather than wait until the cold and flu season is over.
We do not have specific timing recommendations for getting the updated COVID-19 vaccine if you are taking any other DMT, including fumarate therapies (Tecfidera or dimethyl fumarate and its generics; Bafiertam or monomethyl fumarate; Vumerity or diroximel fumarate); Aubagio (teriflunomide); Tysabri, Copaxone (glatiramer acetate) or interferons such as Avonex, Rebif, Betaseron, and Plegridy; OR if you are NOT taking a disease modifying therapy.
There are no absolute guidelines for those with recent COVID infection, but the CDC guidance is you may wish to wait three months before getting the next COVID vaccine.
Annual Flu Shot
Flu shots are recommended for all patients, except those with known allergies to the shots, but providers recommend that MS patients not receive any “live attenuated vaccines” — such as flu mist nasal spray. The CDC’s guidance this year also states that people with allergies to eggs can safely receive any flu vaccine. Regular flu shots are recommended.
If you are on Ocrevus, Rituxan, Kesimpta, or Briumvi) or S1P disease modifying therapies, (Gilenya and its generics, Mayzent, Zeposia, or Ponvory, we recommend that you get the higher dose flu vaccine for individuals 65+ years of age to encourage a better immune response.
For many, it is easier to get the flu shot and COVID vaccine at the same time, one vaccine for either arm. However, some might wish to limit having two sets of vaccine reactions at the same time, and get the vaccines separated by several days, after it is clear the reaction from the first is over or not going to happen (a few days usually). If you already had the flu this season, the recommendation is still to get the flu vaccine, as there may be multiple flu strains that are in the community every year.
RSV Vaccine
If you are over the age of 60, the Respiratory Syncytia Virus (RSV) is recommended, unless you are allergic to one of the components or sick at the time with a virus.