MS, the coronavirus and vaccines – updated global advice

January 25, 2021 | Covid-19

Global COVID-19 advice for people with MS

COVID-19 is a new illness that can affect your lungs, airways and other organs. It is caused by a novel coronavirus (called SARS-CoV-2) that has spread around the world.

The advice below was developed by MS clinicians and research experts. It is based on the emerging evidence of how COVID-19 affects people with multiple sclerosis (MS) and expert opinion.

Advice for people with MS

Current evidence shows that simply having MS does not make you more likely to develop COVID-19 or to become severely ill or die from the infection than the general population. However, the following groups of people with MS are more susceptible to having a severe case of COVID-19:

• People with progressive MS
• People with MS over the age of 60
• Men with MS
• Black people with MS and possibly South Asian people with MS
• People with higher levels of disability (for example, an EDSS score of 6 or above, which relates to needing to use a walking stick)
• People with MS and obesity, diabetes or diseases of the heart or lungs
• People taking certain disease modifying therapies for their MS (see below)

All people with MS are advised to follow World Health Organization guidelines for reducing the risk of infection with COVID-19.  People in the higher risk groups should pay particular attention to these measures. We recommend to:

• Practise social distancing by keeping at least 1.5 metres*** distance between yourself and others, to reduce your risk of infection when they cough, sneeze or speak. This is particularly important when indoors but applies to being outdoors as well.
• Make wearing a mask a normal part of being around other people and ensure that you are using it correctly by following these instructions.
• Avoid going to crowded places, especially indoors. Where this is not possible, ensure to wear a mask and practise social distancing.
• Wash your hands frequently with soap and water or an alcohol-based hand rub (70% alcohol content is considered most effective).
• Avoid touching your eyes, nose and mouth unless your hands are clean.
• When coughing and sneezing, cover your mouth and nose with a flexed elbow or tissue.
• Clean and disinfect surfaces frequently especially those which are regularly touched.
• Talk to your healthcare provider about optimal care plans, through video consultations or in-person visits where needed. Visits to health clinics/centres and hospitals should not be avoided if they are recommended based on your current health needs.
• Stay active and try to take part in activities that will enhance your mental health and well-being. Physical exercise and social activities that can take place outside and with social distancing are encouraged.
• Get the seasonal flu vaccination where it is available and encourage your family to do the same.

Caregivers and family members who live with, or regularly visit, a person with MS in one of the higher risk groups should also follow these recommendations to reduce the chance of bringing COVID-19 infection into the home.

*** National and international guidelines on physical distancing vary between at least 1 metre and 2 metres. People should consider their national guidance and be aware that these are minimum distances, longer being better.

People with MS should get a COVID-19 vaccine

The science has shown us that the COVID-19 mRNA vaccines (Pfizer-BioNTech and Moderna) are safe and effective. Like other medical decisions, the decision to get a vaccine is best made in partnership with your healthcare professional. You should get the mRNA vaccine (Pfizer-BioNTech or Moderna) if and as soon as it becomes available to you. The risks of COVID-19 disease outweigh any potential risks from the vaccine. In addition, members of the same household and close contacts should also get an mRNA vaccine (Pfizer-BioNTech or Moderna) when available to decrease the impact of the virus.

The Pfizer-BioNTech and Moderna COVID-19 vaccines require two doses. You need to get both doses for it to be fully effective. You should follow local, regional and national guidelines on the timing of the second dose. If you have had COVID-19 and recovered, you should also get the vaccine since it does not appear that prior infection protects from future COVID-19 infection indefinitely. Note that following full vaccination (both doses), it may take up to three weeks to reach maximal immunity.

We do not know how long a vaccinated person is protected from COVID-19, although clinical trial data indicates that protection is very high (ie; vaccinated persons have a very low, less than 5% risk, of having COVID-19 symptoms if exposed to the virus) for at least multiple months. Repeated doses of the COVID-19 vaccines may be required in future years.

People with progressive MS, those who are older, those who have a higher level of physical disability (e.g. limited walking distance), those with certain medical conditions (e.g. diabetes, high blood pressure, obesity, heart and lung disease), and Black people with MS and possibly South Asian people with MS, are among groups with the highest risk of hospitalisation due to COVID-19.

For further reading, please refer to the original post on the MS International Federation website: https://www.msif.org/news/2020/02/10/the-coronavirus-and-ms-what-you-need-to-know/