Updated: September 26, 2023
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The National MS Society continues to track the latest research on MS and COVID-19 vaccines. The following guidance is based on the data currently available from studies and expert consensus opinion.
Stay up-to-date with COVID-19 vaccines
As of September 12, 2023, individuals ages 6 months and older should receive an updated vaccine dose. People who are immunocompromised may receive one or more additional doses at least two months after receiving their updated vaccine. Stay up-to-date with COVID-19 vaccines through the CDC schedules, and talk to your MS healthcare provider to determine what is best for you.
Having MS does not automatically mean that you are immunocompromised. However, some disease-modifying therapies (DMTs) used to treat MS do alter your immune system, and certain groups of people with MS are more susceptible to having a severe case of COVID-19.
Studies of the COVID-19 vaccine responses in people living with MS have shown a reduced or absent antibody response to the vaccine among those who use certain DMTs. Based on the CDC guidance, people with MS using the following DMTs may be considered immunocompromised:
- Sphingosine 1-phosphate receptor modulators (Gilenya®, Mayzent®, Zeposia®, Ponvory™)
- Alemtuzumab (Lemtrada®)
- Anti-CD20 monoclonal antibodies (Ocrevus®, Kesimpta®, Rituxan® and biosimilars)
Timing vaccines with DMTs
Recent studies of people with MS who use certain B cell depleting DMTs showed a better antibody response when the vaccine was administered 3 months or more after the last dose of DMT. Review our vaccine timing considerations, and work with your MS healthcare provider to determine the best time to get your vaccine dose.
COVID-19 antibodies in people with MS
Antibody tests are helpful to determine if someone may have been exposed to the SARS-CoV-2 virus (the virus that causes COVID-19), but antibody tests are not recommended by the FDA to determine immunity or protection against COVID-19. Learn more from the FDA.
A third dose of the mRNA vaccines produces more robust immune responses against the SARS-CoV-2 virus. These responses can include an increase in antibodies (produced by B cells) as well as an increase in the immune cellular responses (T cells) — both of which offer protection from serious illness due to COVID-19.
People who lack B cells, such as those on B cell depleting therapies, may have reduced or even absent antibody responses to vaccine doses, though other aspects of their vaccine response (T cells) are likely to be increased. Recent studies of people with MS who had a reduced or absent antibody response to the COVID-19 vaccine showed increased T cell responses. This finding shows the importance of vaccination for all people with MS regardless of the anticipated antibody response.
Each state offers the vaccines at different locations and has different requirements for showing proof of eligibility. Visit vaccines.gov to learn more and find a location near you.
Experts consulted in the development of this guidance
MS neurologists and experts
Staff from MS Partner Organizations
- Nancy Sicotte, MD, FAAN — Chair, National MS Society’s National Medical Advisory Committee, Cedars-Sinai Medical Center, USA
- Brenda Banwell, MD — Chair, MS International Federation International Medical and Scientific Advisory Board (IMSB), University of Pennsylvania, USA
- Amit Bar-Or, MD, FRCPC — President, International Society for Neuroimmunology, University of Pennsylvania, USA
- Jorge Correale, MD — Raul Carrea Institute for Neurological Research, FLENI, Buenos Aires, Argentina
- Anne Cross, MD, FAAN — Washington University and Secretary of Board of Governors of the Consortium of MS Centers, USA
- Jaime Imitola, MD, FAAN — University of Connecticut, UConn Health, USA
- Dorlan Kimbrough, MD — Duke University, USA
- Avindra Nath, MD — National Institutes of Health/National Institutes of Neurological Disorders and Stroke, USA
- Scott Newsome, DO, MSCS, FAAN, FANA — Johns Hopkins University and President of the Board of Governors of the Consortium of MS Centers, USA
- Penny Smyth, MD, FRCPC — University of Alberta, Canada
- Rachael Stacom, MS, ANP-BC, MSCN — Independence Care System, USA
- Julie Fiol, RN, MSCN — National MS Society, USA
- Pamela Kanellis — MS Society of Canada
- Julie Kelndorfer — MS Society of Canada
- Hope Nearhood, MPH, PMP — National MS Society, USA
- Leslie Ritter — National MS Society, USA