Table 3.
General guidance for the COVID-19 vaccination and timing recommendations according to National Multiple Sclerosis Society and European Multiple Sclerosis Platform
| DMT | The interval from the last dose of MS treatment to the first vaccine dose | Next treatment dose after full COVID-19 vaccinationa | Starting a new MS treatment after full COVID-19 vaccinationa |
|---|---|---|---|
| Beta-interferons | NA | No delay | No delay |
| Glatiramer acetate | NA | No delay | No delay |
| Teriflunomide, fumarates, natalizumab | NA | No delay | No delay |
| S1P receptor modulators (fingolimod, siponimod, ozanimod, ponesimod) | NA | No delay | At least 2 (to 4b) weeks |
| Alemtuzumab | At least 24 weeks | At least 4 weeks | At least 4 weeks |
| Oral cladribine | NA | 2–4 weeks | At least 2 (to 4b) weeks |
| Anti-CD20 therapies (rituximab, ocrelizumab) | At least 12 weeksb | At least 4 weeks | At least 2 (to 4b) weeks |
| Ofatumumab | At least 4 weeks | At least 4 weeks | At least 2 weeks |
| High-dose steroids | 3–5 days | NA | NA |
Based on National Multiple Sclerosis Society 2022 [50], European Multiple Sclerosis Platform 2022 [51].
DMTs, disease-modifying therapies; NA, non-applicable; NMSS, National Multiple Sclerosis Society; EMSP, European Multiple Sclerosis Platform.
aFully vaccinated means two doses of the mRNA (Pfizer-BioNTech or Moderna) or one dose of the vector vaccine (Janssen) according to NMSS and one dose of Janssen vaccine and two doses of any other type of vaccine according to EMSP.
bOnly EMSP recommendations.