Multiple sclerosis (MS) appears not to be a risk factor for severe adverse COVID-19 outcomes per se in the absence of advanced disability or a progressive phenotype.

Disease-modifying therapy (DMT)-based care is generally safe for patients with MS who develop COVID-19 (more research is needed for anti-CD20 therapies, which may be associated with severe COVID-19).

All currently available DMTs except alemtuzumab can be started safely at this time (careful individual risk–benefit consideration is needed for alemtuzumab).

There is no need to alter the administration of interferon-β, teriflunomide, dimethyl fumarate, glatiramer acetate, natalizumab, fingolimod or cladribine tablets for vaccination against COVID-19.

Delay new starts on other (high-efficacy) DMTs for up to 6 weeks after completion of vaccination (allow white cell counts to recover where applicable).