Table 1.

DMT, vaccination response and timing recommendations.

DMT	Vaccine	Timing	Response	Other
Beta interferons	mRNA-1273 BNT162b2 vaccine ChAdOx1 nCoV-19	No adjustment required	Comparable to untreated MS patients and healthy controls	Less likely to experience short term reactogenicity to vaccine
Glatiramer acetate
Dimethyl fumarate
Teriflunomide
Natalizumab
Sphingosine 1-phosphate receptor modulators		No adjustment required	Low humoral response in many patients	In new starters anti-SARS-CoV-2 vaccination should be completed at least 4 weeks before Less likely to experience short term reactogenicity to vaccine
Anti-CD20 based treatments		Vaccination should take place 5–6 months after the last anti-CD20 treatment	Low humoral response	In new starters anti-SARS-CoV-2 vaccination should be completed at least 6 weeks before
Cladribine		Vaccination should take place 2-4 weeks before course of therapy	Mostly comparable to healthy controls	In cases of lymphopenia, it is advisable to wait until recovery of lymphocyte count
Alemtuzumab		Vaccination should take place at least 3 months after the last course of therapy	Mostly comparable to healthy controls	In new starters anti-SARS-CoV-2 vaccination should be completed 4-6 weeks before.