Understandably, there is a high level of interest within the Multiple Sclerosis (MS) Community for information about how the Pfizer vaccine works and is impacting people with MS globally. Due to this Multiple Sclerosis New Zealand and the Ministry of Health were pleased to co-host a webinar on Wednesday 2nd June, looking into the common questions being raised.
Our speakers were Professor David Tscharke, a person with MS, an MS Researcher and Head of the Department of Immunology and Infectious Diseases at the John Curtin School of Medical Research, Australian National University. David has helped inform the Multiple Sclerosis International Federation and MS Research Australia on COVID-19 vaccines, as well as providing short courses on vaccines for the Australian Government. David’s talk covered several key questions the MS Community are raising, such as:
Ray Finch from Spectrum Care was seconded to the Ministry of Health, to assist in designing the vaccine rollout plan specifically for the disability community. Ray details the focus that the Ministry took to ensure an inclusive lens was placed over the roll out plan, working to ensure the issues and concerns of the sector are considered as the vaccination programme is implemented. Ray discusses the key information those in Group 2 and 3 need to know around how to access the vaccine and Supported Decision Making Tools.
You can watch the recording of the webinar here:
The Ministry of Health have confirmed that people diagnosed with Multiple Sclerosis are considered under Group 3 for access to the Pfizer COVID Vaccine (Comirnaty). Roll out of Group 3 has begun in most DHBs but access is dependent on availability. The Ministry has advised that people in Group 3 should wait to be contacted by your DHB.
Eligibility is due to people with MS having a health condition that means you’re eligible for a free publicly-funded flu vaccination: Eligibility criteria | Influenza – Immunisation & Vaccination Info, NSIG New Zealand
For more information see: COVID-19: Vaccine advice for specific groups and health conditions | Ministry of Health NZ
Disabled persons living in long-term residential settings/communal care, people with complex care needs who have multiple carers supporting their daily life, or who live in the Counties Manukau DHB area, should have been able to already access the vaccine in Group 2 now. If you haven’t been contacted by health authorities, we recommend enquiring with your DHB.
Please note the dates are based on the information provided by the Ministry of Health and dependent on vaccine availability and may differ across DHBs.
The current data and what we know of the mechanism of actions of Tysabri, Aubagio, Tecfidera, Betaferon, Avonex or Copaxone do not present any indication that the immune response received from the Covid mRNA vaccine will be impacted as they are not immunosuppressive.
Patients on ocrelizumab (Ocrevus) or fingolimod (Gilenya) should be aware that these are immunosuppressives and may affect your body’s ability to generate an immune response. However, it is unknown how much of an immune response is required.
Gilenya works by blocking B and T cells in your lymphnodes which can increase susceptibility to some infections. Global data is not currently showing an increased risk of severity of Covid-19 for those on Gilenya and vaccination is still recommended.
Ocrelizumab depletes the B-cells in your body. However, B-cell memory in your bone marrow should remain unaffected and these will continue to make antibodies to maintain any immunity received prior to beginning treatment. There is a much lower ability to produce new B-cell responses and therefore antibodies following treatment initiation. Therefore, patients who are looking to begin treatment with Ocrelizumab are required to complete their immunizations at least 6 weeks prior to initiation of Ocrelizumab (Medsafe Datasheet: https://www.medsafe.govt.nz/profs/Datasheet/o/Ocrevusinf.pdf).
The optimal time for a vaccination in the interval between two doses of Ocrelizumab is not known and might depend on the individual’s risk of SARS-CoV-2.
Various studies are ongoing in this area with varied results:
As the mRNA vaccine is not “live”, meaning you are not receiving a dose of the virus itself, for those people with MS who are already on Ocrelizumab or Fingolimod, vaccination is still recommended however your body’s ability to generate an optimal immune response will be limited. For Ocrelizumab (but not Fingolimod), while the antibody response will be affected, it is expected theoretically that your body will be able to make T-cells against SARS-CoV-2, which should provide a layer of protection.
Patients who are either on or due to begin treatment with Ocrelizumab are highly recommended to contact their Neurology Team, Nurse or Neurologist, to discuss their immunisation schedule based on their treatment regime. Treatment decisions should be made between a patient and their treating neurologist or other medical professional based on a benefit/risk assessment specific to the individual patient, and vaccines must be given in accordance with the approved label for the vaccine.
It is well known that viral infections can cause relapses and trigger exacerbations of multiple sclerosis. The most up to date evidence shows that the risks of relapses outweigh any potential vaccine side-effects therefore people with MS are strongly recommended to get the flu and measles vaccines.
An MS diagnosis entitles you to a free and early access for the flu vaccine. It is also recommended that you receive your flu vaccine no less than 2 weeks prior or 2 weeks following your COVID vaccine.
With Group 3 access beginning, we recommend contacting your primary health provider as soon as possible to make a booking for your flu vaccine so as not to delay you being able to receive the COVID vaccine when this becomes available.
The Ministry of Health has compiled several easy read resources about Covid-19, the vaccine, rollout and staying safe. We encourage you to take a look at these which may be able to answer some of your questions: COVID-19: Easy Read information | Ministry of Health NZ
The COVID-19 vaccination program has highlighted the importance of having clear supported decision-making and consent processes for disabled people. This resource has been developed for family / whanau, close supporters and those working in the disability sector, in preparation of the roll out for the national COVID 19 vaccination programme. The Ministry of Health have prepared some Easy Read Resources on guidance, vaccine information, and some tools for supported decision-making. These resources can be found here: COVID-19: Easy Read information | Ministry of Health NZ