As the COVID-19 vaccine becomes more readily available to people across the country, many patients living with multiple sclerosis (MS), an often debilitating autoimmune disease of the central nervous system, are questioning whether patients on certain medications should get the shot. The answer, according to Nancy Sicotte, MD, a prominent specialist in MS and chair of the Department of Neurology at Cedars-Sinai, is a firm “Yes.” “The big takeaway message is the COVID-19 vaccine is strongly recommended for patients with multiple sclerosis,” said Sicotte, the Women's Guild Distinguished Chair in Neurology at Cedars-Sinai and director of the Multiple Sclerosis and Neuroimmunology Program. “If you have an opportunity to get a vaccine, get it—and the sooner, the better." Sicotte's recommendations are based on recent guidance from the National MS Society, where she serves as chair of the National Medical Advisory Committee. Those recommendations also serve patients with other chronic diseases, said Michael Ben-Aderet, Associate Medical Director of Hospital Epidemiology for Cedars-Sinai. "People with chronic illness or weakened immune systems may be at higher risk for severe COVID-19 disease, and the vaccines are particularly effective at preventing that," Ben-Aderet said. "There is also no evidence that people with weakened immune systems are at any increased risk of adverse events from the vaccine. While everyone should consult their own physician if they have questions, the vast majority of people with chronic illnesses can and should be vaccinated against COVID-19." Vaccines critical for patients with chronic illnesses Multiple sclerosis is a chronic disease of the central nervous system in which the body attacks itself by mistake. The disease—one of the most commoncan affect people differently, with some patients experiencing only mild symptoms, while others may lose their ability to see clearly, write, speak, or walk. According to the National MS Society, more than 1 million Americans are living with the condition. Sicotte says the vaccine is increasingly more critical for people with progressive MS, as well as for patients who are older, have a physical disability or have chronic conditions like diabetes or high blood pressure. Vaccines also are critical for Black and Latino people, as they are among groups with the highest risk for hospitalization due to COVID-19. One of the most common questions Sicotte receives from her patients is whether the vaccine can be combined with daily medications. Although it's true that some medications can make the vaccine less effective, the shot will still provide some vital protection, including ensuring that if a patient does catch COVID-19, their disease is more likely to be mild and not life-threatening. “Unless your healthcare provider advises against it, patients who get the COVID-19 vaccine should continue taking their disease-modifying therapies,” said Sicotte. “Any protection is better than no protection." These recommendations for patients living with MS are similar to guidance for patients with other autoimmune conditions like Guillain-Barre Syndrome (GBS), another acute inflammatory disorder in which the body’s immune system attacks the peripheral nervous system. Richard Lewis, MD, director of the Electromyography Laboratory in the Department of Neurology at Cedars-Sinai, says the COVID-19 vaccine is considered safe to take for patients with previous Guillain-Barre or who have ongoing chronic inflammatory demyelinating polyneuropathy (CIDP). He was one of eight experts who penned an open letter to Anthony Fauci, MD, director of the National Institutes of Health about the shot’s safety for this patient population. “In the past there had been particular concerns that patients who previously had GBS were at an increased risk from all vaccinations, particularly influenza, but also COVID-19,” said Lewis, whose expertise and leadership make Cedars-Sinai a GBS-CIDP Foundation Center of Excellence. “However, to date, no increase in cases of GBS have been associated with COVID-19 infection or the vaccine. Lewis adds that guidelines from the Centers for Disease Control and Prevention address this issue, advising patients with GBS and related conditions that there is not an increased risk of getting GBS from COVID-19 vaccination. Source
