Happy New Year, Welcome 2021. Now what? Holidays are over and after I always feel an unsettling, like what do we look forward to now. I think it happens for me because I love the fall season. My birthday is in November so I like that whole line of October toward. I love when the season starts to change and I can break out my sweatshirts for the first time. When I first start getting cozy at night under my warmer winter blanket. I love that stuff. By the time January rolls around, it isn’t the same. I’ve worn all my favorite sweatshirts and my blanket isn’t as warm as I remember it being when my room is really cold. I’m still waiting for my snowstorm but there isn’t even snow in the forecast. We are still dealing with Covid so I’m limited where I’m going regardless of anything.
Speaking of Covid, I did talk to my neurologist who is recommending the vaccination to all of their MS patients. (Please check with your own doctor for medical advice). They did provide me with information about the vaccine I wanted to pass on to my readers. Again, these are my doctors, please check with your own MS doctors for your individual care.
COVID-19 Vaccine Information
This winter, two COVID-19 vaccines will begin distribution after emergency approval from the US Food and Drug Administration. These two vaccines are made by the drug companies Pfizer and Moderna, and both use the same protective approach using a technique called mRNA.
We are relieved to have these vaccines on the horizon, thrilled to have the opportunity to soon receive them ourselves, and we strongly encourage our patients to receive one of these vaccines as soon as they are made available to you. Each of these two vaccines has been tested in more than 10,000 people so far and no serious adverse effects occurred during the clinical trials. Small numbers of people have experienced an allergic reaction to the vaccine, which was treatable. Having MS or another autoimmune condition does not put you at higher risk for such allergic reactions, and no MS-related adverse events occurred in the trials of the Pfizer and Moderna vaccines. We therefore recommend that you get vaccinated unless you have a history of severe allergy. If you do have a severe allergy, you should consult with your primary care provider or allergist about whether you can receive the vaccine.
Frequently Asked Questions (FAQs) about the COVID-19 vaccines:
What are the benefits and risks to consider in getting the vaccine?
Benefits include 1) protection for yourself against catching this potentially deadly and debilitating virus, 2) protection against the complications of infection, which could exacerbate autoimmune disease activity and symptoms, and 3) protection for your loved ones and the community against the spread of this illness.
Known side effects to the vaccine are mild and self-resolving, as noted above. Unknown long-term risk, as with any new treatment, will take time to determine. However, mRNA from the vaccine is degraded after a few days, so we believe that the likelihood of long-term side effects is low.
What are the side effects and risks of the vaccine?
In the clinical trials, some people receiving the vaccines experienced up to a few days of muscle aches, decreased energy and/or fever, all of which self-resolved. Several individuals with a history of severe allergy experienced an allergic reaction to the vaccine, which was treatable.
In view of the large number of people who have already received the vaccine, risks of additional unforeseen side effects are low, estimated at less than 1/10,000. Monitoring for these and any potential long-term issues is active and ongoing.
Can the vaccine cause autoimmune disease or worsening of my MS/CNS autoimmune disease?
No autoimmune response has occurred among the roughly 30,000 individuals who have so far received the COVID-19 mRNA vaccines. Vaccines do stimulate the immune system, so autoimmunity is always a theoretical concern. Given the current data, however, we consider this risk to be extremely low.
In addition, given previous experience with other vaccines that do not contain live virus, we do not suspect that the COVID-19 mRNA vaccines will exacerbate activity of MS, NMO, or other autoimmune CNS diseases.
What is the new mRNA technology that these vaccines use?
mRNA is a string of nucleic acids found naturally in the normal cell. mRNA provides instructions to your cells on how to produce proteins. When this mRNA is injected into your muscle, your muscle cells use it to produce a non-infectious piece of the COVID-19 virus called the spike protein.
This spike protein is recognized by your own immune cells and stimulates them to produce a protective response to the COVID-19 virus. If the COVID-19 virus subsequently enters your body, your immune system will recognize the virus and promptly destroy it to prevent you from becoming ill. After a few days, the mRNA gets degraded and eliminated from your body similar to other mRNAs that your body naturally produces.
In contrast, other vaccines use either a protein or a killed or weakened form of virus or bacteria to simulate the immune response. The advantages of the mRNA approach is that it is more efficient in stimulating your immune response, it is safer to produce because it does not require eggs or cell culture, which are easily contaminated, and it does not include infectious agents that could trigger illness. In short, this technology appears to be safer and more effective than other vaccine technologies.
Please note that a third vaccine, being developed by Astra Zeneca, uses a different technology that includes a live virus (although not live corona virus). The Astra Zeneca vaccine did seem to cause several MS-type adverse events in the clinical trials. We currently recommend that this particular vaccine be avoided by people with MS and related conditions in favor of the Pfizer and Moderna vaccines that are the first to become available. We will communicate more about the Astra Zeneca and other vaccine options as additional data become available.
Does my diagnosis or use of disease modifying therapy affect the efficacy of the vaccine?
We do not believe that MS or other autoimmune CNS disease itself affects the efficacy of vaccination.
However, disease modifying therapies work to quiet the immune system. Patients on some immune modulating treatments do show a lesser response to vaccination. The degree to which the vaccination response is reduced is not well defined and depends on many factors, including the specific vaccine, the type of disease modifying treatment and additional factors, such as age. Despite the possibility of a less robust response, we nonetheless recommend receiving the vaccine given the strong potential benefits outlined above.
Does my diagnosis affect my priority for receiving the vaccine?
Existing data show that compared to the general population, people with multiple sclerosis have neither an increased risk of catching COVID-19 nor a more severe course of illness if infected. This is good news! The effect of MS disease-modifying therapies on COVID severity is under investigation, but currently available information suggests that most of these treatments do not substantially worsen COVID-19 infection.
Public health organizations at the state level will be tasked with setting the priority lists for vaccination. Given the available reassuring data about COVID and MS, a diagnosis of multiple sclerosis, in and of itself, is unlikely to increase your priority in receiving the vaccine. Certain individual situations, such as being affected with severe MS-related disability, may influence the priority order. We do not anticipate that we will be administering the vaccines at the CGD Center.
Mount Sinai CGD Center | 5 East 98th Street, Suite 1138, New York, NY 10029
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