Yes, we are seeing vaccine breakthroughs in vaccinated patients with MS on ocrelizumab. A colleague of mine has just had two patients admitted to the hospital over the weekend with COVID-19 despite being double-jabbed.
The message is clear if you are on an anti-CD20 or fingolimod or another S1P-modulator (siponimod, ozanimod, ponesimod) please remain vigilant; avoid close contact with people, particularly in indoor spaces, keep using a mask and keep up the hand hygiene. And yes, take up the offer for the booster jab in the autumn when it is likely to be bundled with the flu vaccine.
Much more evidence has emerged on the use of multiple sclerosis (MS) disease-modifying therapies (DMTs) during the pandemic. It is now clear that apart from anti-CD20 therapies (rituximab and ocrelizumab) MS DMTs do not appear to increase your risk of getting COVID-19 or severe COVID-19. PwMS treated with interferon-beta are less likely to get severe COVID-19, presumably due to its antiviral effects.
The risks of COVID-19 associated with anti-CD20 therapy are relatively small with an approximate doubling of risk compared to people on other DMTs and the general population. The most important drivers of severe COVID-19 and death from it are age, disability and the presence of comorbidities (obesity, hypertension, diabetes, lung disease, cardiac disease, kidney disease, etc). Male sex and other social determinants of health such as deprivation and ethnicity also play an important role in outcomes from COVID-19.
Please note even doubling the risk of getting severe COVID-19 if you are on an anti-CD20 therapy when your absolute risk is low, the risk still remains low. I suggest you use the online QCovid® risk calculator developed by the University of Oxford to assess your personal risk. Simply double your odds of a poor outcome if you are on an anti-CD20 therapy.
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