I am 23 and have MS. I have been on Ocrevus for the past year. I have had a flu shot. My understanding is that getting a pneumonia vaccine is safe for people with MS. Is it still safe to get a pneumonia vaccine while on Ocrevus? If so, which should I get, PCV13 or PPSV23 and if both in which sequence? Is it best to get the pneumonia vaccine just before my next infusion or after?
It is certainly safe to receive the vaccine, other than the small risk of some allergic reaction.
We do not know how effective the vaccine will be in people on Ocrevus or other B cell depleting therapies. Evidence in children with immunodeficiency suggest that the Memory B Cell subset, which is depleted by Ocrevus and other B cell therapies, is required for effective immunization against pneumococcus and it generally takes longer than 6 months for the memory B cell population (CD19+, CD27+ cells) to return after an Ocrevus infusion. In high risk populations (older patients and those with splenectomy) we would immunize before starting treatment. As a 23 year old you many have been immunized in childhood, since they started childhood immunizations in 2001. You may want to check your pediatric records.
As long as you are not significantly disabled or immunocompromised and as log as you still have a high functioning spleen, I would not consider you in the high risk group.
Revere (Rip) Kinkel MD
Professor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego
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