Should patients taking Tysabri get a booster shot for COVID-10?

Here is My Question:
Should patients taking Tysabri get a booster shot for COVID-10? Thanks!

Answer:
​All people, with or without MS, over the age of 12 will require COVID19 booster shots. Starting in September all states will provide boosters to anyone over the age of 12 if it has been at least 8 months since their second vaccine dose with either the Pfizer or Moderna COVID19 vaccines. There is still no consensus in the US for boosters in those who received the single dose J&J vaccine, but it is reasonable to obtain a booster with another vaccine if you are immunosuppressed and received the J&J vaccine.

COVID19 vaccine boosters should be given as soon as possible (as early as 28 days after your second COVID19 vaccine shot) to the following people with MS :

1. Older individuals (most states will define the cut of age as > 65) 
2. Immunosuppressed individuals . This includes people with solid organ transplants, Bone marrow transplants (also called hematopoietic stem cell transplants), chronic steroids and those on chemotherapy
3. People with MS on certain disease modifying therapies . This includes those who received alemtuzumab (Lemtrada), Cladribine (Mavenclad) or anti-CD20 therapies (Ocrevus, Kesimpta, rituximab and biosimilars) in the past 3 years and those currently taking a S1P modulator (Gilenya, Mayzant, Zeposia and Ponvory). This also applies to people on a fumarate (Tecfidera, Vumerity or Bafiertam) with absolute lymphocyte counts less than 600.

Special considerations for COVID19 vaccine booster timing in people on intermittent lymphocyte depletion therapies (Lemtrada, Mavenclad, Ocrevus, Kesimpta, Rituximab and biosimilars): 

1. Improved COVID19 vaccine antibody responses were observed in people on anti-CD20 therapies who received a vaccine at least 3 months after their last treatment (infusion or injection). While this data mostly applies to Ocrevus and Rituximab, it is likely to apply to treatment with Kesimpta. We do not have data on those who received Mavenclad or Lemtrada will also experience decreased responses to COVID19 vaccines or boosters for at least 3-6 months after their last treatment. For these reasons if you are between doses of any of these specific disease modifying therapies (DMTs), which are all administered intermittently, or if you are about to start one of these DMTs, it is reasonable to obtain your COVID19 booster shot before your next treatment, or in some cases, before your first dose of the disease modifying therapy. If you received treatment with any of these DMTs in the last 3 months, you should discuss the pros and cons of delaying your booster vaccine with your doctor depending on your situation. In most cases we will encourage that you get the booster and follow additional precautions to avoid exposure to COVID19.  

Revere (Rip) Kinkel MD
Director of the Multiple Sclerosis Program
Professor of Clinical Neurosciences
University of California San Diego