When should I schedule my next Ocrevus infusion and COVID vaccine?

Here is My Question:
Timing for Evusheld, COVID vaccine, Ocrevus...

I followed the guidance here for scheduling my COVID vaccination and Ocrevus treaments.
The next round are further complicated, I was hoping for further guidance in scheduling my next Ocrevus and my 4th COVID vaccine.

Timing info:
- Evusheld. Just had the shots.
- 3rd covid vaccine. End of August
- Ocrevus. Last infusion was mid November.

Thanks!

Answer:
Evusheld (Tixagevimab/cilgavimab) is a combination of two human monoclonal antibodies, tixagevimab and cilgavimab targeted against the surface spike protein of SARS-CoV-2 used to prevent COVID-19. These monoclonal antibodies have been modified to work in a long acting manner and prevent the need for frequent repeat injections. It received emergency use authorization (EUA) on 12/8/2021 to prevent severe COVID19 infections in people unable to mount adequate vaccine responses or unable to receive COVID19 vaccines because of allergic reactions. Evusheld is administered after consent since it has not received full use authorization. This is the same type of authorization initially provided for COVID19 vaccine authorization before full approval was received. 

Evusheld is not a treatment for COVID19 and must be taken before an infection (i.e. preventative). It is administered by two injections during the same visit.

People with MS considered candidates for Evusheld are those on the following treatments;  people with a hematopoeitic stem cell transplant in the last year, those on anti-CD20 therapies (Rituximab, Ocrevus, Kesimpta) within the past year, those on chronic steroid treatments, those receiving Mavenclad or lemtrada in the past year and those on cyclophosphamide, azathioprine or mycophenolate. Medical Centers and geographic locations may have different inclusion/exlusion criteria for receiving Evusheld based on availability and priorities, so do not consider this list hard and fast. It is particularly important for people with MS to receive Evusheld if they are receiving one of these therapies and have other risk factors for severe COVID19 infections (age over 50, hypertension, diabetes, vascular disease, lung disease, obesity)

Evusheld provides protection against COVID19 infection for up to 6 months. It can be taken any time in your treatment cycles. Plasmapheresis is the only therapy that would diminish the effectiveness of Evushelf and should be avoided if possible after receiving Evusheld.

Revere P (Rip) Kinkel, MDProfessor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego

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